Hot Topic: Access to Reproductive Healthcare

Barriers affecting women’s access to reproductive healthcare in Texas.

By Kasee Bailey

In a state that boasts a top-of-the-nation economy, accounts for nearly a quarter of total U.S. exports and includes a capital deemed to be the best barbecue city, Texas holds strong to everything is bigger–but is everyone’s health better? The Lone Star State holds the next-to-last position in overall performance for women’s health and reproductive care–just ahead of Mississippi–along with being the lowest ranked state in coverage, access and affordability to health care, according to the Commonwealth Fund.

“There are huge opportunities for growth,” says Katherine Strandberg, Director of Policy at Every Body Texas. 

The salience of discussion surrounding reproductive healthcare is emphasized by the above-the-fold legislative agendas and policies–including the 2022 U.S. Supreme Court case overturning Roe v. Wade and SB 8–and across-the-aisle conversations happening throughout the United States. In the consequential battleground of this significant hot-button topic, the fact is: where you live matters.

Every Body Texas is the largest Title X grantee in the country that funds a network of 32 agencies and 165 clinics. Strandberg sees opportunities for the organization to support access to healthcare for all Texans.

“And that healthcare, of course, includes access to preventive women’s healthcare services,” says Strandberg. “I think about really basic preventive healthcare–like diabetes screening, cardiovascular health screenings–those levels of population health are so important to people being able to live their full lives.”

Many feel that healthcare for women in Texas is under threat. The 2024 Commonwealth Fund report shares that the “perilous” conditions of the healthcare landscape are evidenced by the fact that, as a state with the second-largest population in the nation, Texas is immensely underperforming in health and reproductive care outcomes; coverage, access, and affordability; and health care quality and prevention. 

Troubling trends in women’s health, like long-term issues or deaths from preventable causes, have emerged in recent years, as policy changes and judicial decisions have been made around access to a full range of health and reproductive services for women. Reproductive health and access to it isn’t just a personal issue, it’s a community concern.

Places in the state, like Every Body Texas, believe that basic access to consistent healthcare services is a cornerstone to being able to have a thriving family.

But in many cases, both basic and quality healthcare for women is inaccessible. Nearly 1.7 million women of reproductive age live in Texas’ contraceptive deserts, according to a study from Power to Decide. Contraceptive deserts are counties–where typically low-income and people of color reside–that lack access to all methods of contraception.

Barriers affecting access to healthcare in Texas, includes: affordability of insurance and care, lack of transportation, costs for time away from work or caregiving, immigration status, access to providers and healthcare clinics due to judicial policies.

“Women of reproductive age have unique healthcare needs that have long left them vulnerable to health industry profit motives and discrimination, and political and judicial decisions that create barriers to their ability to access timely healthcare,” according to the The Commonwealth Fund study. 

The future of women’s access to the full spectrum of healthcare, especially reproductive and sexual healthcare, is largely affected in nearly half of the states where abortion access is either banned or significantly restricted. Since 2022, medical residency applications–across specialities–have declined further in states that ban abortions compared to ones where abortion remains legal, according to the Association of American Medical Colleagues.

And in 2024, with the most recent legislative session, Strandberg does feel there is some space for optimism.

“The authors of the budget set aside ten million dollars for mobile health for preventive women’s health care services, with an eye toward that 1.7 million women who live in reproductive healthcare deserts” says Strandberg. 

In the same session, medicaid coverage for women who give birth was expanded from two months to twelve.

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