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Women throughout Texas have suffered a devastating loss of lifesaving access to health care. Over the last several years, more than 200,000 Texas women have lost their access to basic health care including cancer screenings, birth control, and the providers they trust. Seventy-six neighborhood health centers have had to close their doors.

The real life impact of these policies is severe and heartbreaking. Access to quality, affordable health care is not a political issue, no matter how much partisans in power have tried to make it one. It is a deeply personal issue. When a woman finds a lump in her breast, only to learn that the health care center she relied on is closed, no amount of political posturing alleviates her deep fear. When a woman in the Rio Grande Valley loses access to her annual exam, there is no talking point that will give her back the care she needs.

But now, in an infuriating and insulting twist, it seems as if those who caused such harm expect Texas women to send them Thank You cards. Despite all facts and experience to the contrary, those who cut access to care would like Texas women to believe their access has improved. It is outrageous to decimate women’s access to basic health care. It is even more outrageous to deny the realities of hundreds of thousands of Texas women.

Texas women, however, are anything but stupid. They understand the real world impact these policies have caused in their lives. Last summer made very clear that women are paying attention, and they know what harm has been dealt them.

The facts are that in 2011 the Texas Legislature slashed funding for the state’s family planning program by two-thirds and implemented a tiered funding system that excluded specialty family planning providers like Planned Parenthood from the program. As a result, Texas’ family planning program served only 75,160 women in 2012—63% fewer women than in 2011—and paid 15% more per client for care. This reduced access to birth control is expected to cost Texas taxpayers up to $273 million.

As a direct result of these policies, 76 health centers have closed or stopped providing family planning services and another 55 providers have reduced their hours.

During the most recent legislative session, the Texas Legislature adopted a biennial budget for 2014-15 that added $100 million in new funding to the state’s primary care program for women’s health, including family planning. But this new funding will primarily go to organizations that have not traditionally been the lead provider of family planning services in Texas. Despite the infusion of funding, Texas is still struggling to provide care for as many women as were being served before the budget shredding in 2011.

In yet another move to politicize women’s health care, in 2011, the Texas Health and Human Services Commission adopted rules that would exclude Planned Parenthood from the Medicaid Women’s Health Program. Nearly 40% of the women in the program relied on Planned Parenthood for cancer screenings, birth control, and other preventive health care.

In order to circumvent federal law preventing Texas from denying women access to qualified providers like Planned Parenthood, state lawmakers ended the Medicaid Women’s Health Program, rejecting approximately $40 million in federal matching funds for the program that covered 90% of the program’s cost. Researchers from George Washington University concluded that alternative providers are unable to handle the massive increase of patients that would be necessary to preserve the level of care the program provided in 2011 without Planned Parenthood. During the first six months of the new program, it was reported that birth control services declined by 38% and the number of well woman exams decreased by 23% overall.

No amount of fuzzy math or spin changes these facts, or the reality that women throughout the state are unable to get the care they need and deserve. What can change that reality is this November’s election. Women will decide the outcome of this election. And one fact we can all agree on is that you can’t win in Texas by working against Texas women.