In politics, there’s at least one thing you can always count on: Power exists on a pendulum. Public sentiment is always shifting.
For years this inconvenient fact kept most politicians, and especially the dominant political parties, tilting toward center. They’ve understood that whenever massive force is applied in one direction, the back swing is as equally severe.
Iowa’s Republican Majority is brazenly testing fate.
A case in point is Senate File 2, which was approved this week by the full chamber on a party-line vote. The bill directs state officials to opt out of the federal Medicaid family planning network waiver and instead create a new state-run program. Unlike the federal program, which requires providers of all eligible services to be reimbursed for those services, the state-run program chooses which providers are eligible for reimbursement. That determination is based on whether or not the provider offers, or is affiliated with another provider that offers a completely separate service.
In short, the state-run program allows the state to discriminate against health care providers who offer comprehensive services that include abortion. Why? Lawmakers behind the bill don’t like abortion, and aren’t satisfied with existing federal prohibitions against public funding. By brushing aside federal funding (at least from this particular pool), they hope the state can legally withhold funding from providers that are eligible under federal rules.
The Legislative Services Agency’s fiscal report on the bill shows an increase in general fund spending of $2.1 million in FY 2018 and $3.1 million in FY 2019. Currently the state chips in only about $500,000 for family planning.
One of the more disturbing aspects of the bill is that it wasn’t written to improve health care in Iowa, nor to increase or expand access to family planning services. Sen. Amy Sinclair, an Allerton Republican and lead author, made clear during debate Thursday the bill was written to address specific religion-based concerns about abortion — views in the minority. Perhaps that explains why Senate Republicans ran a bill concerning public health through the judiciary committee.
It may also explain why the bill, as it currently stands, would likely prohibit many hospitals and their affiliated health centers from receiving family planning funds. There is no exception made for pregnancy terminations due to severe fetal anomalies, such as anencephaly.
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Still, Republicans have the votes and, presumably, support from the Governor’s Office. The bill is likely to become law.
One day, however, the pendulum will swing. Bills written for the sole purpose of excluding one group or viewpoint can easily have their target modified. In fact, all bills pushed forward and passed by only one side are especially vulnerable to later repeal or significant manipulation.
An example? How about the Sedition Act? More recently, the inability of Democrats to persuade even a single Republican to support the Affordable Care Act was a signal of its eventual demise.
Public sentiment is always shifting. That’s the danger and shortsightedness of a “kick the door in” strategy.
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