In 2011 Texas reduced public funding for family planning and other reproductive health services, cutting funds by two thirds — from $111 million to $37.9 million for the two-year period. The Texas legislature also imposed new restrictions on abortion care and reauthorized the exclusion of organizations affiliated with abortion providers from participation in the state Medicaid waiver program, the Women’s Health Program.

To implement the legislation and funding cuts, the Texas Department of State Health Services reduced the number of funded family planning organizations from 76 to 41. The remaining funds were allocated through a three-tiered priority system, with organizations that provide comprehensive primary care taking precedence over those providing only family planning services (see pie charts).

As part of a comprehensive three-year evaluation of the legislative changes to family planning policy in Texas, we interviewed 56 leaders of organizations throughout the state that provided reproductive health services using Title X and other public funding before the cuts went into effect. From these interviews, we have identified the likely channels through which the legislation will influence reproductive outcomes and the women who are most likely to be affected.

The purpose of the law was largely to defund Planned Parenthood in an attempt to limit access to abortion, even though federal and state funding cannot be used for abortion care. Instead, these policies are limiting women’s access to a range of preventive reproductive health services and screenings. We are witnessing the dismantling of a safety net that took decades to build and could not easily be recreated even if funding were restored soon.