Lack of health care coverage contributes to Texas's serious sexual health problems. 

What Women Really Think
July 9 2012 1:41 PM

Texas Refusal To Comply With ACA Will Hurt Sexual Health Outcomes

Rick Perry
Gov. Rick Perry addresses the the annual Conservative Political Action Conference on Feb. 9, 2012 in Washington, D.C.

Photograph by Win McNamee/Getty Images.

Gov. Rick Perry is known for his love of playing footsie with the idea of secession, though he tends to couch that rhetoric by claiming that the breaking point is at some hypothetical future date, when those damn Yankees think of doing something as awful as they did last time, with their claims that slavery was an evil that shouldn't be tolerated in a free society. And while we're not at letting-the-abolitionists-have-their-own-political-party level, that rhetoric has its consequences. It's no doubt why Perry was swift to announce that Texas is simply going to refuse to participate in two of the biggest pieces of the Affordable Care Act that would help the 25 percent of Texans that are currently uninsured get coverage: the state exchanges and the Medicaid expansion.

Of the two, the latter seems like it's going to be the bigger issue. The federal government has protocols to set up exchanges for states that don't do it, so Perry's petulance won't prevent people from getting insurance through an exchange. But refusing the Medicaid expansion will leave 1.8 million Texans who would otherwise be insured out in the cold. This is going to be bad for a whole host of reasons, but one that's worth noting is that it's going to be very hard to turn the ship around when it comes to Texas' shockingly poor sexual health outcomes when you leave so many people uncovered.


While STD and unintended pregnancy rates are the result of complex factors, the aggressive lack of interest the Texas government shows in getting health care to its residents shouldn't be discounted as a major part of why it's so bad there. It's a simple formula: When people don't get treated for STDs, they're more likely to pass them on. When women don't have the money to go to a doctor, they're unlikely to get onto some of the most effective forms of birth control. The results are startling. For instance, the chlamydia rate in Texas from 2003-10 rose from 310 cases out of 100,000 people a year to 467 cases per 100,000, which means a net gain of 50,000 cases, a 73 percent increase in cases. How much of this increase is due to people ignoring symptoms because they simply can't afford to see a doctor?

Texas doesn't do much better when it comes to teen pregnancy, either. The national teen pregnancy rate in 2005 was 70 pregnancies per 1,000 girls ages 15-19. In Texas? Eighty-eight pregnancies per 1,000 girls. Some of why that rate is so much higher becomes much more clear when you compare Texas contraception rates to the rest of the country. Texas teenagers reported using a condom the last time they had sex by about 3 percentage points under the national average. But the gap between Texas girls on the pill at last sex and girls nationwide is bigger, at six percentage points. Considering that 17 percent of Texas minors are uninsured compared to 10 percent of minors nationwide, that gap is utterly unsurprising. Getting onto the birth control pill is something that's mostly available to those with insurance. The slow squeezing out of contraception funding in the state over the past few years certainly hasn't done anything to make that situation better. 

Amanda Marcotte is a Brooklyn-based writer and DoubleX contributor. She also writes regularly for the Daily Beast, AlterNet, and USA Today. Follow her on Twitter.



The Democrats’ War at Home

How can the president’s party defend itself from the president’s foreign policy blunders?

Congress’ Public Shaming of the Secret Service Was Political Grandstanding at Its Best

Michigan’s Tradition of Football “Toughness” Needs to Go—Starting With Coach Hoke

A Plentiful, Renewable Resource That America Keeps Overlooking

Animal manure.

Windows 8 Was So Bad That Microsoft Will Skip Straight to Windows 10


Cringing. Ducking. Mumbling.

How GOP candidates react whenever someone brings up reproductive rights or gay marriage.

Building a Better Workplace

You Deserve a Pre-cation

The smartest job perk you’ve never heard of.

Hasbro Is Cracking Down on Scrabble Players Who Turn Its Official Word List Into Popular Apps

Florida State’s New President Is Underqualified and Mistrusted. He Just Might Save the University.

  News & Politics
Sept. 30 2014 9:33 PM Political Theater With a Purpose Darrell Issa’s public shaming of the head of the Secret Service was congressional grandstanding at its best.
Sept. 30 2014 7:02 PM At Long Last, eBay Sets PayPal Free
Sept. 30 2014 7:35 PM Who Owns Scrabble’s Word List? Hasbro says the list of playable words belongs to the company. Players beg to differ.
  Double X
The XX Factor
Sept. 30 2014 12:34 PM Parents, Get Your Teenage Daughters the IUD
  Slate Plus
Behind the Scenes
Sept. 30 2014 3:21 PM Meet Jordan Weissmann Five questions with Slate’s senior business and economics correspondent.
Brow Beat
Sept. 30 2014 8:54 PM Bette Davis Talks Gender Roles in a Delightful, Animated Interview From 1963
Future Tense
Sept. 30 2014 7:00 PM There’s Going to Be a Live-Action Tetris Movie for Some Reason
  Health & Science
Medical Examiner
Sept. 30 2014 11:51 PM Should You Freeze Your Eggs? An egg freezing party is not a great place to find answers to this or other questions.
Sports Nut
Sept. 30 2014 5:54 PM Goodbye, Tough Guy It’s time for Michigan to fire its toughness-obsessed coach, Brady Hoke.