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A decision later this year by the U.S. Supreme Court expected to restrict abortion rights or overturn its own Roe v. Wade ruling has set off a renewed round of abortion battles in state legislatures.
Leaders in Iowa's Republican-led Legislature, however, say they're waiting to see how court cases play out first before taking any further steps to restrict abortion access in the state — an assertion not all Democrats are buying.
"I don't see us passing a bill," House Speaker Pat Grassley, R-New Hartford, said in an interview previewing the legislative session, which begins Monday in Des Moines. “ … I think right now, there's a lot of 'ifs' surrounding the life issue, to be honest with you."
Senate Majority Leader Jack Whitver, R-Ankeny, echoed Grassley.
“From my perspective, we really need to see what's going to happen at the federal level in the Supreme Court, but also the state Supreme Court," Whitver said. "I think waiting to see what happens at both of those, both the federal and the state level is something we need to do.“
Some Iowa Democrats, however, argue the GOP-led Legislature is likely to press an all-out abortion ban that would take effect if Roe is later reversed. The 1973 U.S. Supreme Court decision affirmed a woman's right to an abortion before a fetus is viable outside the womb, usually about 24 weeks of pregnancy.
"Republicans just can't help themselves when it comes to attacking women's right to make their own health care decisions," said House Minority Leader Jennifer Konfrst, D-Windsor Heights. "And so I can't fathom a legislative session in which nothing comes up. … We've seen some pretty harsh attacks on women in this arena, and I can't fathom they'll just let it go. That's just not who they are, especially in an election year."
Across the rotunda, however, Senate Democratic Leader Zach Wahls of Coralville said he did not foresee more legislative action on abortion this year.
"But in terms of whether or not Iowans are paying attention, I think if we see a Supreme Court decision that overturns either Roe or (a later ruling on Planned Parenthood v.) Casey, you're going to see a whole heck of a lot of folks really wake up and realize the stakes of what we're dealing with right here," Wahls said. "Young Iowans are overwhelmingly supportive of a woman's right to choose."
A Des Moines Register/Mediacom Iowa Poll conducted in September found a majority of Iowans — 57 percent — believe abortion should be legal in most or all cases.
The U.S. Supreme Court heard arguments in December in a case concerning a Mississippi law that bans most abortions after 15 weeks of pregnancy and challenges the landmark abortion-rights ruling, which overturned would leave states with more freedom to restrict procedures terminating a pregnancy. A majority of the Supreme Court during debate last month signaled it is open to upholding Mississippi’s abortion ban, but left unclear how far it may go to curtail or overturn the right.
Several states have already passed "trigger laws" to automatically outlaw abortions upon a court decision overturning Roe.
A 2018 Iowa Supreme Court decision ruling that the state's constitution protects a right to an abortion, however, provides a major legal hurdle and would remain in place should Roe be overturned — meaning nothing would happen immediately in Iowa.
Iowa Republicans, though, started earlier this year on an effort to pass an amendment to the Iowa Constitution to undo the Iowa Supreme Court decision. The House and Senate passed a resolution during the 2021 legislative session proposing an amendment that says the state constitution "does not recognize, grant, or secure a right to abortion or require the public funding of abortion." State lawmakers would need to approve the resolution again in the next General Assembly, beginning in 2023, in order to place the amendment on the ballot.
Iowa voters would still have to approve the change to the state's constitution in a general election, meaning the soonest that would appear before voters is 2024.
Republicans, too, are waiting to see how the Iowa Supreme Court rules in coming months in the state's appeal of a district-court decision that permanently blocked a 2020 law requiring a 24-hour waiting period before receiving an abortion.
Iowa activists against abortion rights have said they're hopeful a more conservative court will reverse the 2018 ruling, which struck down a prior 72-hour waiting period. Since the 2018 decision, Republican Iowa Gov. Kim Reynolds has appointed four of the state’s seven Supreme Court justices, and has called on the U.S. Supreme Court to overturn Roe v. Wade.
Sixty Iowa Republican legislators this fall asked the state Supreme Court to overturn its 2018 ruling on the Iowa Constitution.
"I think they created out of thin air a fundamental right to an abortion," said Rep. Steven Holt, R-Denison, who led passage of the constitutional amendment during the 2021 session. "I think we certainly have appointed judges that are more constructionist in nature. That doesn't necessarily mean rulings will go the way I think they should go. Am I cautiously optimistic? Yes. But … I don't think there's anything certain as to how the court might rule."
‘Focus needs to change’
Iowa Democrats and abortion-rights supporters worry that if a new Supreme Court ruling or constitutional amendment passes, state lawmakers will be granted the unchecked ability to regulate and restrict access to abortion services, which will disproportionately harm low-income Iowans who cannot afford to travel out of state to receive the procedure.
"The constitution is meant to give rights and not take them away," said state Rep. Beth Wessel-Kroeschell, D-Ames, the ranking Democrat on the House Human Resources Committee. which considers abortion legislation.
"If there’s a focus this session, it should be maternal health care … and making sure it’s safe to have a baby in Iowa and we’re not doing that," Wessel-Kroeschell said. "We’re making it more and more difficult and taking options away from Iowa families. The focus needs to change to supporting Iowans instead of taking away their rights."
Iowa hospitals have closed 18 labor and delivery departments since fiscal year 2017, when the state hired private national firms to manage its Medicaid program. Hospitals in the state lost a combined over $38 million in calendar year 2020 between the amount billed by each provider and the amount paid for delivery claims under Iowa’s privatized Medicaid system, according to figures provided by Sen. Janet Petersen, D-Des Moines.
"As hospitals are dumping labor & delivery services at record speed, our state is becoming a more dangerous place for birthing parents and their babies," Petersen wrote in a June 15 letter to Iowa Department of Human Services Director Kelly Garcia.
Garcia responded, arguing Iowa Department of Public Health data "shows that access and quality do not appear to be declining, even when accounting for the decline in labor and delivery units." Garcia, too, pointed to the declining number of women giving birth in the state and nationwide.
The Gazette Des Moines Bureau and Associated Press contributed to this report.