Real Men support Choice! 
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Heather Paffe of TAPPA 
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Real Men for Women's Health! 
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PPWT lobbyist working the Burma Shave! 
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PP of Texas Capitol Burma Shave 
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Peggy Romberg of Women's Health and Family Planning of Texas 
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Back from Austin

It was a full day. But a productive one. We got to talk about the Medicaid waiver, funding, and pharmacy refusal with the very people who will make decisions about it. The Medicaid waiver seems to have some strong interest.

Although we are back home, the work isn't over. We need you to let your legislators know that you support these measures.

Go here and let your voice be heard!
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Carla with Jay and Ashley from KMID  
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prepping for our visits with Karen and David 
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updating the blog and taking a rest before Sen Seliger 
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Your PPWT lobbyists! 
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Karen, Sarah Weddington, Dawnna Dukes, Peggy Romberg

So far, we have met with Speaker Craddick, Rep. Campbell, Rep. West, Sen. Duncan, and Sen. Fraser. Productive meetings. A lot of interest in Medicaid waiver and the pharmacy refusal bill. Positive interest.
The Speaker's office had a lot of questions about the waiver and how it will save tax payer money. They fact we have already lost $131 million from not doing the waiver makes them perk up. Rep. Campbell comment that he had gotten a lot of emails and faxes about the waiver.

Thanks to all of you who have responded to our alerts, the legislators we are meeting with are really, really impressed.

On to Senator Seliger's office. It has been amazing to see so many people from all parts of Texas lobbying with us. Lubbock, Dallas, Houston, Waco. . .everyone is doing all that they can to help make Texas stronger.
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In Austin

It is 7:00 am and Elizabeth and I are waiting for our flight. We should be flying with a news crew from Midland. We are in need for lots of coffee but we are excited about lobby day. PPWT has an issue that is going to make the state money. Both Republicans and Democrats should be in favor of it and the visits should be very productive.

We will also be talking to legislators about the Pharmacy Refusal bill. This bill is so potentially harmful to all women in Texas. In this bill, a pharmacist could refuse to fill a doctor’s prescription for emergency contraceptives or even birth control because of moral reasons. No pharmacist’s moral beliefs should trump a doctor’s prescription for healthcare. This is even more dangerous in rural communities that only have one pharmacist. Where are those women suppose to go to get birth control? Many of the women in our service area would have to drive 50 or more miles to the next pharmacy.

I haven’t forgotten to update. Just having problems trying to get a connection.

We are now in Austin. Sarah Weddington, the lawyer who argued and won the Roe v. Wade case, is now talking. She is reminding those who are in their 20s that they are the next in line to pick up the banner for women’s health. “We’ve won some, and we’ve lost some”, she says, “and now we are here again. To work on funding, on legislation, and to work.with legislators.” She quotes Barry Goldwater, a Republican supporter of Planned Parenthood--“The true conservative position is that it is none of the government’s business to be in our personal decisions.”

The crowd gives her a standing ovation.

Next to speak, are Rep. Jessica Farrar (Houston) and Rep. Dawnna Duke (Austin). They have formed a Women’s Health Caucus in the state legislature to help start change.
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See How Well it Works?

MEDICAID WAIVER FOR WOMEN’S HEALTH
Fact Sheet

What is a Medicaid Waiver for Women’s Health?
A Medicaid Waiver for Women’s Health would allow Texas to provide subsidized family planning services to women in families earning up to 185% of the federal poverty level (FPL) by expanding the current eligibility level for these services.

Currently in Texas, women must live at or below 17% of the FPL to qualify for Medicaid family planning services. (17% of poverty = annual income less than $3,000 for a family of four). Texas must apply to the Centers for Medicare and Medicaid Services for a “Waiver” to expand the income eligibility level.

The federal/state match rate for a Waiver is 90/10. In other words, for every dollar Texas spends on these services, the federal government will spend nine.

Services covered by a Waiver would include well-woman exams, counseling and education on contraceptive methods, provision of contraception, screenings for diabetes, breast and cervical cancer, sexually transmitted diseases, hypertension, cholesterol and tuberculosis, risk assessment and referral of medical problems to appropriate providers.

Why Does Texas Need A Medicaid Waiver for Women’s Health?

