On Thursday Iowa Senate Republicans approved a bill that would end most state and federal funding for Planned Parenthood’s family planning services. All 29 Republicans and independent Senator David Johnson voted for Senate File 2, while all 20 Democrats voted against the measure. The Senate Judiciary Committee had approved the bill on a party-line vote the previous day.
Passage was a foregone conclusion, since the entire GOP caucus co-sponsored the bill, and statehouse Republicans have been trying to defund Planned Parenthood for years.
Although I already knew Republican lawmakers were willing to force the state to spend ten times more for family planning services, with no reliable funding stream, I still learned some new things watching Senate File 2 move through the upper chamber.
Republicans didn’t even try to claim Planned Parenthood doesn’t offer quality family planning services.
Planned Parenthood is the largest Iowa provider under the Medicaid Family Planning Waiver, which covers not only contraception services, but also pregnancy tests, Pap smears, and testing or treatment for some sexually transmitted diseases. According to Iowa Department of Human Services spokesperson Amy Lorentzen McCoy, about $963,000 of the $3.4 million spent on the Iowa Family Planning Network during the last fiscal year went to Planned Parenthood clinics. She could not say how many of the 12,219 Iowans who used the network last year obtained their services through Planned Parenthood. They must number in the thousands.
As Democratic State Senator Janet Petersen described in her opening remarks during the February 2 Senate debate (enclosed in full at the end of this post), the Iowa Family Planning Network “has helped more than 80,000 Iowa women and men access family planning services across our state since 2006.” The program has been inexpensive for Iowans, because of the 90/10 federal match. It has contributed to the trend of fewer unplanned pregnancies and abortions in Iowa. The program has also saved taxpayers lots of money, Petersen added.
An evaluation of the program by the University of Iowa Public Policy Center in May of 2016 showed:
The family planning waiver has increased the number of women receiving family planning services within the Medicaid program.
Medicaid costs for deliveries and birth and first years of life have declined by nearly $345 million.
Very conservative estimates of net Medicaid savings are more than $265 million.
No Republican at any stage of debating Senate File 2 argued that there was anything wrong with the non-abortion services thousands of Iowans have received through Planned Parenthood. Rather, their bill is an ideological statement.
Near the end of the Senate Judiciary Committee’s February 1 meeting on Senate File 2, committee chair Brad Zaun read out a long letter he received from an Iowa woman thanking him for supporting the bill. Most of her message was about how she wishes she had not had a medical abortion through Planned Parenthood. I empathize with Zaun’s correspondent, but what she went through has nothing to do with family planning services. If she had been able to avoid her unwanted pregnancy, she would never have chosen to have an abortion she now regrets. (Incidentally, most women who have had an abortion do not regret their decision.)
In her concluding remarks before the Judiciary Committee voted on Senate File 2, State Senator Amy Sinclair said the bill was about “connecting folks with their home health care” and “defending the conscientious objections of the many, many Iowa taxpayers in subsidizing organizations that participate in the intentional and unnecessary termination” of pregnancies.
Similarly, Sinclair told Democratic Senator Matt McCoy during the February 2 floor debate that taxpayers of Iowa “do not wish to subsidize the shared facility costs of those organizations that provide abortion.” She ignored the fact that some Planned Parenthood clinics in Iowa do not offer abortion services.
During Senate floor debate on January 26, Petersen challenged Senator Mark Costello, the new chair of the Senate Human Services Budget subcommittee, on several aspects of Senate File 2. Asked to justify the bill, Costello said, “It’s our belief that we don’t need to have people doing business with someone that they feel is not a responsible party.”
Which “they” are you talking about Senator? Surely Costello meant that he and his GOP colleagues want to prevent others from doing business with an entity anti-abortion activists don’t care for. He put it more plainly speaking to KMA News on February 3: “I believe myself that people should not have to do business with abortion providers, because many provide [sic] it very unacceptable.”
Contrary to what Costello implies, no one has to do business with Planned Parenthood under the current system. Yet he and 29 colleagues would deny Iowans the option of using their preferred health care provider, because some people find abortion “unacceptable.”
DHS spokesperson McCoy explained that Senate File 2 would not affect Planned Parenthood’s reimbursements for providing non-abortion services to Iowans who are covered by Medicaid, rather than through the Iowa Family Planning Network. Nevertheless, thousands of Iowans who have utilized the Family Planning Waiver will have to seek medical care elsewhere if Senate File 2 becomes law–and that won’t be as easy as Republicans make it sound.
