Texas outlines rules for women's health care program But if court backs Planned Parenthood, women would lose all care

AUSTIN — As Texas prepares to take over a key health program for low-income women, its new rules specify the program will be killed if a court requires Planned Parenthood to be among service providers.

The state is assuming full responsibility for the Women's Health Program - doing without federal funds, which had paid 90 percent of the program - so that it can exclude clinics that are affiliates of abortion providers, even if the clinics themselves don't provide abortions.

The federal government says its rules don't allow for the exclusion, which notably affects Planned Parenthood, a main provider in the program that offers contraceptives and health screenings to more than 100,000 women.

After Planned Parenthood sued, state officials said the program would disappear if the group prevailed, and the new rules make that clear.

"If the courts make us do something that's not consistent with state law then it says we'll stop the program," said Dr. Kyle Janek, Health and Human Services executive commissioner. "If the courts say you have to include Planned Parenthood, then yes, it goes away."

The state is preparing to take over the program starting Nov. 1, so it is laying out its rules in advance of that.

Janek noted that the rules had just been finalized and said part of his job is to build the most "robust" network possible. "As long as there's a market, we are very confident we are going to get the number of providers that it takes to take care of them," he said.

Doctors gain changes

In the rules outlined Thursday, changes also were made to address objections from doctors and others who said state regulations as initially proposed would intrude on the physician-patient relationship by forbidding any discussion of abortion.

Janek said the new rules will allow discussion of abortion as long as the doctor doesn't direct a course of action to women in the program.

They also will allow doctors who don't provide abortions to take part in the program even if they are in a group practice with a doctor who provides them, he said.

Dr. Michael E. Speer, president of the Texas Medical Association, said he was encouraged by the change in what is considered promotion of abortion, although he said he still needed to comb through the rules.

Speer voiced concern about the prospect of the program ending if Planned Parenthood wins its effort to be included, saying such action would likely spur court action as well, but that in the meantime, women would be left without care.

"As a physician, that upsets me greatly," said Speer, a neonatologist at Texas Children's Hospital in Houston. "It's the women who are being hurt."

Provider outraged

Planned Parenthood representatives expressed outrage at the "poison pill" clause that would do away with the program if they win the right to participate.

Rochelle Tafolla of Planned Parenthood Gulf Coast said that clause "definitively reveals that the state ranks politics ahead of women's health. There is no rational reason for jeopardizing the health care of tens of thousands of Texas women simply to cut off access to Planned Parenthood, the provider that nearly half of the women in this program rely on for their basic health care."

Gov. Rick Perry and others who back the ban on Planned Parenthood have said it's important to ensure government funds don't prop up organizations that provide abortions, which they oppose.

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