• It’s fiscally responsible:
• Every $1 spent on preventive family planning saves $3 in maternity and newborn care in Medicaid alone. [1][2]
• In 2001, Texas spent $31.1 million on Medicaid family planning; New York spent nearly twice as much, even though their population is smaller. California spent over $260 million-- MORE THAN 8 TIMES AS MUCH AS TEXAS -- and their population is not even twice Texas’. [3]
• It will decrease the number of abortions:
• Without publicly-funded family planning, abortions are estimated to increase by 40%, teen births by 25% and teen abortions by 60%. [4]

Texas women need it:

• Texas has the highest rate of uninsured women aged 18-64 - 28.3% - in the nation (US average is 17.7%). [5]
• About 40% of ALL Texas women live below 200% of poverty, and 50% of them are uninsured. [6]
• 46% of Hispanic Texas women are uninsured. [7]

Do Other States Have Medicaid Waivers?
19 states have Medicaid Waivers that allow them to provide family planning services to many more women, and get the 90% federal match for that care (AL, AZ, AK, CA, DE, FL, IL, MD, MN, MS, MI, NM, NY, OR, RI, SC, VA, WA, WI).

A new study of these waivers found that ALL of them have saved their states and the federal government significant amounts of money. [8]

Why Hasn’t Texas Applied for A Medicaid Waiver for Women’s Health?

Texas first developed a Waiver application more than 10 years ago, but no waiver application has ever been submitted to federal Medicaid authorities.

A bill mandating that Texas apply for a Waiver was filed in the 77th Texas Legislature as Senate Bill 812 (SB 812) by Senator John Carona (R-Dallas) and House Bill 1156 (HB 1156) by Reps. Garnet Coleman (D-Houston), Glen Maxey (D-Austin), Bob Glaze (D-Mineola), Craig Eiland (D-Galveston), and Kyle Janek (R-Houston).

Ultimately, the bill was rolled into SB 1156 by Senator Judith Zaffirini (D-Laredo). This omnibus bill was passed into law by both chambers, but vetoed by Governor Perry in June 2001. According to the Legislative Budget Board’s (LBB) fiscal notes for SB 812 and HB 1156, the Waiver would have required modest start-up costs, but achieved net savings in the second year after implementation. Over the first 5 years of the waiver, total net savings would have exceeded $122 million in general revenue.

Projected Savings from Medicaid Women’s Health Waiver

Net Savings (State General Revenue)
2001 --<$9,924,000 >
2002-- $2,639,741
2003-- $24,909,020
2004 --$47,849,329
2005-- $56,647,963
Net savings over 5 years -- $122,122,053

Source: LBB Fiscal Notes, SB 812, HB 1156, 77th Legislative Session.

SB 1156 would have provided Medicaid-funded family planning services for Texas women over age 18 and up to 185% of the FPL. Federal funds would have covered 90 cents of every dollar spent.

Even restricted to women 18 and older the Waiver could have an enormous impact. The average current age of clients receiving Medicaid maternity coverage is 23.7 and about 87% are age 18 or older. The average age of women in the Medically Needy program (before suspended by 78th Legislature) was 34 years, and the average age of Texas TANF mothers is 29-30. [9]

[1] Alan Guttmacher Institute, 2002
[2]
[3] Kaiser Family Foundation, Medicaid: A Critical Source of Support for Family Planning in the United States, April 2004
[4] Kaiser Family Foundation, Medicaid: A Critical Source of Support for Family Planning in the United States, April 2004
[5] Kaiser Family Foundation, Women’s Health Policy Facts, February 2004
[6] Kaiser Family Foundation, Women’s Health Policy Facts, February 2004
[7] National Women’s Law Center, Making the Grade on Women’s Health, 2004
[8] Contraceptive Technology Update, May 2004
[9] Texas Department of Human Services, 2003 Reference Guide

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What we are all about!

