AUSTIN -- It was standing room only inside the Department of State Health Services' Criss Cole Rehabilitation Center auditorium, with supporters and opponents of Planned Parenthood each waiting their turn to be heard by state officials in charge of the Texas Women's Health Program.
The majority of those waiting to testify were Planned Parenthood supporters who weighed in on the Texas Legislature's decision to pass a law banning any organization affiliated with an abortion provider from participating in the Medicaid Women's Health Program. The program is designed to offer women's health services including contraceptives and screenings for cancer and sexually-transmitted diseases to around 130,000 low-income Texas women.
The federal government responded by announcing plans to withhold Medicaid dollars responsible for 90 percent of the program's funding, and Texas Governor Rick Perry vowed to continue the roughly $33 million program with state money as the Texas Women's Health Program. In August, a federal court ruled in that Texas can withhold funding from Planned Parenthood pending an October trial.
"These thousands of women may have to travel further for a provider and wait longer for appointments," testified State Sen. Kirk Watson (D-Austin), one of several Democratic lawmakers that asked the Texas Department of State Health Services for Tuesday's public hearing.
Planned Parenthood staff and patients from across the state met with media Tuesday morning at the organization's East Austin clinic to voice their concern over the potential loss of women's health services provide by Planned Parenthood, which is already prohibited from using taxpayer money to provide abortion services under current law.
"My major concern is that [women] will just simply not be treated," said Brendettae Payne, a former patient from Houston. "They will go undiagnosed, which will lead to future medical problems for them, and it will cause a dire impact on women's health care."
"Planned Parenthood, when people think about health care, low income, that's where women think to go," said Austin patient Amanda Elmore. "I think that they need to take the politics out of it."
"It becomes very, very inconvenient and very difficult to find the same level of service elsewhere," said Alexis Lohse of Fort Worth, who says the website recently launched by DSHS to guide patients to Women's Health Program providers hasn't been helpful.
"According to my zip code, I find about five providers," said Lohse. "They give you this giant list that is, 'Wow, a hundred providers!' Really it's about the same five providers listed over and over at different clinics. There's really actually not that many providers."
Former Brian Planned Parenthood director and current anti-abortion activist Abby Johnson attended the hearing to testify the opposite.
"Not only does Planned Parenthood not provide adequate care, but the care that women are receiving is shabby care at best," said Johnson. "Not only does Planned Parenthood not need to receive tax money from Texans, but they don't really even need to be seeing Texas women."
"There are so many centers in the State of Texas that are able to see women that need access to health care," said Johnson, who contends that other providers would be able to provide more types of care than are offered at Planned Parenthood clinics. Lohse argues that the specific services offered by Planned Parenthood make it possible for working women to get in and out quickly.
"These are general health providers. This isn't specific to reproductive health services," said Lohse. "This is a place where I'd go, and I'd be in line for hours to see a physician or a nurse practitioner. I'd be there with other sick people. I'd have to take off, take off school."
According to Department of State Health Services spokesperson Stephanie Goodman, Planned Parenthood clinics make up fewer than 40 of the roughly 3,000 providers listed as participating in the Women's Health Program. At the same time, those clinics treat far more women than any other participating provider.
"That's still a concern," said Goodman. "We have been trying to get more providers in. That number 3,000 is up about 500 over several months ago, so we think we're doing a good job of getting more providers in, working with them and making sure they're ready to take on more patients."
Despite the public hearing, the department has to implement the law, yet it may have some flexibility in exactly how it does so. Some in the health care industry have voiced concern over language in the law preventing doctors participating in the Texas Women's Health Program from even discussing abortions with their patients.
"We don't want to get in the middle of that doctor-patient relationship, so we may be able to adjust the wording some to address those concerns," said Goodman. "But in terms of the basic heart of the law: Can abortion providers and affiliates be part of the program? That we have no discretion over."
According to DSHS, running the program will cost Texas nearly $40 million in 2013. Through measures such as a reduction in overtime and an administrative hiring freeze, Goodman says the program will be fully funded within the department's existing budget. The cost of the program beyond 2013 will largely depend on Texas' plans regarding the Medicaid expansion component of the Affordable Care Act passed under President Barack Obama.
"Planned Parenthood health centers haven't changed, but the politics around women's health have absolutely changed," said Sarah Wheat with Planned Parenthood of Greater Texas. "In the meantime, we will continue to be a voice for our clients and look at all of our options to see what we can do to make sure our health centers can stay open and continue to provide these vital services."
"It's not okay. It's simply un-American, because this country was built on freedom of choice," said Payne. "For you to decide as a legislator to make the choice for my health care, that's a problem."
With heavy donations coming in, Wheat says Planned Parenthood will continue to offer screenings and other services at its existing locations. Just how long before the organization is forced to make significant changes in operation is still up in the air.