Texas' Medicaid waiver is a 'canary in the coal mine' for abortion carve-outs
Skip to main content
Sister Publication Links
  • Modern Healthcare Metrics
MDHC_Logotype_white
Subscribe
  • Subscribe
  • Register
  • Login
  • News
    • This Week's News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Joan Budden
      Q&A: Priority Health CEO eager to share best practices with Total Health Care
      Wright Lassiter III
      Healthcare leaders urge full court press on social determinants of health
      $4.6 billion: Estimated annual costs of physician burnout, attributed to turnover and reduced clinical hours
      Data Points: Physician burnout rates vary by specialty
      Capitol Building with pills
      Week Ahead: House to vote on drug bill; SCOTUS hears risk-corridor case
    • November was healthcare's second strongest hiring month of 2019
      Primary-care provider ChenMed to enter five new markets
      Lacking specialist access drives health disparities
      Genetic Counseling
      Addressing barriers to expanding genetic counseling
    • Joan Budden
      Q&A: Priority Health CEO eager to share best practices with Total Health Care
      Silver-loading, CSR elimination lowered premiums for some rural enrollees
      Centene to sell Illinois plan to CVS Health
      Blue Cross of Idaho unveils souped-up short-term health plans
    • Capitol Building with pills
      Week Ahead: House to vote on drug bill; SCOTUS hears risk-corridor case
      MedPAC thinks hospice payments are too high
      MedPAC says ambulatory surgical centers don't need a pay raise
      States focus on healthcare costs to address coverage problems
    • Analysts to CommonSpirit Health: Show us the savings
      Smallest hospitals saw biggest earnings gains last month
      Sutter Health postpones financial filing
      doctor helping patient stock image Sandoz
      Sponsored Content Provided By Sandoz
      As hospital executives look to reduce costs, biosimilars offer a compelling option
    • astronaut
      Astronauts developed bloodstream issues in space
      Sponsored Content Provided By ABM Healthcare
      Protecting and Maintaining Medical Devices
      human hand robotic hand stock image
      Sponsored Content Provided By Deloitte
      The Health System of the Future: How Digital Health Technology is Transforming Care
      EHR
      EHR vendors most in-use throughout Medicare incentive program
    • MRIs of dense breasts find more cancer but also false alarms
      Flu season takes off quickly in Deep South states
      Uber driver says South Carolina hospital dumped patient on him
      1 in 3 adults age 45 and older reported being lonely in a 2018 AARP survey
      Data Points: Loneliness and its impact on health
    • Jim Allison playing the harmonica
      Documentary tells tale of Nobel winning researcher
      Seema Verma
      Seema Verma's bold initiatives land her in No. 1 'Most Influential' spot
      New CEO takes the helm at Lurie Children's Hospital of Chicago
      Mayo Clinic taps Dr. John Halamka to lead its Google partnership
    • Midwest
    • Northeast
    • South
    • West
  • Special Features
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Arkansas Children’s was a founding partner in Solutions for Patient Safety.
      Children's hospitals collaborate rather than compete on patient safety
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • Linda Kenney
      Patient advocate recalls two medical errors that nearly killed her
      Arkansas Children’s was a founding partner in Solutions for Patient Safety.
      Children's hospitals collaborate rather than compete on patient safety
      Kim Hollon
      Hospitals fall short of patient-safety goals 20 years after 'To Err is Human'
      Dr. Mark Chassin
      One-size-fits-all approach to patient safety improvement won’t get us to the ultimate goal—zero harm
    • Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Paging Dr. Robot: Artificial intelligence moves into care
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • ProMedica doubles down on social needs data analysis
      Amazon taps first pharmacy for Alexa Rx management
      Trump administration unveils new price transparency rules
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
    • VA dives into artificial intelligence R&D
      Home health to pare down therapy services, up telehealth offerings
      Amazon launches medical transcription service
      Hospitals' uncompensated care continues to rise
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • Value-based pay still struggles to improve costs, quality
      Hospitals sue HHS over negotiated price disclosure rule
      Bundled payments get a boost in two states with employee programs
      CMS wants primary-care docs to take on financial risk
  • Data/Lists
    • Rankings/Lists
    • Data Points
    • Modern Healthcare Metrics
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Steve Strongwater
      How Atrius Health stayed independent by not shying away from risk
      Why moving the VA to a new EHR was a pivotal decision
      Why AdventHealth's rebrand was more than a name change
    • Terry Shaw
      A diverse and inclusive culture should empower others
      Paving the path to diversity and inclusion
      The next step in healthcare evolution
      Breaking Bias: A road map to boost women and minorities into healthcare leadership
    • Dr. Richard Snyder
      Outdated privacy laws hinder coordinated care, especially in the fight against addiction
      David Dill and Keith Myers
      Healthcare partnerships are a proven path to better care, healthier communities
      Health systems need to devote more resources to caring for the caregivers
      Chip Kahn and Alan Morgan
      Rural healthcare needs innovation, policy changes to survive
    • Letters: Let’s keep humanity in discussions about patient safety
      Hospital with money
      Letters: Let providers set their prices,
 and then publish them all
      Letters: Ambulatory surgery centers aren't getting a break on regulation
      Letters: Rising Medicaid spending isn't a windfall for providers
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Nominate
    • Award Programs
    • Previous Award Programs
    • Other Award Programs
    • Nominations Open - Top 25 Minority Leaders
      Nominations Open - Health Care Hall of Fame
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • Kronos webinar logo lockup
      Sponsored Content Provided By Kronos
      Webinar: The Future of Work in Healthcare
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Critical Connections: Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Minority Leaders Gala (2020)
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
May 16, 2017 01:00 AM