Republicans can’t back up their talking points about “access.”
Republican lawmakers have repeatedly asserted that Senate File 2 will make family planning services more available, especially in rural Iowa. This portion of an e-mail my own State Senator Charles Schneider sent to a different constituent is typical:
Currently, family planning funding is only available in a limited number of clinics in Iowa. This bill will substantially increase the number of facilities at which these services will be provided. This is especially important for women who live in rural Iowa and must travel long distances to access care. The bill ensures that those who currently receive family planning services from Planned Parenthood will still be able to receive those same services (and in some cases even better levels of service) but at more locations. Thus, this bill increases the options available to women and improves their access to care.
What a disingenuous message from someone who is often among the more thoughtful and fact-oriented members of his caucus. If Republicans wanted to increase the number of qualified providers of family planning services, they could do so without excluding Planned Parenthood from the program.
Many health care providers have long backlogs. Senate Republicans don’t need to take my word for it–just ask GOP State Representative Ashley Hinson. She explained at a public forum last month that she used Planned Parenthood services when she moved to the Cedar Rapids area and “couldn’t get in to an OB/GYN for over a year.”
Republicans claim hundreds of federally qualified providers could meet the needs of Planned Parenthood’s clients. Yet when KCCI’s Todd Magel investigated some Des Moines facilities on that list, he found they included a dental practice, a high school nurse’s office, and a homeless shelter.
In addition, some clinics Republicans have suggested as alternative providers (such as Agape or Birth Right, mentioned by Senator Zaun during the Judiciary Committee meeting) are only crisis pregnancy centers. Women can receive free pregnancy tests and anti-abortion counseling there, but not STD testing, cancer screenings, long-term reversible birth control, and so on.
Even when a local health care provider does offer a wide range of family planning services, many Iowans choose Planned Parenthood instead. William Petroski’s latest report for the Des Moines Register noted, “for many rural Iowa women, Planned Parenthood’s supporters say its urban clinics offer privacy and discretion not always available at small town doctors’ offices.”
During the Judiciary Committee meeting and on the Senate floor, Petersen cited alarming statistics on what happened in Texas after state lawmakers defunded Planned Parenthood services and redirected much of the “family planning” funding to crisis pregnancy centers. Maridith Morris wrote here last year about the twofold increase in maternal mortality in Texas, accompanied by a spike in unplanned pregnancies among teenagers and low-income women.
For those reasons, some members of the medical community have warned Iowa lawmakers against passing Senate File 2. Petersen read out one such letter yesterday during her opening remarks. She also noted that in committee,
I questioned several bill sponsors about how their new program would “increase access.” Not one senator could answer the question.
Iowa women aren’t buying your “increased access” talking point.
That is because SF 2 DOES NOT “INCREASE ACCESS” to providers.
Senate File 2 DOES NOT GIVE WOMEN MORE OPTIONS FOR HEALTH CARE.
In fact it will force thousands of Iowa women to leave a provider they chose and go to a provider selected by 29 politicians.
It will disqualify many of Iowa’s most qualified health specialists from serving Iowa women in the program.
Providers aren’t magically going to fall out of the sky for this new program.
The most cringe-worthy moment from the committee meeting was featured in Steffani Nolte’s January 31 report for KCCI-TV. Petersen asked new GOP Senator Jeff Edler, “What new providers will be added in your area once this legislation becomes law?” Edler replied, “More access.” Petersen followed up: “What do you mean by more access?” Edler responded, “Basically, they’re gonna have, well, the access is existing, but it is gonna provide [long pause]…” Nolte added, “Senator Edler turned off his microphone and didn’t finish answering the question.”
The names of health care providers who can serve Planned Parenthood’s clients are not the only thing Republicans don’t know.
Republicans can’t say how they will fund the new family planning program.
For two years running, Iowa House Republicans proposed diverting federal funds from the Social Services Block Grant to pay for a family planning program excluding abortion providers. Governor Terry Branstad’s staff told Barbara Rodriguez of the Associated Press last month that the same federal block grant would cover some $3 million in annual costs to operate the new program.
Turns out Senate Republicans are not committed to that plan.
