Texas Gov. Rick Perry attempted to defund his state's Planned Parenthood clinics earlier this year by barring it and another "abortion affiliates" from receiving federal money under the Texas Women's Health Program (TWHP).  After the policy effectively cut off half of the state's participating clinics from the program, the Obama administration announced it would end Medicaid funding for TWHP, which serves low-income women. Perry insisted the state would fund the program itself -- and on its own terms.

In Texas, that apparently means blocking funding for clinics with doctors who even talk about abortion.

In a letter sent to the Court of Appeals for the Fifth Circuit this week, Texas' Department of Health and Human Services and Attorney General's Office made it clear that, in the state's new program, doctors would be banned from even discussing even the existence of abortion with their patients.

In the letter explaining the new rules, the state writes that it has expanded its funding ban from abortion affiliates -- abortion providers or clinics associated with providers -- to "promoters" and anyone affiliated with them.

"Section 39.38 requires a health-care provider to follow procedures set out in Title 1, Chapter 354 of the Texas Administrative Code. The section also requires a TWHP provider to ensure that (1) outside the scope of TWHP, the provider does not perform or promote elective abortions and does not affiliate with an entity that performs or promotes elective abortions; and (2) within the scope of TWHP, the provider does not promote elective abortions, is physically separated from any abortion-providing or abortion-promoting entity, and does not operate under an identification mark that is registered to an entity that performs or promotes elective abortions," the letter explains.

What does it mean to "promote" abortion? According to the state of Texas, it includes providing a patient with a referral to a facility that performs abortions, displaying information to a patient that "publicizes or advertises an abortion service or provider", displaying a "brand name" of a health care provider that performs abortions or referring to abortion as "within the continuum of family planning services."

That essentially means that if a low-income woman with coverage under TWHP becomes pregnant and decides to seek out an abortion, her doctor would be banned from offering any guidance whatsoever on that decision.

The change is just the latest bit of bad news for low-income women in Texas. This week, Perry also announced the Lone Star State will turn down funding for the Medicaid expansion available under the Obama administration's health care reform law, which would have provided health insurance coverage for two million low-income state residents.

Texas and the Obama administration are currently duking it out in federal court over the legality of the state's attempt to remove Planned Parenthood from its Women's Health Program. So far, a judge has issued an injunction preventing the state from enforcing its new rule.

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