-- 

Promote Healthy Women, Families and Communities

• Retain current funding levels for family planning in Appropriations Bill--Oppose any attempts to deny public funding for subsidized family planning to agencies that use separate, privately-raised funds for abortion services or to impose unnecessary restrictions on agencies that obtain family planning funds


• Medicaid Waiver for Women’s Health--Support measures encouraging the State of Texas to apply to the Centers for Medicare and Medicaid Services for an 1115 Medicaid waiver to expand eligibility for family planning and reproductive health services to 185% of the federal poverty level (annual income of $34,872.50 per year for a family of four)

Prevent Unintended Pregnancies and Reduce the Need for Abortion

• EC in the ER--Work with the sexual assault survivor community to promote legislation requiring EC education and medication at hospital emergency rooms for survivors of sexual assault


• Refusal Clauses--Ensure that women are able to have prescriptions for emergency contraception and birth control filled without hardship


• Comprehensive Family Planning, Sex Education and Access to Birth Control--Guarantee that Texas maximizes family planning resources, ensure that all FDA-approved methods of birth control are covered by health insurance plans, ensure that women have access to emergency contraception through pharmacies and in hospital emergency rooms, and provide teens with comprehensive information about sex education

Protect the Health and Safety of Adolescents

• Comprehensive Sex Education--Support efforts to ensure that teens have access to comprehensive sex education in their health textbooks


• Parental Notification/Consent for Contraception--Remove Rider 35 from Appropriations Bill, which requires parental consent for minors seeking contraceptives from publicly funded family planning clinics


• Sexual Abuse Reporting Requirements--Remove Rider 37 from Appropriations Bill, which requires that agencies contracting with the Texas Department of Health report teen sexual activity to law enforcement without regard for professional judgment of clinicians on whether abuse has occurred


• Abortion Access for Minor--Oppose attempts to require parental consent for minors seeking abortions and oppose attempts to create further barriers to obtaining a judicial bypass for minors seeking abortions

Provide Medically Accurate, Compassionate Care to Women

• “Misinformed” Consent--Support measures that would: eliminate the requirement that abortions performed after the 16th week of pregnancy be done in an ambulatory surgical center, allow all family planning providers to be listed in all state-mandated resource materials for pregnant women, eliminate the mandate that women be informed about a mythical link between breast cancer and abortion, exempt women who are rape or incest survivors from the 24-hour waiting period for an abortion, exempt women with fetal abnormalities from the 24-hour waiting period for an abortion--
  
  and
  
  Oppose measures that would: mandate that women be provided with “misinformed consent” materials

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More Info on the Medicaid Waiver

Let's say a single 20 year old woman walks into one of our clinics and she makes gross $1,435 a month. That puts her at 185% poverty. She is not eligible for Medicaid.

$1,435 a month is not that much money. After Uncle Sam gets his cut and she pays for housing, utilities, phone, food--she really is not left with too much money. An exam with a pack of birth control pills will cost her about $55 copay to PP. (The exam actually cost about $150. We give her a discount and get no state funding for her to make up the $95.) Let's say she doesn't have the money to pay for the exam, so she decides to go without birth control for awhile.

Now let's say she has sex with someone she cares about and the condom breaks and she gets pregnant. She is now eligible for Medicaid prenatal, labor, delivery, and postpartum care. Which will cost the taxpayer over $8,000 (that's with no complications). Sixty days after she gives birth, she is off Medicaid and at 150% of poverty. She now has to pay for daycare on top of all her expenses and is less likely to afford birth control. She is poorer and still at risk of getting pregnant.

With the Medicaid waiver, she would get her well-woman exam paid for and that would save the taxpayer the cost of Medicaid pregnancy. She still is financially strapped but she is less likely to get pregnant.

The beauty part is that the federal government will reimburse the state 90% of the cost of the well woman exam. If we had gone after the waiver in 2000, the state would now have $131 million dollars in general revenue.
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Could Texas use $131 Million?

http://www.whfpt.org


One of the major issues we will be dealing with on Lobby Day is to get lawmakers to see the wisdom of apply to the federal government for a Medicaid waiver for family planning. States with Medicaid waiver projects in place have successfully and significantly increased the numbers of births averted and generated huge savings in Medicaid expenditures. California’s waiver program averted 21,335 births for net savings of $76,182,694! (Alan Guttmacher Institute and Kaiser Family Foundation, “Medicaid: A Critical Source of Support for Family Planning in the United States”, April, 2004)

In SFY 2002, Texas spent almost $1.5 billion to provide care for Medicaid pregnant women living at or below 185% of the Federal Poverty Guidelines.

Hmmmmmm let's see. . . . . . we could get a waiver and get $131 million. . . .or. . . .pay $1.5 billion for Medicaid pregnancies and births. . .

