Doctors in Women's Health Program Can Discuss Abortion

In a peace offering of sorts to medical and women's groups on Thursday, Texas Health and Human Services Executive Commissioner Kyle Janek announced rules for the new state-run Women's Health Program that permit doctors to discuss abortion with their patients and practice alongside physicians who provide abortions.

“What we wanted was to allow for the one-on-one, private, non-directive counseling between a physician and her patient,” Janek said.

But the new rules have done little to stem the frustration of family planning providers: They come as the state's Republican leaders prepare to run the Women's Health Program on their own — without the federal support the state has received for years, and without Planned Parenthood clinics.

“Once and for all, we implore Texas to put politics aside and put women’s health first," said Ken Lambrecht, president and CEO of Planned Parenthood of Greater Texas. "The Women’s Health Program and Planned Parenthood have worked together to provide women with essential health services, including cancer screenings, birth control, and well-woman exams, for the past five years." 

The drama over the Women's Health Program reached new heights during the last legislative session, when Republican lawmakers pushed to enforce long-ignored rules that stated that clinics "affiliated" with abortion providers could not participate in the joint state-federal program. They got legal opinions from the state's Republican attorney general and proceeded to boot Planned Parenthood and other clinics that perform abortions at some of their facilities — but none receiving taxpayer dollars — out of the program.

The Obama administration called the move a violation of the federal Social Security Act, threatening to rescind the $35 million in federal funding the program received every year. When state leaders didn't balk, federal officials followed through. The state is currently wrangling with various ways to replace that money, including further crackdowns on Medicaid fraud.

State officials quickly began debating new rules for the refashioned state-run program. As originally proposed, they would've prohibited discussion of abortion between physicians and patients in the program, a measure strongly opposed by the Texas Medical Association, which represents about 47,000 physicians and medical students statewide. TMA called the rule a "gag order" and claimed it endangered patients' relationships with their physicians.

Some Texas lawmakers opposed the rule as well, including breast cancer survivor and Republican state Rep. Sarah Davis of Houston who cited the "sacred nature" of the doctor-patient relationship in a letter voicing her opposition.

On Thursday, Janek acknowledged that the drafted rule “was a bit of a gag rule." Under the final rule, doctors cannot call abortion providers on behalf of patients, but can give names and contact information.

“What seemed to make the big play was that a physician could not talk to her patient about something that was legal and allowable," Janek said. "We wanted to clear that up.” 

Other changes to the originally-drafted Women's Health Program rules include a clarification allowing physicians who are in private practice with abortion providers but who do not provide abortions themselves to participate in the program. 

The new rules will go into effect Nov 1.

TMA President Michael E. Speer said while the organization is still reviewing the revised rules, physicians are encouraged by the changes.

"It is very important that patients are able to trust that their doctor is giving the best medical advice for them — based on their medical needs and nothing else," he said in a statement.