Only days ago, some Iowa legislative sources indicated lawmakers were on track to adjourn by the end of this week. That never seemed likely, with the health and human services budget not yet approved by either chamber. Disagreements over abortion-related language in that bill have been one of the last sticking points between Iowa House Republicans and Senate Democrats in recent legislative sessions. The pattern is set to continue this year.
A marathon battle over whether Medicaid would continue to cover abortions in certain rare circumstances kept the 2011 legislature in session until the very last day of the fiscal year. In 2013, House Republican efforts to end state funding for abortions led to an deal giving Iowa's governor the unusual power to determine whether Medicaid would reimburse for abortions. (Governor Terry Branstad has never had to exercise that authority, because the University of Iowa Hospitals and Clinics decided not to seek reimbursement for the small number of abortions performed there annually.) In 2015, one of the final disputes House and Senate negotiators resolved was over new ultrasound requirements for women seeking abortions.
House Speaker Linda Upmeyer repeatedly promised last year that her caucus would try to end state funding to Planned Parenthood. Although Governor Terry Branstad supports that goal, there is almost no chance Iowa Senate Democrats will go along with the plan.
Planned Parenthood has never received state funding for abortions performed in Iowa, but it has long been one of the providers in the Iowa Department of Public Health's Iowa Family Planning Network, funded by Medicaid. Services covered:
• Birth control exams and advice.
• Limited testing and treatment for sexually transmitted infections (STIs).
• Pap tests
• Birth control supplies for men and women (see page 2).
• Voluntary sterilization for men and women who are over the age of 21
and have signed a valid Sterilization Consent Form.
• Pregnancy tests.
Family planning services provided as part of or as follow-up to a family planning visit are covered. Examples include services such as: colposcopy, repeat Pap smear, drugs for the treatment of STIs and treatment of yeast infections.
During last year's legislative session, House Republicans approved provisions in the health and human services budget that would have created a "State Family Planning Services Program" in place of the Medicaid Family Planning Network Waiver. (You can read that language here.)
House File 2460, the health and human services budget for fiscal year 2017, included nearly identical language, starting on page 81:
The Iowa House debated the health and human services budget until midnight on April 19. GOP State Representative Sandy Salmon had introduced an amendment with even stronger language on defunding Planned Parenthood, but she withdrew that amendment early in the floor debate. Over the next several hours, House Republicans rejected various Democratic amendments along party lines, including one that would have allowed Planned Parenthood to remain among the family planning network providers.
During the Iowa House floor debate, State Representative Beth Wessel-Kroeschell was among those who spoke out for continuing Planned Parenthood funding. She noted that Iowa would be turning down $3 million in federal funding by ending the family planning waiver program under Medicaid, Barbara Rodriguez reported for the Associated Press. She also pointed out that lawmakers "have a mandate" because "Iowans overwhelmingly support Planned Parenthood funding," Erin Murphy reported for the Mason City Globe-Gazette.
Wessel-Kroeschell was referring to the February 2016 poll by Selzer & Co for the Des Moines Register.
The Iowa Poll shows that 74 percent of Iowa adults want the state to continue paying Planned Parenthood for health services other than abortion. Just 22 percent oppose such payments. Even among Republicans, a slight majority support continuing the payments.
Planned Parenthood of the Heartland says about one-fourth of its Iowa financing, or nearly $2.7 million per year, comes from public sources. Most of that money comes from programs under Medicaid, which is jointly financed by the federal and state governments.[...]
The Iowa Poll shows that Republicans are split on the issue, with 51 percent favoring continued state financing of non-abortion services at Planned Parenthood and 48 percent saying it should be ended. Among Democrats, 94 percent favor continued funding, while just 4 percent oppose it. Political independents favor state financing of such services by 75 percent to 19 percent.
Seventy-eight percent of women want continued state financing of non-abortion services at Planned Parenthood, compared to 70 percent of men, the poll shows. Young people are more likely than their elders to favor it. Eighty-four percent of Iowa adults younger than 35 support continued funding, compared to 60 percent of people 65 or older.
Other unsuccessful Democratic amendments to the health and human services budget would have funded stronger oversight of the recently-privatized Medicaid program and would have required insurance companies to cover certain interventions for children with autism. (A bill to that effect died last month in the House Commerce Committee.)
Iowa House rules don't allow for votes after midnight, so the chamber adjourned at that time on April 19. The next day, state representatives passed House File 2460 along party lines. At this writing, the health and human services budget is under consideration by the Iowa Senate. The 26 Senate Democrats will not approve language defunding Planned Parenthood, especially knowing that public opinion is on their side.
How long this year's legislative session drags on will depend in part on how long Republican negotiators want to make a show of fighting over this issue. In 2015, GOP leaders capitulated relatively quickly on Planned Parenthood funding, more motivated to enact new language on ultrasounds for women seeking abortions. Lawmakers who will work out a deal on the health and human services budget will have other provisions to argue about, in particular Medicaid oversight. But Upmeyer may want to demonstrate to Republicans who deeply oppose Planned Parenthood that she is making good on her promise to defund.
Speculation about the eventual human services budget compromise or other relevant comments are welcome in this thread.
UPDATE: When the Iowa Senate debated the human services budget on April 22, Democrats offered a substitute amendment that did not include the defund Planned Parenthood section. GOP State Senator Ken Rozenboom offered an amendment to the Democratic amendment, which would have added language replacing the Medicaid family planning waiver with a new state program, excluding abortion providers.
Rozenboom's amendment fell one vote short of passage, with Democratic Senator Joe Seng joining all 24 Republicans to support it. The other 25 Democrats voted no.
Shortly thereafter, the Senate adopted the substitute amendment by voice vote and approved the human services budget along party lines. Although the roll call shows Minority Leader Dix joining the 26 Democrats to support the bill, he submitted a comment to the Senate Journal later that day, explaining that he had pressed the wrong button by accident during the voting.
Speaking to reporters on April 25, Branstad expressed support for the House Republican proposal to defund Planned Parenthood: "I think that is the appropriate way to go, and I respect the legislative processes of working these differences out."
Last year Branstad faced pressure from social conservatives when he refused to order a halt to state funding for Planned Parenthood, as some other GOP governors have done (in breach of federal law).