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Texas Disavows Controversial Women's Health Study

Miguel Guitierrez Jr./KUT
The Texas Health and Human Services Commission said a study from the New England Journal of Medicine didn't properly reflect the reality of women's health care in Texas.

From the Texas Tribune: Texas health officials have asked a prominent academic journal to take the state's name off a published finding that Texas women lost access to health care services after lawmakers kicked Planned Parenthood out of a family planning program.

The study published last month by the New England Journal of Medicine found that fewer women accessed the family planning program after Planned Parenthood was kicked out in 2013 — a conclusion vehemently contested by the state's Republican leadership.

That study “purports” to be from the Texas Health and Human Services Commission but “does not reflect the views of the Commission,” wrote Karen Ray, the agency’s chief counsel, in a letter to the journal. She asked the journal to remove any "suggestion of an affiliation with" the state agency.

Jennifer Zeis, a spokeswoman for the New England Journal of Medicine, said late Monday the publication had appended a note to the article clarifying it did not "necessarily represent the views or policies of the Texas Health and Human Services Commission."

Two state employees were listed as co-authors on the article, including Rick Allgeyer, the health commission’s former director of research. State Sen. Jane Nelson, a Republican of Flower Mound who spearheaded the changes to the women’s health program that excluded Planned Parenthood, raised concerns about the study’s findings, and Allgeyer resigned from the agency days later.

Agency chief Chris Traylor wrote a letter to Nelson on Monday saying the article’s findings were “broad and not sustainable” because they did not take into account the full range of women’s health services offered by the state.

“It is imperative that Texas women understand the truth surrounding their access to care and that the Legislature clearly knows how its historically high funding levels in women’s health have positively impacted health care for women statewide,” Traylor wrote in his letter to Nelson, the senate’s lead budget writer.

Traylor assured Nelson that the health commission did not approve the study, which he said violated state agency protocol.

The study’s authors, including researchers from the University of Texas at Austin’s Texas Policy Evaluation Project, found that by excluding Planned Parenthood in 2013 from Texas’ family planning program, state lawmakers may have restricted women’s access to long-acting birth control.

That year, the Women’s Health Program — which was 90 percent federally funded through Medicaid — was replaced by the wholly state-funded Texas Women’s Health Program. Both programs provided services to Texas women ages 18 to 44 who had incomes at or below 185 percent of the federal poverty level.

But Nelson and officials from the health commission disputed those findings, saying the researchers selectively ignored other women’s health programs offered by the state, including a family planning program and a breast and cervical cancer program. That painted a picture of Texas' health care services that was “incomplete and misleading,” state health officials said, and they disputed other statistics cited by the researchers. 

“The article presents an incomplete picture of women’s health services in Texas by ignoring the movement of clients to other state programs and focusing on only one contraceptive device,” Ray wrote. “We also believe the article includes incorrect statements concerning the birth rate and number of births in Texas.”

Joseph Potter, one of the UT researchers who co-authored the study, said in an email that the paper addressed the "specific question" of how the exclusion of Planned Parenthood from the Texas Women's Health Program affected women. Nothing raised in Traylor's letter, he said, contradicted the researchers' conclusions.

"We made no claims about access to reproductive health care as a whole in Texas," he said, and he stood by the finding that claims for long-acting contraceptives fell after Planned Parenthood was excluded from the women's health program.

Added Potter: "Our paper underwent several rounds of peer review at the country's preeminent medical journal, and we stand by the claims made in the paper."

Edgar Walters is a reporter with the Texas Tribune.
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