A Cautionary Tale from Texas for Low-Income Women in Ohio

Last week, Governor John Kasich signed a bill into law that defunds Planned Parenthood in Ohio. If the current state of affairs in Texas is any indication, low-income women in Ohio are about to see their economic security plummet.

In 2011, the Texas state legislature barred Planned Parenthood from its Medicaid program and excluded from state health plans any clinic affiliated with an abortion provider. This policy decision has had damaging consequences for some of the most vulnerable women in the state. A recent report found that in counties where Texas defunded Planned Parenthood affiliates, there was a dip in usage of long-acting reversible contraceptives (LARCs) and injectable contraceptives--the most effective forms of contraception available. During this time period, there was also an increase in births to mothers covered by Medicaid. Given that this surge in births occurred in the very counties where women faced new barriers to accessing contraceptives, it is highly probable that many of them were unplanned.

These troubling outcomes are also likely attributable to the Texas omnibus abortion law--known as the Targeted Regulation of Abortion Provider (TRAP) law--which went into effect the same year that Planned Parenthood was excluded from state health plans. TRAP includes a number of provisions that make it more burdensome for women to obtain abortions. Among the provisions are bans on abortions that occur after 20 weeks, restrictions on medication abortions, and a requirement that physicians have admitting privileges at a hospital within 30 miles of where they perform abortions. A challenge to the law is currently before the Supreme Court.

Passed under the guise of protecting women's health, TRAP has not only closed six health care clinics, but has made accessing comprehensive reproductive health services--like cancer screening, health education, and wellness care--more difficult for millions of vulnerable women.

Together, these restrictive policies have threatened not only women's reproductive health and autonomy but also their economic security. Women without coverage are more likely to forgo care in order to prioritize other basic needs like food, rent, and childcare. And some low-income patients in states with restrictive abortion laws now face prices that are triple the cost of what women in states with access and availability pay for care. The scarcity of these services also means that many women have to travel hundreds of miles to obtain annual wellness visits, cancer screenings, and maternal care. Many of these women will lose wages to travel time and, adding insult to injury, will incur the additional expenses of transportation, food, and childcare.

Perhaps most horrific of all, we know that women who have lost access to services are now attempting to self-abort in the absence of accessible and affordable abortion care. The true irony is that by enacting harmful policies targeting abortion--a safe and legal medical procedure--policymakers have jeopardized the ability for low-income women in particular to make timely and informed decisions about reproduction.

And yet, the abortion war continues to rear its ugly head. In 2015 alone, 17 states passed more than 50 abortion restrictions. Eleven states slashed funding to Planned Parenthood or any clinic that provides abortion care among its health services. As states continue to introduce this kind of harmful legislation under false pretenses, one truth remains the same: the legal right to abortion and other reproductive health services means nothing without the ability to affordably and reasonably access it.

While the Supreme Court weighs the merits of Texas's TRAP law, and the women of Ohio brace for an uncertain future, these states should be a cautionary tale not only for 2016, but for years to come.