The Legislative Service Agency’s fiscal note on Senate File 2 estimated the bill would “increase General Fund expenditures by $2.1 million in FY 2018 and $3.1 million when implemented for a full year in FY 2019.”
When questioned by Petersen on January 26, Costello admitted he doesn’t know how much money the state of Iowa currently spends on the Medicaid Family Planning Waiver, and indicated that he doesn’t know how the new program will be financed.
When the Judiciary Committee discussed this bill, GOP Senator Jason Schultz said “they’ll find the money elsewhere,” without being specific.
McCoy hammered this point home during his February 2 remarks on the Senate floor. Beginning around the 5:00 mark of this video, he asked Sinclair where the money will come from. She countered, “This is a policy bill strictly,” and its financial aspects will be handled during the appropriations process. Sinclair acknowledged that the governor made a recommendation (alluding to the Social Services Block Grant), then told McCoy, “I can’t say that that’s where the final appropriation will come from. […] This bill does not identify the source of funding.”
McCoy then pressed Costello, the lead Senate Republican on appropriations for human services. Costello couldn’t say where Republicans will find an extra $3 million per year for family planning services but promised, “We are committed to getting the money from somewhere. […] We will find the money, we will make it a priority to do that.”
Costello told KMA News on February 3,
Some of that may actually come through the form of a block grant from the federal government–we’re not sure how, exactly, we’ll take the funds from that. But, that’s the idea of that. I think it’s a good thing that people who don’t believe in abortions should not be required to pay for them.”
As Bleeding Heartland discussed here, taking $3 million from the Social Services Block Grant would undercut services for vulnerable children and adults with disabilities. Moreover, Congress may discontinue that block grant soon. But why worry about fiscal responsibility when you can score points with your base?
One more reality became clear during Senate deliberations on the bill defunding Planned Parenthood.
Senator Sinclair is not ready for prime time.
As the only woman in the 29-member GOP Senate caucus, Sinclair was the perfect choice to run this bill. Again and again, she denied Senate File 2 would hurt women’s health care and described how women and men would benefit from access to family planning in their own communities.
Sinclair demonstrated that she can deliver prepared statements in a polished manner. When thrown off script, she was far less impressive.
The Judiciary subcommittee hearing on Senate File 2 brought hundreds of Planned Parenthood supporters to the capitol. Chairing that proceeding, Sinclair didn’t handle the situation gracefully. She allowed only 25 minutes of public comments and in a striking breach of Iowa Senate practices did not let Petersen ask questions about the bill.
After Democratic Senator Nate Boulton spoke against the legislation on February 2, Sinclair ad libbed, “Senator Boulton, I’m a little surprised at you … 1973 ruling, I mean, I don’t know how old you are, but your mom could have chosen for you to not be here.”
Then she smirked.
Sinclair apologized on the Senate floor following an objection from Minority Leader Rob Hogg, but it was too little, too late. At this writing, the video of her tasteless comments has hundreds of social media shares. I saw many Facebook posts on Thursday encouraging friends to donate to Planned Parenthood of the Heartland in Sinclair’s “honor.”
People will remember Sinclair’s contempt for colleagues who stood up for women’s health care.
If Iowa House Republicans are smart, they will choose a more capable floor manager for this bill.
Any relevant comments are welcome in this thread.
UPDATE: A reader forwarded correspondence with GOP Senator Mike Breitbach. Asked how he could vote for a bill that will cost Iowa taxpayers more money, just to punish Planned Parenthood, Breitbach replied, “It was an easy vote all I had to do was think about 4000 babies being killed each year in Iowa.”
According to last year’s Iowa poll for the Des Moines Register by Selzer & Co, “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.”
State Senator Janet Petersen’s opening remarks during the February 2 floor debate on Senate File 2 (emphasis in original):
Thank you Mr. President.
This bill is bad for Iowa women and families.
It will create more unintended pregnancies, more high risk pregnancies, and cost Iowa taxpayers more.
Iowans don’t support it. Doctors warn against it. We should listen to them and reject it.
Last week, Senator Sinclair held a 25-minute subcommittee on Senate File 2.
Hundreds of Iowans came to the statehouse that day to make their voices heard about their opposition to Senate File 2, which will gut Iowa’s Family Planning Network.
Senator Sinclair cut off their testimony after 25 minutes.
Senators were not allowed time to ask questions about the bill or provide facts about Iowa’s Family Planning Network.
