Planned Parenthood of San Antonio and South Central Texas had an unexpected reason to
celebrate at today's luncheon with author Anna Quindlen. News came
through during the noontime event that Texas Health and Human Services
Commissioner Albert Hawkins had authorized an increase in the Medicaid
reimbursement for oral contraceptives to clinic-based pharmacies, also
known as Class D pharmacies, from $2.80 to $20.88. The new rate becomes effective September 1.
Last fall, following a rate-increase hearing for 452 drugs, HHSC
implemented reimbursement increases for 451 of them -- but left oral
contraceptives at their 30-year-old $2.80 rate. "It was foolishness. It
was all political," said Yvonne Gutierrez of Planned Parenthood's
Government Affairs Council. "It was all [Republican Senator] Steve
Ogden." It was also a huge financial burden on public-health and
family-planning clinics, which have faced steep increases in
contraceptive costs since the 2005 Deficit Reduction Act went into
effect last year. The DRA eliminated the ability of safety-net
providers like Planned Parenthood to negotiate prices with
manufacturers. "We're stuck with whatever they dictate," said
Gutierrez. Although Planned Parenthood had not yet passed along the
increased cost to its clients, Gutierrez told the Current that
without federal or state intervention, they -- and other providers --
would eventually have no choice.
Democratic State Representative Mike Villarreal of San Antonio, who
recently launched an online petition that asked Hawkins to instate the
recommended increase, said he was "shocked" when he heard today's
announcement. "Better late than never, though."
"On a public-policy level it's a no-brainer," said Villarreal. "It
saves money by not requiring Medicaid women to fill their prescriptions
at a retail pharmacy that will charge the state $40 instead of allowing
them to fill it at the clinic where they're receiving care, and at half
Gutierrez and Villarreal note that studies have shown on-site
contraceptive distribution is crucial. "It's been proven that for women
to walk out of their gynecological exam with birth control is so much
more effective," said Gutierrez.
But even those significant short-term savings are outweighed by the
"When this population of Medicaid women, when they have an unintended
pregnancy, who pays? Well, by definition we do, because they're covered
by Medicaid ... $9,000 for every Medicaid birth," said Villarreal.
Although Gutierrez and Villarreal were in valedictory moods, there is
still a $20 gap between retail-pharmacy and clinic reimbursement rates,
a gap Villarreal would like to see closed. "I think it is a question
about equity," he said. "Why would we favor for-profit pharmacies over
public pharmacies, public clinics that are providing direct health-care
suggestion: follow the $$.)
Villarreal gives credit for Hawkins' change of heart to the 1,800
people who signed his online petition, and to fellow legislators --
including Texas Rep and U.S. Senate candidate Rick Noriega -- who also
wrote the commissioner: "That's a whole lot of Texans saying, 'You
gotta rethink this decision, Mr. Hawkins.'"