Rick Perry was one of the four Republican presidential candidates to speak Friday morning at the National Right to Life convention, a conference put on each year by the anti-abortion group. In the lead up to his comments, Perry focused on what he said was the havoc wreaked by the Affordable Care Act.
As a point of contrast to the 16.4 million people who are newly insured as a result of the healthcare law, Perry pointed to his own state as a model for what he'd like to see happen nationally.
"I'm really proud of what we did in the state of Texas," he said.
Later into the speech, he continued:
Access to healthcare is the real issue. I don't think it's right for us, I don't think it's the appropriate thing for us to judge success by how many people can we force to buy insurance. I think it's important how many people have access to really good quality healthcare. That's what we aught to be working on.
This is where he jumped into women's healthcare specifically, explaining that the Texas model focused on providing access to "the least among us." His choice to focus on low-income women's access to healthcare was…interesting.
One of the signature policies under Perry's tenure as governor was HB2, the omnibus abortion bill that—until a Supreme Court order issued earlier this month temporarily blocked its total enforcement—threatened to shutter all but a handful of clinics in the state. (It was a victory of sorts, though it's probably better to call it the maintenance of a profoundly shitty status quo.)
HB2 is very much a bill designed to restrict access to abortion—through forced waiting periods, expensive clinic renovations, business contracts between clinics and hospitals—so it's no great surprise that access in the state is now severely restricted.
According to an analysis from the Texas Policy Evaluation Project, HB2 has forced hundreds of thousands of women to travel long distances to access basic care (emphasis added):
The number of women of reproductive age in Texas living more than 50 miles from a clinic providing abortion in Texas increased from 816,000 in May 2013 to 1,680,000 by April 2014. When the ASC requirement goes into effect this will increase to 1,960,000.
The number of women of reproductive age in Texas living more than 100 miles from a clinic providing abortion in Texas increased from 417,000 in May 2013 to 1,020,000 by April 2014. When the ASC requirement goes into effect this will increase to 1,335,000.
The number of women of reproductive age in Texas living more than 200 miles from a clinic providing abortion in Texas increased from 10,000 in May 2013 to 290,000 by April 2014. When the ASC requirement goes into effect this will increase to 752,000.
But let's assume that access to abortion isn't part of Perry's calculation about how great women's healthcare was in Texas while he was governor. (I mean he is, after all, at a national anti-abortion convention talking about his bonafides as a pro-life governor. This isn't a stretch of the imagination.) But other kinds of reproductive healthcare also tanked under Perry.
Data released by the Department of State Health Services (DSHS) in 2013 (two years after the Texas legislature cut state family planning funds by two-thirds) found that doctors involved in the program saw 77 percent fewer family planning patients. And for each clients they did see, costs were 17 percent higher.
Andrea Grimes, a senior political reporter at a reproductive health-focused site called RH Reality Check, reported on this back in 2013:
In 2010, providers in the state’s fully funded family planning program saw nearly 212,000 patients. In 2013, the providers that managed to stay afloat after the funding cuts saw a little over 47,000 patients. […]
At a DSHS council meeting Wednesday in Austin, commissioner Dr. David Lakey told council members that the decline in clients served was a direct result of the 2011 funding cuts.
“There’s been significant changes in the way that we’re addressing some of these issues following the last two legislative sessions,” said Lakey.
But the legislature tried a little bit of self-correction in 2013, restoring some funds to fill in the gaps created by previous cuts. But access remains limited.
According to another report from the Texas Policy Evaluation Project, his one released in 2015, women in the state—particularly low-income women and women of color—are still struggling to access basic services. According to that report, 55 percent of women "reported at least one barrier to accessing reproductive health care services, including cervical cancer screening or family planning services."
Those included cost-barriers, time, and logistical barriers—getting the time off work to make an appointment, for example—and finding a provider they trusted. Low-income and Spanish-speaking women reported the most barriers to accessing contraception.
The gaps in coverage for women extend far beyond contraception—the state's rejection of the Medicaid expansion under the new healthcare law has had real costs—but the stats on reproductive healthcare are a convenient blind spot for Perry. And while the state's uninsured rate has dropped in recent years, it still tops the national list.
But if Perry's mission was to close off low-income women from abortion, cancer screenings, pap smears and other basic health services, then he succeeded beyond his wildest imagination. Maybe that's what he means when he says he's proud.
Perry's team did not respond to Fusion's request for comment.