Planned Parenthood: Iowa bills create more barriers to care

Iowa Republican lawmakers are advancing bills that would give unborn children stronger legal protections, allow health care providers to refuse care on the basis of “religious beliefs and moral convictions” and make it easier to fund pregnancy resource centers that counsel against abortion.

Abortion rights advocates on Friday decried those legislative efforts, asserting the legislation will create additional barriers to care at a time when the state faces worsening health care outcomes for mothers and babies and a shortage of health care workers.

Supporters contend the legislation provides additional support for pregnant women and their babies and further protects unborn life.

Iowa faces multiple health crises, yet Republican lawmakers are focused on “medically unnecessary and harmful legislation that only further sends the state down a dangerous path that has already deeply cracked the foundation of Iowa’s health care system,” Mazie Stilwell, public affairs director of Planned Parenthood Advocates of Iowa, told reporters during a news conference.

The week marked the first legislative “funnel” deadline, where most bills must pass out of a committee in either the House or Senate to remain eligible for consideration going forward, though there are exceptions.

Among the bills lawmakers advanced:

'Personhood’ and ‘wrongful death’ of unborn child

House File 2518 would allow a civil wrong death action for the “wrongful death” of an embryo or fetus at any point in pregnancy.

House Study Bill 621 makes the nonconsensual causing of death or serious injury to an unborn “person” a class A felony. It also assigns personhood to embryos and fetuses from the moment of fertilization.

Critics called the bills an attempt by conservatives to enshrine the concept of “personhood” — the belief that life starts at fertilization — into state law, while ignoring already existing medical malpractice laws.

They also expressed concerns with how such a law might impact access to contraception and affect embryos created through in vitro fertilization, causing spillover effects into other areas of reproductive care.

Medical providers could refuse services that violate beliefs

Senate File 2286 would allow any health care provider, facility, or insurer to refuse care on the basis of “religious beliefs and moral convictions” without fear of retaliation.

Providers could deny procedures they deem violate their religious values, and insurance companies could deny claims post-service on the same basis. Health care facilities would still be required to provide emergency medical services to all individuals, as required by federal law.

Tom Chapman, executive director of the Iowa Catholic Conference, said the legislation is meant to protect medical providers from discrimination and punishment for exercising their “fundamental right of conscience.”

Groups representing Iowa nurses and physicians said there are already legal protections for doctors to exercise their conscience while balancing the rights of patients to receive proper care.

Requiring schools to show fetal development

House File 2031 would require schools provide instruction on the development of a pregnancy. Students in grades 7-12 would be required to be shown “a computer-generated rendering or animation” that shows every stage of an embryo and fetus’ development, using an anti-abortion rights video as a model.

Republicans and anti-abortion rights activists say the video provides a medically accurate animated representation of fetal development, which Planned Parenthood and others dispute. They note the information and views contained in the “Meet Baby Olivia” video referenced in the bill runs contrary to those accepted by the American College of Obstetricians and Gynecologists.

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Rep. Anne Osmundson, R-Volga, said many of the facts in the video come from the Endowment for Human Development, citing the organization’s stated commitment to neutrality on “all controversial bioethical issues.”

“I don’t see that is one-sided,” Osmundson said. “This bill is about teaching children the basic facts about human development in an approachable way.”

Postpartum Medicaid expansion

House Study Bill 643, Senate File 643 and Senate File 2251 would extend postpartum Medicaid from the current 60 days to 12 months, but significantly lower the income cap so the law remains budget neutral — meaning fewer pregnant Iowans would be eligible for Medicaid coverage during and after a pregnancy, though eligible ones would receive help for a longer time.

Making it easier to fund crisis pregnancy centers

House File 2267 and Senate File 2252 would make it easier for the state to funnel $2 million to pregnancy resource centers that promote childbirth and discourage abortion.

The state has failed twice to find a third-party administrator with at least three years of experience managing a statewide network of providers of pregnancy support services. It would allow the Iowa Department of Health and Human Services to administer the program directly. The state still could opt to contract with an administrator, but the bill removes the requirement it have three years of experience managing a similar program.

Abortion rights advocates oppose state funding for the pregnancy resource centers, saying they mislead women about their options and misrepresent themselves as legitimate medical providers.

Supporters, including the Iowa Catholic Conference and The Family Leader, said the bill provides needed adjustments to the original law to allow the stalled More Options for Maternal Support — MOMS — program to move forward and provide more meaningful assistance and support to new and expecting mothers.

Representatives for the Family Planning Council of Iowa and Planned Parenthood Advocates of Iowa said the bill reduces transparency for the public by removing the requirement for program administrator and subcontractor criteria to be published on the Iowa Department of Health and Human Services website.

Behind-the-counter birth control

Lawmakers also advanced legislation to the House floor allowing access to birth control without a prescription.

House Study Bill 642 would allow pharmacists to distribute self-administered hormonal contraceptives without a prescription to those age 18 and older. The order would cover oral birth control, vaginal rings and patches but would not include drugs intended to induce abortion.

Pharmacists would only be allowed to dispense an initial three-month supply at a time. They would undergo training and have the patient take a self-screening risk assessment and perform a blood pressure screening before giving out birth control. Following that initial visit, Iowans could receive up to a year’s worth of birth control, but after 27 months, they would need to see a doctor.

Supporters, including Planned Parenthood, say the measure would provide better access to contraception for women, thus leading to fewer unplanned pregnancies and reliance on government assistance programs.

PP: Bills will exacerbate Iowa’s health care deserts

Iowa is one of four states in the nation to have significant increases in infant mortality rates from 2021 to 2022. At least 34 maternity units have closed since 2000, leaving rural Iowans less likely to access care.

A 2023 report from the March of Dimes found a third of Iowa's counties are "maternity care deserts" — that they have no hospital birthing centers or OB-GYN providers.

Pat Magle Jones, a retired rural family practice doctor in Iowa, said new bills pushed by Iowa’s Republican-led Legislature haven’t fixed that problem but have made the medical landscape scary for doctors and dangerous for patients.

“Doctors in Iowa increasingly are facing medically unnecessary restrictions that tie their hands, putting them in the position of either choosing their medical license or violating their code of ethics, even facing criminal charges for providing necessary care,” she said.

Tori Cunningham, a fourth-year OB-GYN medical student at the University of Iowa, said if Iowa keeps pursuing anti-abortion policies, the state will continue having trouble attracting and retaining doctors.

“The politicians proposing these dangerous bills do not have medical expertise,” Cunningham said. ”The last place that they belong is in an exam room.“

Comments: (319) 398-8499; tom.barton@thegazette.com