Texas' Medicaid waiver is a 'canary in the coal mine' for abortion carve-outs

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print

    The Trump administration will soon review Texas' proposed plan to regain federal funding for its family planning program that does not include Planned Parenthood or providers that support or perform abortions. If the CMS approves the waiver, other states could seek similar permissions and risk millions losing access to care.

    Texas lost federal funding for its family planning program known as Healthy Texas Women in 2013 after it stopped reimbursing for services performed at Planned Parenthood. Since then, the program has been totally state-funded.

    Now facing a $2 billion budget shortfall, Texas is looking for ways to reduce spending. The state on Friday posted a draft Medicaid waiver seeking up to $300 million in federal funds to continue Healthy Texas Women for another five years through 2023.

    If the waiver is granted, the impact could ripple far beyond Texas and jeopardize care for millions of women.

    "The concern is that this would set a precedent for federal approval of family planning programs that excludes providers that provide abortions and their affiliates," said Stacey Pogue, a public policy analyst for the Austin, Texas-based Center for Public Policy Priorities.

    Of the more than 74 million people on Medicaid, nearly 17 million are non-elderly women who depend on Planned Parenthood as their primary source of essential healthcare. None of these women are getting abortions paid for by the program as that's prohibited by federal law. Instead, a Planned Parenthood clinic is often where they see their primary-care docs or get screenings for ailments such as breast cancer.

    Prohibiting willing providers from seeing Medicaid patients is prohibited by federal law, but state officials are hopeful the CMS under Trump will allow it to test this new family planning vision.

    "We've been encouraged to present new and innovative ideas to CMS for discussion for possible funding," said Carrie Williams, spokeswoman for Texas' state health department. "There is a new administration, and we're looking at what opportunities may exist for us."

    Patients relying on Planned Parenthood or those with doctors who are affiliated with any provider that supports or performs abortions could find themselves displaced if Texas and similar states are granted this kind of Medicaid waiver.

    Under the Healthy Texas Women program, doctors must sign a contract that stipulates that they can't bill the program if they promote elective abortions or are affiliated with a group that performs or promotes elective abortions.

    Texas' waiver is "a canary in a coal mine" for other states, as Healthy Texas Women has created access to care problems for low-income women that could be replicated elsewhere, according to Blake Rocap, legislative counsel for NARAL Pro-Choice Texas.

    Healthy Texas Women has only served approximately 200,000 women as of March. However, there are as many as 1.8 million low-income women in the state in need of publicly subsidized family planning services, Rocap said.

    Out of 298,000 providers registered in the Medicaid program, only 5,000 are a part of the Healthy Texas Women program, according to state estimates.

    Advocates have said that the Healthy Texas Women provider network isn't providing beneficiaries with adequate care because the doctors have small Medicaid practices or aren't knowledgeable about family planning.

    University of Texas researchers found that claims for injectable contraceptives fell 31.1% and Medicaid-covered childbirths rose 27% during the first two years of Texas' Planned Parenthood ban.

    Still, some experts support the CMS approving the waiver because its unclear if Texas will be able to continue family planning services at all, given the state's budget woes.

    "Receipt of the federal funds, in a tough budget year, will help offset the need for devastating cuts to Medicaid eligibility for a pregnant women and/or Medicaid payments to physicians," said Marcus Cooper a spokesman for the Texas Medical Association. "TMA wants to preserve state capacity to serve women in need ."

    Texas wouldn't send a waiver to the CMS for a program that harms a patient's ability to get the care they need, according to Billy Millwee, a health policy consultant at Sellers Dorsey and former Medicaid director for Texas

    "Federal Medicaid waivers come with strict accountability requirements," Millwee said. "My sense is that Texas will be able to demonstrate adequate access to care."

    Texas' Healthy Texas Women program also requires teenagers to get parental approval before accessing family planning services. Although many states don't have similar requirements at the moment, they could adopt similar limitations in their Medicaid waivers, according to Yvonne Gutierrez, executive director of Planned Parenthood Texas Votes, the group's political arm.

    Adding that limitation could spark an increase in unplanned pregnancies or sexually transmitted diseases. Texas has seen a 13% increase between 2012 and 2015 in the number of residents with HIV and an 11% uptick in women living with the virus, according to state data.

    Texas officials are accepting comments on the draft waiver through June 12. They will host a public meeting June 9 to discuss the waiver.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    Modern Healthcare
    Copyright © 1996-2019. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Special Features
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Data Points
      • Modern Healthcare Metrics
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Critical Connections: Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Minority Leaders Gala (2020)
      • Webinars
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing