Until this year, federal funds covered 90 percent of the cost of the Women's Health Program, which provides routine exams, contraception and preventive health services to low-income women. But after Texas lawmakers banned groups affiliated with abortion providers from participating in the program, the federal Centers for Medicaid and Medicare Services said it would cut off funding because federal law guarantees women the right to choose their health care providers.
Federal officials proposed phasing out funding for the program by September, but Texas' Medicaid director Billy Millwee said Tuesday the state needs more time to publish new rules for the program. He has proposed phasing out the funding by November.
The Centers for Medicaid and Medicare Services did not immediately respond to a request for comment.
Meanwhile, Attorney General Greg Abbott has sued the federal government to have funding restored, and nine clinics affected by the rule have sued the state.
Gov. Rick Perry has ordered Texas to cover the lost federal funding. Allowing the $35 million program to expire would have cost the state more in the long run because of additional unplanned pregnancies and health problems among poor women covered by Medicaid.
Millwee's proposal calls on the state to contact women enrolled in the program and help them find new providers. "If a provider cannot be identified for the client, call center staff will escalate to appropriate Medicaid and Provider Relations staff who will recruit additional providers," the plan said.
Women who earn income less than 185 percent of the federal poverty level, or roughly $20,000 a year, are eligible for the program, and state officials say 292,000 are enrolled. More than 40 percent of women in the program visited one of the clinics that will be kicked out of the program under the new rules.
The state will use community outreach and face-to-face visits to recruit more doctors and clinics into the program, the plan said, and identify parts of the state where there may not be enough health care providers.
State law already bans clinics that perform abortions from receiving any kind of state funding and all clinics currently in the program are legally and financially separate from abortion providers. But the new rule goes a step further, excluding any clinic that shares a name, ownership or the same board of directors as a clinic that performs abortions.
The state said that it will take 143 days to fully implement the new rules governing the clinics, with a public comment period for the rules lasting from June 18 to July 30 and the rules not becoming effective until Sept. 1. The plan calls for Texas to fully take over the program on Nov. 1.