What do you think? Leave a comment. Need more info?
Don't you think Texas could use $131 Million?

(courtesy of WHFPT--Thanks Peggy!)

Without a doubt, members of the 79th Texas Legislature would welcome another $131 million to offset the need and demand for additional funding in education, Child Protective Services and other state programs. If Texas had applied for and been granted a Medicaid waiver for women’s health care services in SFY 2002, by the end of SFY 2006, the state would have a net savings of more than $131 million!

According to the Legislative Budget Board Fiscal Note on SB 812 (2001), which called for Texas to apply for such a waiver, the following projections were made:

Fiscal Year----------Net Savings (in General Revenue)

2002----------------<$ 924,000>

2003---------------- $ 2,639,741

2004---------------- $ 24,909,020

2005---------------- $ 47,849,329

2006---------------- $ 56,647,963

Total Net Savings:-- $131,122,053

Reducing the number of unintended pregnancies being paid for by the state’s Medicaid program, including the costs of prenatal care, delivery and newborn care generates the savings.

In SFY 2002, Texas spent almost $1.5 billion to provide care for Medicaid pregnant women living at or below 185% of the Federal Poverty Guidelines.

Hmmmmmm let's see. . . . . . we could get a waiver and get $131 million. . . .or. . . .pay $1.5 billion for Medicaid pregnancies and births. . .

What would you like to do?
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Gearing up for March 1

March 1, 2005 is Women's Health Lobby Day!

Early in the morning, hundreds of women, men and children will be boarding buses and airplanes. Perhaps yawning or drinking another cup of coffee, they will be coming from Dallas, Corpus Christi, Houston, McAllen – coming from cities and towns all over Texas. All coming to Austin on March 1 to make a difference.

Will you be joining them?

Planned Parenthood invites you to a one-day lobbying event in Austin. We will have a short briefing session and then off to the capitol we will go. We will meet with our elected officials to tell them that we support family planning, access to birth control, contraceptive equity and much more. No prior experience is necessary - just bring your enthusiasm!

Join in the fun. Southwest Airlines is offering great prices on an up and back (same day- 3/1/05) ticket. You will need to book your own early morning flight (7:20am arriving Austin 8:25am) You will need to leave Austin on the late flight (7:00pm arriving Midland 9:25pm). If you are PPWT Staff you will not need to use your PTO for the work day just get your supervisors permission. Once you have your ticket, let me know. I need a count for the briefing session. You will also be responsible for your meals and transportation.

I will need to know that you are going....Don't be shy - come to Austin and make a difference!
Need more information? Give Carla a call at 432/580-9855 ext. 103 or email her at mailto:carla@ppwesttexas.org.

Need a reason to attend? Take your pick!

• A bill has already been filed in the Texas House to allow pharmacists and pharmacies to refuse to fill prescriptions for emergency contraception - and birth control! They would not be required to refer women to other providers.
• There have been no significant increases in the state budget for family planning services for the last several sessions, and approximately 1 million Texas women have no access to basic reproductive health care such as Pap smears.
• In 2001, Governor Perry vetoed a bill that would have given more Texas women access to family planning services and would have saved the state $122 million by 2005.
• In 2003, the state legislature approved an amendment to the state budget that disqualifies organizations that provide abortions from receiving funding to provide family planning services.
• Anti-choice legislators claim the rider is necessary to insure that no family planning funds are used to provide abortion care, but Texas law already prohibits health care providers from using public funds to pay for the direct or indirect costs of providing abortion services.
• Last session, a bill was passed that changed the definition of an "individual" to include "an unborn child at every stage of gestation from fertilization until birth."
• Another bill passed last session now requires Texas women to wait an additional 24 hours before they can have an abortion and requires providers to offer women misleading and inaccurate information about the procedure - including the false link between abortion and breast cancer.

Come join us!

Tentative Schedule--

7:20 am

plane leaves Midland arrives Austin 8:30

10:30

Lobby Day Kick off Austin Covention Center

11:30-12:30

lunch at the Capital (on your own)

12:30 - 5:30 visits

7:00pm

plane ride home arrive Midland 9:30

Each will get a tote, button and wrist band for the day. WE also have a camera crew from the KMID (ABC station) joining us for the day.....

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