I have served in the Iowa Legislature for 17 years. I have never seen a subcommittee conducted that way.
I stayed for nearly an hour after the meeting to listen to Iowans and make sure their stories were heard.
It is unfortunate that not one of the 29 Republican sponsors stuck around to hear what Iowans have to say about their bill – Senate File 2.
Apparently 28 Republican men and 1 Republican woman know what’s best for women’s health care.
To the thousands of Iowans who have written me, asking me to FIGHT SF 2, and to the hundreds of Iowans who have SHOWN UP at the statehouse to have my back, I am HONORED to be your voice today.
Here is what I’ve learned about Senate File 2 so far…
Senate File 2 guts Iowa’s Family Planning Network, a program that has helped more than 80,000 Iowa women and men access family planning services across our state since 2006.
We know the Iowa Family Planning Waiver works.
It has helped reduce abortions and Medicaid costs in Iowa.
The Iowa Family Planning Network is inexpensive for taxpayers.
Iowa’s Family Planning Network program has saved Iowa taxpayers MILLIONS of dollars.
We shouldn’t mess with the program.
LET’S LOOK AT THE FACTS:
The Iowa Family Planning Network WORKS.
An evaluation of the program by the University of Iowa Public Policy Center in May of 2016 showed:
The family planning waiver has increased the number of women receiving family planning services within the Medicaid program.
Medicaid costs for deliveries and birth and first years of life have declined by nearly $345 million.
Very conservative estimates of net Medicaid savings are more than $265 million.
The Iowa Family Planning Network saves Iowa taxpayers money.
For every 10 cents Iowa taxpayers invest in the program, we get an additional 90 cents from the federal government to help pay for the program.
Iowans invest roughly $300,000 in the program each year. When you add the federal dollars to Iowa’s investment, we get more than $3 million in preventative health services for Iowa women and men throughout the state.
The University of Iowa study shows Iowa taxpayers have saved nearly $3.40 for every dollar they invested in the Iowa Family Planning Network.
Under Senate File 2, Iowa will walk away from all of the federal funds that go to the Iowa Family Planning Network.
The new program devised by 28 men and 1 woman in the Iowa senate, NONE of WHOM have a medical degree, will put the entire cost of the program on the backs of Iowa taxpayers.
It is also important to note, there is no money in Senate File 2 to start this new program.
Yesterday, Rep. Hogg asked Senate President Whitver to send the bill to the budget committee after we received the fiscal note that shows Iowa taxpayers will have to pay $3 million more EVERY YEAR for this Republican concocted program.
The President’s ruling:
Apparently, it doesn’t matter how much Republican-sponsored bills cost Iowa taxpayers anymore.
Just pass the bill and worry about the money later. We’ve heard that one before.
The current Iowa Family Planning program has reduced unintended pregnancies and abortions.
Senate Republicans want to scrap the successful program and force Iowa taxpayers to spend 10 times the money just to exclude Planned Parenthood from providing care to Iowa women and men.
SENATE FILE 2 does more than DEFUND PLANNED PARENTHOOD.
Under the Republican plan – Senate File 2 completely eliminates the Iowa Family Planning Network and replaces it with a state-run program that doesn’t exist and doesn’t have guaranteed funding to make it happen.
IT IS IMPORTANT TO REMEMBER, the Iowa Family Planning Network has NEVER funded abortions.
The Iowa Family Planning Network has been successful in preventing abortions and improving Iowa’s birth outcomes.
When you make it harder for Iowans to access family planning services, you increase the number of unintended pregnancies.
Gutting the Iowa Family Planning Network will cause more unintended pregnancies and abortions.
Senate File 2 – puts politicians in charge of women’s health care and THAT IS DANGEROUS.
We’ve been told a new state program will offer more providers and give women more options. That simply is not true.
On Tuesday, I questioned several bill sponsors about how their new program would “increase access.” Not one senator could answer the question.
Iowa women aren’t buying your “increased access” talking point.
That is because SF 2 DOES NOT “INCREASE ACCESS” to providers.
Senate File 2 DOES NOT GIVE WOMEN MORE OPTIONS FOR HEALTH CARE.
In fact it will force thousands of Iowa women to leave a provider they chose and go to a provider selected by 29 politicians.
It will disqualify many of Iowa’s most qualified health specialists from serving Iowa women in the program.
