Iowa Governor Doesn’t Want to Decide Who Gets Medicaid Funds for Abortion Care

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Iowa Governor Doesn’t Want to Decide Who Gets Medicaid Funds for Abortion Care

Teddy Wilson

The governor of Iowa has signaled that he doesn't want to be the sole arbiter of whether the state Medicaid program pays for certain types of abortion care, while Republican lawmakers in the state legislature seem unwilling to allow the governor to relinquish the role.

The governor of Iowa has signaled that he doesn’t want to be the sole arbiter of whether the state Medicaid program pays for abortion care under certain circumstances, while Republican lawmakers in the state legislature seem unwilling to allow the governor to relinquish the role.

Gov. Terry Branstad (R) in 2013 signed a bill into law that gave him the authority to decide on a case-by-case basis whether Medicaid funds will be used to reimburse people for abortion services when their pregnancies are the result of rape or incest, when there are fetal abnormalities, or to protect the life of the woman.

No other state in the nation has such a law.

Iowa Republicans during the 2013 legislative session had sought to prevent Medicaid funding for any abortion care, but Democrats, who controlled the senate, blocked the proposal. Branstad did not support fully eliminating the funding.

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Iowa Republicans’ attempts to block Medicaid funding for abortion care had failed in prior attempts.

During a tense floor debate, Sen. Jack Hatch (D-Des Moines) called the GOP-backed legislation “extreme,” and said that it was in direct conflict with federal law. “Are you willing to take over $1.5 billion of federal dollars away from the health and safety of every women, every child and every family involved in Medicaid in this state?” Hatch asked his colleagues.

Iowa lawmakers were able to negotiate a compromise in which Medicaid funding for abortion was not completely banned, and the governor would be given the power to decide on a whether Medicaid funds will be used for abortion care that qualified.

Branstad, since signing the law, has only been able to talk about the policy hypothetically. Since the rule was implemented there has yet to be a request for abortion care reimbursement.

The University of Iowa Hospitals and Clinics, where most of the Medicaid reimbursement-qualifying abortions were performed, has not billed the state since the implementation of the new law. Since July 1, 2013, the clinics have provided 34 abortion procedures, at an average cost of $961, that would have qualified for reimbursement under Medicaid, university spokesman Tom Moore told the Associated Press.

Branstad moved this week to change the policy.

Jimmy Centers, the governor’s spokesperson, told the Des Moines Register that Branstad did not include a renewal of the rule in his Medicaid budget proposal, in part because the rule has never been invoked.

“Gov. Branstad proposed language for the [Health and Human Services] budget that does not call for his approval for reimbursement on Medicaid claims,” Centers said.

Republican lawmakers may attempt to reinsert the language during the state’s legislative process. Rep. Linda Miller (R-Bettendorf), chairwoman of the Human Resources Committee, said that the language could be added to the Department of Human Services budget.

“I don’t think there’s been any change in the house’s position at this point,” Miller told the Des Moines Register.

Iowa Right to Life, the state’s largest anti-choice organization, had been supportive of the law. The organization now seems receptive to the governor’s move to change the policy, still confident that Branstad will support anti-choice policies.

Jenifer Bowen, executive director of Iowa Right to Life, told the Des Moines Register that after meeting with the governor’s staff, her organization has become supportive of the proposal. “We have no doubt he’s still solidly with us on this issue,” Bowen said.