Population Research Center, University of Texas at Austin, Austin, TX, United States.
Austin, TX, United States.
Contraception. 2023 Dec;128:110141. doi: 10.1016/j.contraception.2023.110141. Epub 2023 Aug 18.
This study aimed to explore Planned Parenthood Medicaid patients' experiences getting reproductive health care in Texas after the state terminated Planned Parenthood providers from its Medicaid program in 2021.
Between January and September 2021, we recruited Medicaid patients who obtained care at Planned Parenthood health centers prior to the state termination using direct mailers, electronic messages, community outreach, and flyers in health centers. We conducted baseline and 2-month follow-up semistructured phone interviews about patients' previous experiences using Medicaid at Planned Parenthood and other providers and how the termination affected their care. We qualitatively analyzed the data using the principles of grounded theory.
We interviewed 30 patients, 24 of whom completed follow-up interviews. Participants reported that Planned Parenthood reliably accepted different Medicaid plans, worked with patients to ameliorate the structural barriers they face to care, and referred them to other providers as needed. After Planned Parenthood's termination from the Texas Medicaid program, participants faced difficulties accessing care elsewhere, including same-day appointments and on-site medications. Consequences included delayed or forgone reproductive health care, including contraception, and emotional distress.
Planned Parenthood Medicaid patients found it difficult to connect with other providers for reproductive health care and to obtain evidence-based care following the organization's termination from Medicaid. Ensuring all Medicaid patients have freedom to choose providers would improve access to quality contraception and other reproductive health care.
Medicaid-funded reproductive health care access is restricted for people living on low incomes when providers do not reliably accept all Medicaid plans or cannot participate in Medicaid. This situation can lead to lower quality care, delayed or forgone care, and emotional distress.
本研究旨在探讨 2021 年该州终止计划生育联合会（Planned Parenthood）在其医疗补助计划中的服务提供商后，德克萨斯州的计划生育联合会医疗补助患者获得生殖保健的经历。
在 2021 年 1 月至 9 月期间，我们通过直邮、电子信息、社区外联和医疗中心的传单，招募了在州政府终止服务之前在计划生育联合会医疗中心获得护理的医疗补助患者。我们对患者之前在计划生育联合会和其他提供者处使用医疗补助的经历以及终止对其护理的影响进行了基线和 2 个月的后续半结构化电话访谈。我们使用扎根理论的原则对数据进行了定性分析。
我们采访了 30 名患者，其中 24 名完成了随访访谈。参与者报告称，计划生育联合会可靠地接受了不同的医疗补助计划，与患者合作解决他们在护理方面面临的结构性障碍，并在需要时将他们转介给其他提供者。在计划生育联合会被德克萨斯州医疗补助计划终止后，参与者在其他地方获得护理遇到了困难，包括当天预约和现场用药。其后果包括避孕等生殖保健的延迟或放弃，以及情绪困扰。
计划生育联合会医疗补助患者发现，在该组织被医疗补助终止后，他们很难与其他提供者联系以获得生殖保健，也很难获得循证护理。确保所有医疗补助患者都有选择提供者的自由，将改善获得优质避孕和其他生殖保健的机会。
当提供者不能可靠地接受所有医疗补助计划或不能参与医疗补助时，低收入人群的医疗补助资助的生殖保健机会就会受到限制。这种情况会导致护理质量下降、护理延迟或放弃，以及情绪困扰。
