Before March , approximately 8, Texans used Medicaid to pay for basic reproductive health care at Planned Parenthood locations each year. By the end of that month, they no longer had that option. Texas had changed the rules and barred or, in legal terms, terminated Planned Parenthood from Medicaid. The termination stands today, even though federal policy prohibits the exclusion of qualified medical providers from Medicaid.
Enrollees are also disproportionately people of color. To learn how this change affected Texans, our team interviewed 30 people who had previously used Medicaid for services at Planned Parenthood but no longer could. The participants were Medicaid-enrolled women between 16 and 50 years old who had attended an appointment at a Texas Planned Parenthood health center in the previous six months.
We asked open-ended questions about their experiences with Planned Parenthood and with other providers, and about how the change affected them. Participants shared how Planned Parenthood was nearly irreplaceable in their lives. In their view, Planned Parenthood staff had gone above and beyond to make medical care accessible. Respondents described how staff helped them overcome structural barriers to care stemming from poverty, such as unreliable transportation, lack of childcare, and unpredictable work schedules.
Offering flexible, often same-day care and allowing children to attend some appointments, among other services, made these barriers less burdensome.
The change, therefore, places new burdens on a population that already faces structural disadvantages in accessing care. Our participants described how hard it was to find a new reproductive health care provider after the termination, partially because fewer than one in three Texas obstetricians and gynecologists accept new Medicaid patients. Moreover, in some communities, other providers are not conveniently located. After the change, participants struggled to get timely care for urgent medical needs.
