AUSTIN, Texas (AP) - Texas is asking the federal government to reverse course and provide funding for a state-run women's health program that excludes abortion providers, an apparent test of the Trump administration that could provide a model for other conservative states.
Since 2011, Texas has chosen to forgo millions in federal Medicare dollars rather than let abortion providers, such as Planned Parenthood, participate in a statewide program that provides birth control, pregnancy testing and health screenings for low-income women.
Although the move showed the resolve of Republican lawmakers determined to get Texas out of business with abortion providers, a state report found that 30,000 fewer women were served in the program after the changes. More than 80 family planning centers also closed in Texas, a third of which were Planned Parenthood affiliates.
Texas health officials say the program has since improved and now want the Trump administration to provide dollars blocked under President Obama.
The stakes potentially extend far beyond Texas. Abortion-rights groups worry that if Texas succeeds, other conservative states will also cut off Planned Parenthood and put clinics in jeopardy.
"There is a new administration, and we're looking at what opportunities may exist for us," said Carrie Williams, a spokeswoman for the Texas Health and Human Services Commission.
At a public hearing Monday, Planned Parenthood supporters criticized Texas health officials for seeking the waiver while continuing to exclude the nation's largest abortion provider from the state program, which is now known as Healthy Texas Women. Texas expects to finalize its request this summer to the federal Centers for Medicare and Medicaid Services.
Only Missouri and most recently Iowa have joined Texas in spurning federal dollars rather than let abortion providers into its women's health programs, said Elizabeth Nash, a policy analyst with the Guttmacher Institute, a national organization that supports abortion rights. But Texas is the first state to seek a waiver with the Trump administration, and Nash said other states could follow.
"If Texas is successful, there's no reason to think these others states wouldn't try to do the exact same thing," Nash said.
Planned Parenthood currently has about 35 clinics in Texas and served more than 126,000 individual patients last year, including those seeking abortions.
State officials estimate that more than 169,000 women are now enrolled in the Healthy Texas Women program, nearly a two-fold increase over when the revamped program launched last summer.
But the program has seen stumbles. In March, The Associated Press found that an anti-abortion group that received $1.6 million under the Healthy Texas Women program to bolster smaller clinics had done little of the sweeping outreached or advertising promised. That led the Republican chairwoman of the Texas House ethics committee to demand answers from state health officials.
Follow Paul J. Weber on Twitter: www.twitter.com/pauljweber