A senior Texas Democrat hammered GOP Gov. Rick Perry this week over new rules blocking Medicaid funding to providers affiliated with abortion services.
Rep. Lloyd Doggett suggested the move is a direct threat to the roughly 130,000 low-income women who receive cancer screenings and other preventive services under the state's Women's Health Program, which could crumble without the federal funds.
"His eagerness to do as little as possible for health care … only make[s] Texas less competitive at the same time that it jeopardizes the health of so many," Doggett added.
Perry's administration announced Thursday that it will soon implement a GOP law banning Medicaid funding for the Planned Parenthood Federation of America (PPFA) and other healthcare providers that either furnish abortions or are affiliated with those that furnish abortions.
Current law already bars federal funding for abortions. But critics of the present system argue that money's fungibility makes it impossible for abortion providers to isolate the private funds they receive for abortions from the federal funds they get for cancer screenings, contraceptives and other preventive-care programs.
Perry's administration said the new state restrictions, scheduled to take effect March 14, are perfectly legitimate.
"Under federal law, states administer Medicaid and have the right to set the criteria for providers in the program. That is what Texas is doing," Texas Health and Human Services spokeswoman Stephanie Goodman told the Texas Tribune. "We have a state law that our Attorney General says is constitutional, and it clearly bans abortion providers from taking part in the Women's Health Program.
"We can't violate a perfectly valid state law just to appease Washington," Goodman added.
The Obama administration disagrees. It says the Texas law violates the federal statute allowing all qualified providers, including the PPFA, to participate in Medicaid. The Centers for Medicare and Medicaid Services (CMS) is threatening to withhold about $35 million for the Women's Health Program – roughly 90 percent of its funding – over the new Texas law.
Texas legislators have effectively decided they would rather lose that money than allow Planned Parenthood to get a portion of it.
Roughly 16 percent of Texans are on Medicaid, matching the national rate, according to the Kaiser Family Foundation, while 25 percent of state residents have no health insurance at all – by far the highest uninsured rate in the country.
With implementation of the Texas rule just weeks away, reproductive healthcare advocates are anticipating a court challenge to block it. The federal law, they say, is on their side.
"You can't discriminate against the providers," said Jessica Arons, director of the women's health and rights program at the Center for American Progress.
Planned Parenthood, for its part, isn't showing its hand yet in Texas. Amanda Harrington, a spokesperson for the group, said the PPFA "is evaluating all possible actions" to protect the Women's Health Program and the tens-of-thousands of long-income folks dependent on it.
CMS did not respond Friday to requests for comment about the agency's next steps.
Texas is hardly alone in its push to defund Planned Parenthood and other abortion providers. GOP leaders in Congress have pushed for years to prevent any federal money from going to the PPFA, and Indiana lawmakers have enacted legislation very similar to Texas's controversial law.
In the latter case, Planned Parenthood of Indiana (PPIN) last year filed for – and won – a preliminary injunction blocking the state law from taking effect. A final decision is pending, but meanwhile PPIN is allowed to participate in Medicaid.
Women's healthcare advocates say a similar scenario will likely play out in Texas, forcing the state to let PPFA and other abortion providers remain in the program.
"I don't see how Texas can take money away from just one provider," said Judy Waxman, vice president of health and reproductive rights at the National Women's Law Center. "I think they're going to have to do it."