Patients faced difficulties accessing reproductive care after Planned Parenthood services were terminated from Medicaid coverage in Texas in 2021, according to a study published in August by UT researchers.

Medicaid offers health coverage for low-income patients, and Planned Parenthood offers reproductive and preventative health services, like HIV testing and birth control. The researchers interviewed Planned Parenthood patients who used Medicaid to understand their experiences. 

Study author Anna Chatillon said over email that the policy’s consequences included emotional distress in patients and patients missing or postponing medical care.

“Texas’ previous terminations of Planned Parenthood from publicly funded programs adversely affected low-income residents’ access to essential reproductive health services, resulting in delayed care and increases in births, many of which researchers identified as likely unintended,” Chatillon said.

Samuel Dickman, a physician with Planned Parenthood and an author of the study, said Planned Parenthood clinics had been a “lifeline” to patients when they accepted Medicaid because of their inclusive space and flexibility in scheduling. 

“(Planned Parenthood) is seen as a place where it’s safe to be yourself, and that is probably not true for all medical facilities,” Dickman said. “The vibe is friendly and non-judgmental, and I think patients really respond well to that.”  

Dickman said that two years after the termination in 2021, people are still having difficulties accessing reproductive care.  

“Texas has the highest level of uninsured people in the country,” Dickman said. “(People) have very few options that are affordable, especially if they live out in rural areas or (have) lower incomes.”

Chatillon said patients were not easily able to access high-quality care after the termination. 

“Patients expressed that other providers could not fill the gap left when Planned Parenthood was no longer able to accept Medicaid, and emphasized that as a result, they were unable to access time-sensitive, affordable reproductive health care following the termination,” Chatillon said. 

Dickman said the laws limit the quality of care he and other physicians can provide, as physicians are forced to tell patients their health insurance isn’t accepted. 

“The more that state policy forces us to make decisions not based on need but based on people’s ability to pay or politically motivated restrictions, like Texas cutting Planned Parenthood off of Medicaid, it makes it difficult for physicians like me to really fulfill our duty to take care of patients and communities,” Dickman said. 

Dickman said Medicaid expansion was crucial to increase accessibility of healthcare. He said those with health insurance are able to go to medical centers like MD Anderson, while those who can’t afford health insurance are left without adequate care. 

“We know that the single biggest public health intervention for low-income Americans has been Medicaid expansion,” Dickman said. “Texas is one of a very small number of states that has refused to expand Medicaid, and that’s having this tragic impact on low-income Texans and is putting Texas further and further into this regime of hugely unequal access to health care.”