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 Independent health experts dispute the claim, saying Texas still
has a long way to go before it can provide the level of service it
did when Planned Parenthood was an integral part of its family
planning efforts.
According to figures provided to Reuters by Texas health officials,
the state's retooled family-planning programs reached 317,393 women
in the 2014 fiscal year, nearly as many as the 320,044 the state
served in fiscal 2010, before it cut off funding to Planned
Parenthood.
After recruiting other health clinics and doctors to provide
contraceptives to low-income women, state officials say their
biggest challenge at this point is getting the word out.
"There is access for every woman in Texas to be able to receive the
services she needs," said Lesley French, who oversees women's health
programs at the Texas Health and Human Services Commission.
Anti-abortion activists have long targeted Planned Parenthood
because it provides abortion along with contraception and other
women's health services. Criticism mounted this summer when
undercover videos showed Planned Parenthood officials talking about
providing fetal parts for research.
 Federal law already prohibits taxpayer money from being spent on
abortions, except in cases of rape or incest or when the mother's
life is in danger, and Planned Parenthood relies on private
donations to pay for its abortion services.
In 2011, the Texas state legislature cut Planned Parenthood out of
one family-planning program and revamped the way another program
hands out funds, placing private clinics like Planned Parenthood at
the bottom of the list.
Last month, Governor Greg Abbott said he would block the
organization from participating in all Medicaid programs in the
state.
Legislators also imposed a welter of expensive new regulations on
abortion clinics, forcing many of them to close.
SCALING BACK
Once the state's largest birth control provider, Planned Parenthood
has dramatically scaled back its presence in Texas. The network now
operates 35 clinics there, 46 fewer than in 2010. Some 16 have
closed their doors permanently, while others have consolidated or
severed ties with the national network.
The cuts have hit hardest in remote areas, the group says. Along the
Rio Grande Valley, the local Planned Parenthood affiliate closed
four of its eight clinics and laid off half its staff.
The affiliate cut its ties to Planned Parenthood in order to tap
state funds, but expects it still won't have the capacity to serve
many of its former patients.
"Who has picked them up? We don't know," said Patricio Gonzales,
chief executive of the now-renamed Access Esperanza health group.
Planned Parenthood hasn't been the only casualty. Some 36 other
family-planning clinics across the state have also closed their
doors since the changes, according to the Texas Policy Evaluation
Project, an academic effort that tracks the state's family planning
efforts.
Those that remain open now often charge money for services that they
once provided for free.
Marisol Rincon, 35, said she was unable to afford the $60 that
Access Esperanza charged her when it was cut out of the state
family-planning program. She opted to use condoms, even though they
had resulted in an unwanted pregnancy previously.
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"It was between having to buy food for my kids or paying for some
type of exam or birth control," she said.
There is no statistical evidence to date that the changes have led
to more unwanted pregnancies. Texas birth rates have fallen and
abortions have dropped, in line with national trends.
But there are signs that the state's safety net has frayed. One in
three Texas women in 2014 said she had no regular health-care
provider, up from 1 in 5 in 2010, according to the U.S. Centers for
Disease Control.
Texas's family-planning costs ballooned from $15 million in fiscal
2011 to $104 million in fiscal 2014, driven partly by the Obama
administration's decision to pull its share of funding after Texas
cut off Planned Parenthood.
The state also set up a new $50 million program that combines family
planning with other health services like diabetes screening. Planned
Parenthood isn't allowed to participate.
Anti-abortion activists say voters in Texas are willing to foot the
bill to ensure that their money doesn't go to Planned Parenthood.
"Taxpayers are protected, by and large, from having their tax
dollars being used to promote abortion as a method of birth
control," said Joe Pojman, executive director of the Texas Alliance
for Life.
The state has worked to recruit doctors and health clinics to serve
patients who had formerly relied on Planned Parenthood.
With a record $285 million budgeted for women's health over the next
two years, lawmakers and officials say women should now be able to
find care through other medical providers.
Independent health experts say Texas is overstating its case. A more
accurate assessment, they say, would show that the state actually
provided family planning services to about 250,000 women in fiscal
2014, still far short of the 320,000 who were served before Planned
Parenthood was forced out.
They say the state is inflating its numbers by tens of thousands by
including women who used the state's new Expanded Primary Health
Care program for services other than contraception, such as
hypertension and diabetes screening.
"Texas has a big job to do to make the new programs work across the
state," said Janet Realini, president of Healthy Futures of Texas, a
coalition of women's health providers that does not include Planned
Parenthood.
(Reporting by Andy Sullivan; Editing by Sue Horton)
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