Adenocarcinoma found via Pap test. Pap “stain” is what provides the color (and thereby the coloration and visibility) in this slide.

There’s a proposal pending in Texas which would effectively decertify Planned Parenthood as a Medicaid provider. Andrea Grimes, an investigative reporter who writes about reproductive and women’s health issues at RHRealityCheck, made inquiries as to the actual availability of health care to women on Medicaid in the Austin area.

Grimes used as her criterion the Pap smear, which should be a routine test for adult women (at intervals of three years for those at least risk, more frequently if other risk indicators are present). Among other things, a Pap smear can be the first indication of cancer. In other words, it’s a basic service. A provider of women’s health services who isn’t providing Pap smears isn’t providing basic, necessary services. So the criterion is a reasonable proxy.

While widely available provider lists suggest wide availability a total of 181 medical providers within a thirty-mile radius from one ZIP code in Austin. One potentially barred Planned Parenthood clinic which Grimes reports as “busy” is located within the ZIP boundaries.  Grimes confirmed that, in fact, only thirteen of the 181 providers accepted Medicaid and performed Pap smears. That’s 7.2%.

Grimes has done  a very elegant piece of investigative reporting, but we wish to stress that she’s demonstrated two problems:

1. the controversy about Planned Parenthood, in the first place, suggests a level of political discourse in which life-or-death decisions are made with reckless disregard for the ground truth;
2. the prospect of a radical reduction of basic health services to women – also a life-or-death issue. It seems akin to making transportation arrangements – for a group without a lot of political voice – without as much counting the life boats or verifying that they are seaworthy.

Here’s an excerpt from Ms. Grimes’ piece, Without Planned Parenthood, What’s Left for Texas Women? Not Much.

Of the 13 providers that could actually see a Medicaid Women’s Health Program patient, the thirteenth is a forty minute drive from East Austin. And that’s with no traffic. And if you live in Austin, you know there’s no such thing as no traffic. By public transportation it would take over two hours to get to that clinic. And that’s with a half mile walk at the end. Excluding Planned Parenthood from the Women’s Health Program absolutely reduces access to quality care. Full stop. Already, the state has demonstrated that the systems it says it has in place to support women without Planned Parenthood don’t work. Trying to get low-income, quality reproductive health care in Texas, in a major metropolitan area like Austin, without Planned Parenthood is like trying to get a pap smear at a colonoscopy clinic. And I know because I actually tried.