What, now? Birth control, reproductive health in Texas

In the wake of the Supreme Court's Friday decision to overturn Roe v. Wade, eliminating the nearly 50-year-old constitutional right to abortion, many across the country and the state of Texas are unclear about their options for reproductive healthcare such as birth control.

AMARILLO, Texas (KAMR/KCIT) - In the wake of the Supreme Court's Friday decision to overturn Roe v. Wade, eliminating the nearly 50-year-old constitutional right to abortion, many across the country and the state of Texas are unclear about their options for reproductive healthcare such as birth control.

The state of Texas is among those with "trigger laws" criminalizing the act of providing an abortion, which is expected to go into effect after 30 days. However, as of the time of the Supreme Court decision, other forms of reproductive healthcare have remained more easily available in Texas.

Using resources such as the Centers for Disease Control and Prevention website, as well as Texas Health and Human Services, we have compiled an overview of common questions and resources regarding reproductive healthcare in the state.

What kinds are there? Types of birth control

Short-Acting Hormonal Reversible Contraceptives

• Oral contraceptive pills
• Contraceptive patch
• Vaginal ring
• Contraceptive shot

Long-Acting Reversible Contraceptives

• Intrauterine devices (IUD)
  • Levonorgestrel intrauterine system (LNG IUD)
  • Copper T intrauterine device (IUD)
• Contraceptive implants

"Barrier Method" Contraceptives

• Male or female condoms
• Spermicides
• Diaphragms
• Cervical Caps

"Natural Family Planning" or "Fertility Awareness-based" Birth Control

• Monthly fertility pattern and body temperature tracking

Emergency Contraception

• Copper T IUD
• Emergency contraceptive pills

Permanent Methods of Birth Control

• Female Sterilization - Tubal ligation or "tying tubes"
• Male Sterilization - Vasectomy

Where can I find it? Reproductive healthcare access

The Marketplace - subsidized health insurance

• Those interested in low-cost health insurance through the Affordable Care Act may check with Healthcare.gov to review costs and qualifications.

Title X - Sliding scale clinics

• Texas is home to around 200 "Title X" clinics, which offer reproductive healthcare services and do not turn away people for an inability to pay. According to the US Department of Health and Human Services, Title X clinics also offer services such as:
  • HPV vaccination
  • Provision of HIV pre-exposure prophylaxis (PrEP)
  • Breast and cervical cancer screening
  • Screenings for obesity, smoking, drug and alcohol use, mental health and intimate partner violence.
• Teens under the age of 18 do not need parental consent to get birth control at a Title X clinic, according to the Texas Legal Services Center.*

Title X clinics around the state of Texas can be found using the department's locator tool.

Healthy Texas Women - Texas state program

• The state of Texas hosts thousands of Texas doctors participating in the program covering basic reproductive healthcare. In order to qualify, a person must be:
  • A citizen or long-term legal resident
  • Female
  • Have an income of under 200% of the federal poverty level (around $25,000 for one person)
• More information and resources on the Healthy Texas Women program can be found here.

Family Planning - Texas state program

• The Family Planning program through the state of Texas is available to residents with an income under 250% of the federal poverty level (around $32,225 for one person) and covers basic reproductive healthcare.
• Parental consent is required for minors.
• More information and resources on the Texas Family Planning program can be found here.

Web applications - Low-cost birth control deliveries

• A number of commercial apps allow for ordering birth control, emergency contraception, STI screening kits, and HIV prevention medication online that can be mailed to a person's doctor.
• A list of delivery and online resources for birth control can be found here.

Is it covered? Reproductive healthcare costs and insurance coverage

Subsidized Health Insurance

According to the Affordable Care Act, plans in the subsidized health insurance marketplace must cover contraceptive methods and counseling for all women, as prescribed by a healthcare provider. Those plans must cover those healthcare services without charging a copayment or coinsurance when provided by an in-network provider.

FDA-approved contraceptive methods prescribed by doctors are covered, such as:

• Barrier methods
• Hormonal methods
• Implanted devices
• Emergency contraception
• Sterilization procedures
• Patient education and counseling

However, those plans are not required to cover drugs that induce abortions and services for male reproductive care such as vasectomies.

Employer-provided coverage

Religious employers

• Health plans sponsored by certain exempt religious employers, such as churches and houses of worship, do not have to cover contraceptive methods and counseling.

Nonprofit religious organizations

• Some nonprofit religious organizations - such as hospitals and institutions of higher education that certify they have religious objections to contraceptive coverage - don't have to contract, arrange, pay, or refer for contraceptive coverage. However:
  • If a health plan is sponsored or arranged by this type of organization, an insurer or third-party administrator will make separate payments for contraceptive services.
  • A person will have access to contraceptive services without a copayment, coinsurance, or deductible when they are provided by an in-network provider.

What about minors? Texas confidentiality laws

As noted by Chapter 32 of the Texas Family Code, and the University of Michigan in a 2018 review of Texas confidentiality laws, a parent or guardian must provide consent on behalf of a minor before healthcare services are provided, with several exceptions. Those exceptions are based on a minor's status, the type of service, and/or the clinic's funding source.

Minor Consent Based on Status

Minors are considered to be able to consent to healthcare services without a parent or guardian if they are any of the following statuses, including:

• Married
• On active duty in the armed services
• Serving in an adult prison
• 16 years old or older, living apart from parents or guardians, and managing their own financial affairs.

Minor Consent Based on Service

Patients under 18 may consent to certain health services without a parent or guardian's consent, such as:

• Pregnancy testing and prenatal care, other than abortion
• Non-prescription contraceptives
  • Condoms
  • Over-the-counter emergency contraception
• STI testing and treatment for reportable STIs
  • Chlamydia
  • Gonorrhea
  • HIV
  • Syphilis
• Counseling and treatment for suicide prevention or substance abuse
• Inpatient mental health care, for those aged 16 or older
• Counseling and treatment for suspected abuse or neglect

Minor Consent Based on Funding Source (Medicaid or Title X)

• Patients of childbearing age may receive all FDA-approved contraceptive methods aside from sterilization without parental consent. Minors with Medicaid who are accessing contraception have a federal right to confidentiality.
• Almost all children in the foster care system are covered through Medicaid, and therefore may consent to their own contraception including long-active methods like implants or IUDs.

Healthcare providers can choose but are not obligated, to tell parents or guardians about any care provided to the minor patient.