After sitting on the application for over two years, the Trump administration has approved a Medicaid 1115 waiver that will allow Healthy Texas Women, a state program that provides healthcare for low-income women, to receive approximately $350 million in federal funding over the next five years.
The program’s federal funding had previously been cut by the Obama administration because of state requirements that prohibited the funding from flowing to abortion providers or their affiliates.
In 2006, Texas was granted Medicaid funding for women’s health and family planning for a five-year demonstration period.
During that time, the Texas legislature amended the human resources code to prohibit the program funding from being “used to perform or promote elective abortions, or to contract with entities that perform or promote elective abortions or affiliate with entities that perform or promote elective abortions.”
In 2011, the state applied to renew its federal funding, but the Obama administration denied the request because of its new restrictions.
However, the federal government agreed to continue funding the program until the end of 2012 to help the transition to a fully state-funded program.
In 2016, the state consolidated its women’s health services and launched the Healthy Texas Women program.
In June 2017 — after the end of the Obama administration and beginning of the Trump administration — Gov. Greg Abbott submitted a request for a new demonstration waiver with a proposed effective date beginning in September 2018 and ending in August 2023.
The Department of Health and Human Services (HHS) opened the waiver request for public comments, but did not approve or deny the request until last week.
“The vast majority of comments received oppose the provider restrictions required in order to conform to the Texas state law,” reads the letter from the Centers for Medicare and Medicaid Services (CMS). “CMS disagrees with commenters’ assertions…. [N]one of the beneficiaries in this demonstration have access to all preferred providers under the current state-funded program, and overall the demonstration provides thousands of individuals with access to family planning providers they would not otherwise have.”
The letter also noted that CMS “reserves the right to withdraw its authority if it is determined that the provider limitation negatively impacts health outcomes.”
According to a press release from the Texas Health and Human Services Commission, health services under the demonstration include “family planning, breast and cervical cancer screenings, well-women exams and screening and treatment for postpartum depression, hypertension, cholesterol, and diabetes.”
The release also notes the following qualifications for women to be recipients of aid in the program:
- Ages 18 through 44
- U.S. citizens or qualified immigrants
- Texas resident
- Not currently pregnant
- Does not currently receive benefits through a Medicaid program that provides full benefits, Children’s Health Insurance Program (CHIP), or Medicare Part A or B, and does not have any other creditable health coverage
- Net family income at or below 200 percent of the federal poverty level
Gov. Abbott applauded the decision by the Trump administration, stating, “The Lone Star State is once again in partnership with the federal government to provide meaningful family planning and health services while fostering a culture of life.”
A press release from the governor’s office states that the program is expected to serve over 200,000 clients per year during the next four years.
Likewise, conservative organizations in Texas have also lauded the administration for the action.
Jonathan Saenz, President of Texas Values said, “Texas is a state that values life, and we are proud to see President Trump stand with us on this issue. Texas is proving it is possible to both care for women and protect life.”
In contrast, Planned Parenthood criticized the measure, stating, “The Lone Star State is once again in partnership with the Trump administration to drastically slash meaningful family planning and health services, while fostering a culture that is anti-women, anti-choice[,] and anti-healthcare.”
The waiver is effective beginning immediately and will extend to the end of 2024, barring any withdrawal from CMS.
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Daniel Friend is a reporter for The Texan. He participated in a Great Books program at Azusa Pacific University and graduated in 2019 with a degree in Political Science. He has studied C.S. Lewis’s science fiction trilogy and in his spare time you might find him writing his own novel partly inspired by the series.