Providers aren’t magically going to fall out of the sky for this new program.
The so-called TIER process outlined in the bill and in DHS’s plan is totally confusing. We just got DHS’s plan yesterday.
Finding a provider to give you a Pap Smear shouldn’t be rocket science, but thanks to Senate Republicans – it soon could be.
EXAMPLE – if you pick a TIER 3 provider – you’ll have to let them know you would have to travel more than 25 miles to see another provider.
DHS says they can do marketing to explain their new PAP SMEAR TIERS.
Is that really what we want DHS wasting their time doing?
WOULDN’T we rather have DHS spend its time doing child protective investigations, figuring out how to get better mental health care for Iowans, taking care of Iowans with disabilities?
WHY are we getting rid of a program that works?
WHY are we getting rid of a program that prevents abortions and unintended pregnancies and the spread of sexually transmitted infections?
The bill doesn’t even explain how, when and how much providers will get paid to participate in the program.
Let’s remember, the women participating in our current Family Planning Network program are not participating in the program for ABORTIONS. It is the absolute opposite.
These Iowa women are participating in the Iowa Family Planning Network to take care of their bodies and to prevent unintended pregnancies and abortions.
YET, now a group of 29 politicians (28 of whom have NEVER gotten completely undressed, put on a paper gown, and put their feet in the stirrups for a vaginal exam) are telling women they know what is best for them.
Iowans have every right to be concerned about this legislation.
Iowa taxpayers have every right to be angry that we are giving up millions of dollars in federal funding to start another government program that will be paid for fully on the backs of Iowa taxpayers.
Iowans who worry about the health and safety of our children, people with mental illness and disabilities, should be piping mad that this program will take away funds that should have been going to them.
To the thousands of Iowa women who may lose their health care coverage and family planning coverage when Republican repeal ObamaCare – Senate File 2 is not prepared to add you to the program. You will be out of luck for your care under the new Republican program. It will offer first come, first serve birth control. If we keep our current system that actually works, the program would be able to include you – and at a very small cost to Iowa taxpayers.
God forbid, if we have a ZIKA outbreak or other disaster – the size of the program will not increase to keep up with the demand for Family Planning services as it would under the current Iowa Family Planning Waiver.
The document I received from DHS on Tuesday STATES on PAGE 5 – If spending exceeds the appropriated amount, CLAIMS WILL NOT BE PAID.
Yesterday, I asked a few of the bill sponsors about the letter we received from the American Congress of Obstetricians and Gynecologists (ACOG) and American College of Nurse-Midwives.
One sponsor said he’s sure he got the letter, but he didn’t read it or remember reading it.
IT WAS A WARNING LETTER ABOUT THE BILL from Iowa’s top health care professionals.
READ LETTER-
I cannot stress enough how dangerous it is to IGNORE doctors warnings about the dangers of this bill to women, girls and families in our state.
DO NOT TELL ME YOU ARE SUPPORTING THIS BILL BECAUSE YOU ARE PRO-LIFE – because this bill will most certainly lead to TRAGEDY like it has already, affecting our sisters in Texas.
HIGHLIGHT Texas Disaster examples
BOTTOM LINE –
This bill is dangerous and endangers the health of thousands of Iowa women.
This bill will cost Iowa taxpayers more money.
Under this bill Iowa women fewer options for their health care, NOT MORE. It decreases access.
28 Republican men and 1 Republican woman will tell women where they can go and can’t go for their care.
Let’s remember – 74% of Iowans support public funding to Planned Parenthood for family planning
THIS NEW PROGRAM only offers FIRST COME, FIRST SERVE birth control.
Who wants to come to a state that treats women like that?
Senate Republicans got rid of the economic development committee after taking control of the Iowa Senate. They said ECONOMIC DEVELOPMENT would be part of every committee’s work.
SO, let me say this – Senate File 2 – is a step in the wrong direction.
Gutting the Iowa Family Planning Network is not going to help Iowa improve its ranking from DEAD LAST for women entrepreneurs.
Why would we GUT the Iowa Family Planning Network?
The program works.
It SAVES taxpayers millions of dollars
It has helped reduce abortions and Medicaid costs.
We shouldn’t mess with it.
I urge the body to stand up for Iowans.
Stand up for Iowa women.
Stand up for Iowa girls.
Stand up for Iowa’s future.
REJECT SF 2.
END