each version of repeal has been analyzed by independent industry professionals who predict that, in the wake of repeal, the nation would experience a surge in the number of uninsured people. Here in Texas, where Medicaid coverage is already so low, the effect of “un-insuring” people will likely be large. Prior to the ACA, fully one-fourth of Texas adults did not have health care coverage. Planned Parenthood’s continued inclusion in Medicaid cannot be assumed. Each effort by Congress to damage or change the ACA has included special language that would also exclude Planned Parenthood organizations from Medicaid nationwide (It makes no sense— first damage coverage through commercial insurance by hitting ACA and then damage Planned Parenthood, a safety net provider, at the precise time that millions more Americans will not be able to afford a private doctor in the for-profit marketplace). For PPST, Medicaid revenue in 2016 was $572,663, up 18% over 2015. In 2017, revenue from Medicaid is again projected to be more than $500,000. While we could grudgingly adjust operations if we lost this money, and of course we would explore a legal challenge, an ultimate loss would be
tragic in that Medicaid in Texas covers family planning only when the woman lives at or below 18% of federal poverty. This revenue is used to provide family planning to the poorest of the poor. The personal and public health implications of losing Medicaid are heartbreaking. Texas remains hostile towards Planned Parenthood. The Texas government is pursuing additional family planning funds that, according to public statements and descriptions, are designed to 1) cover persons living below 200% of the federal poverty level, and, unfortunately, 2) these funds would exclude Planned Parenthood organizations from the network of providers. Telemedicine rules in Texas were changed significantly in the 2017 legislative session. These changes, a surprising bright spot, are helpful because now health care delivery via various telecommunications and technology platforms is much more possible. While Texas prohibits any abortion care via telemedicine, our family planning program could use telemedicine, and perhaps do so in a way that connects with otherwise hard-to-reach populations.
There are also assumptions that remain in place and continue to be part of our view of the external environment surrounding the care we provide. Let’s briefly remind ourselves of assumptions we described in the 2016 Stakeholders Report that remain unchanged: »»
The unmet need for family planning services remains high.
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Health disparities persist. Cervical cancer, sexually transmitted diseases, and HIV occur in Latino and African American populations at rates that exceed those of Anglos.
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People will continue to have sex, and they will want more privacy for their sexual health care when compared to their general health care.
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By wide margins, Millennials and Generation Z are aligned with the mission and values of Planned Parenthood.
Taken together, these new and continuing assumptions can feel daunting, but there are solid reasons to expect success from PPST despite the difficulties in our external environment.
We have developed considerable organizational capacity in delivering on our mission without government as a helpful partner. Texas has been, unfortunately, an effective training ground for what now presents itself in our federal government. That doesn’t make it okay, but it does mean that we are smart and strong. We will step into the breach where women’s health is concerned, like we have for 78 years. There has always been a gap between what women need and what most women can find in the health care marketplace, especially women who have limited economic means. Stepping in to help is what we do. Stakeholders Report 2017 | 7