More than simply banning abortion providers like Planned Parenthood from participating in the Texas Women’s Health Program (WHP), the state Department of Health and Human Services has proposed new rules that would prevent any doctor in the program from discussing the option of abortion with patients.

But medical groups in Texas are pushing back against this restrictive measure. In a letter to the state health department, the Texas Medical Association and four other groups representing 47,000 doctors and medical students explained that the provision would endanger ethics and relationships with patients if they cannot discuss all options:

“The relationship between patient and physician is based on trust and creates the physician’s ethical obligations to place the patient’s welfare above his or her own personal politics, self-interest and above obligations to other groups,” the letter states.

State health officials responded in a written statement, saying they appreciate the groups’ concerns and will carefully review all the input they get on the proposed rule. “We understand that doctors have certain professional obligations to their patients, and we want to ensure that the rule allows doctors to meet those obligations,” Health and Human Services Commission spokeswoman Stephanie Goodman said.

If the rule goes into effect, the groups argued that doctors might stop working with the embattled Women’s Health Program. The 130,000 women in the program were already facing a limited number of care providers after Texas officials blocked Planned Parenthood and abortion providers, which made up half of the participating clinics. As the Texas Tribune points out, the Women’s Health Program provides health screenings and contraception — but not abortions — to some of the poorest women in Texas who will be hurt the most as the state continues to limit their health care options.

The passage of the Affordable Care Act has marked significant benefits for women, including ensuring increased access to contraceptive services and putting an end to discriminatory insurance practices that charge women higher rates simply based on their gender. And there is yet another important way that Obamacare is helping to advance women’s health under a new program called the Pregnancy Assistance Fund (PAF).

PAF helps fund programs across the country that provide services for pregnant teens and young adults, such as increased sexual education and parenting classes. As RH Reality Check reports, Shauna Humphreys runs one organization working with young Native American mothers in Oklahoma that benefits from PAF grants to bolster their critical services:

Vastly more robust than the program Humphreys ran prior to receiving a 3-year PAF grant at $900,000 per year, [her organization] is staffed with six caseworkers who visit clients’ homes monthly to deliver parenting and life skills training. Caseworkers also serve as a general support network for young women who are experiencing domestic violence.

“These young women need this level of support. They typically don’t have anyone helping them to meet their personal goals,” said Humphries, herself a mother of twins. “I can’t imagine being pregnant in high school and trying to figure out my life after having a child.”

The United States has a higher rate of teen pregnancy than any other developed country in the world. Although the teenage pregnancy rate has been steadily dropping throughout the country, it still remains high in some states that are failing to provide adequate preventative care, such as comprehensive sex education, for teenagers and young adults. Teen pregnancy is correlated with increased education and income gaps.

Of course, if Republicans succeed in repealing the health care law — which they have already spent up to 89 hours and $51 million dollars trying to do — PAF will cease to exist along with the rest of the important provisions of the law that work to expand access to health services to millions of Americans. Stories like Humphreys’ underscore the point, however, that the battle over health care reform is more than a purely political issue when it directly impacts American people struggling to gain access to the care they need.

In a new report, the Centers for Disease Control and Prevention (CDC) found that only 69 percent of doctors nationally would accept new Medicaid patients — though those numbers vary nationwide. For example, 40 percent of New Jersey doctors would take new Medicaid patients, compared to 99 percent in Wyoming, largely because of the varying reimbursement rates for Medicaid doctors. New Jersey has the lowest reimbursement rate, while Wyoming has the highest.

The study’s author Sandra Decker, an economist with the CDC, points out that this correlation applies to the overall trend for the places where doctors are more likely to accept more Medicaid patients:

And Decker notes that having more doctors accept new patients under Medicaid “may increase the number of times that a Medicaid patient sees a physician and decrease reliance on hospitals for outpatient care.”

But with one-third of doctors reporting that they will not take new Medicaid patients, access to doctors is a growing problem ahead of the full implementation of Obamacare. When the health care reform law is fully in effect by 2014, millions of people will be added to the health care program under the Medicaid expansion. States can choose to opt out of the expansion, and some Republican state officials have indicated that they will do so, despite the billions of dollars the federal government is offering to help pay for the additional patients and to expand community health centers.

The Affordable Care Act helps with this issue by increasing the reimbursement rate for primary care doctors in 2013 and 2014 who treat Medicaid patients to boost doctor participation. But the higher amount — a 30 percent increase nationally and 50 percent in New Jersey — is only temporary, although Congress likely will be pressured to continue it.