Political leaders in Iowa and in Washington, D.C., have made it their mission to politicize reproductive health care. As a result, Iowa now faces a public health crisis.
In a two-year span, these lawmakers’ reckless policies have decimated Iowa’s once robust safety net that ensured people could get affordable reproductive health services. Now, Iowa’s most vulnerable citizens are faced with losing the care they need or paying out of pocket for it — which many can’t afford.
It started in 2017 when state lawmakers cut Planned Parenthood and other providers out of a program providing birth control, STD testing and treatment, cancer screenings, and breast exams to Iowans. State politicians turned down $3 million a year in federal funds that supported the program and had to replace it with state dollars — and now Iowa taxpayers are footing the bill.
Since then, thousands of Iowans have dropped out of the now state-funded family planning program. Health centers across the state have shuttered their doors. STDs in the past two years have increased at alarmingly faster rates, especially in communities that no longer have providers. In the four counties where Planned Parenthood health centers closed, the 460-plus additional STD cases reported in 2018 was more than the previous six years combined, according to figures from the Iowa Department of Public Health. The increase in STDs point to a larger health crisis to come, as they are the leading indicator for poor health outcomes. Additionally, maternal mortality rates are on the rise.
Iowa lawmakers said when they defunded Planned Parenthood that other providers would pick up the slack. That simply hasn’t happened. Overall, more than 4,000 fewer Iowans received health care from the state-funded program than its predecessor in the first nine months, according to the Department of Human Services. The state hasn’t disclosed figures for the program’s second year.
This will only get worse now that access to reproductive health care has been dealt another blow — this time by the Trump administration. Title X is the nation’s only dedicated federal program for affordable birth control and reproductive health care for people with low-incomes. Last month the Trump administration imposed a gag rule on Title X providers that prohibits them from referring patients for abortions, forcing Planned Parenthood’s exit from the 50-year-old program.
Planned Parenthood’s doors remain open and its health centers have implemented a new sliding fee scale to help offset the cost of services for patients. However, the administration’s rule means 14,000 more Iowans could lose access to affordable birth control and health services if they can’t pay out of pocket.
The ramifications of this latest blow have been swift: Dozens of Planned Parenthood patients have canceled or not shown up for their appointments. Others have left without the care they need because they cannot afford it.
In the span of one day at one of our Des Moines health centers, a patient came in for STD testing and left when he realized he couldn’t cover his copay. Another young person came for her regular birth control shot and left in tears without it when she learned she would have to pay $120 rather than having no out-of-pocket cost. And, another patient informed staff she would stop taking her birth control when she ran out and “just be more careful” because the cost was too much.
Research shows access to reproductive health care and comprehensive, medically accurate sex education programs reduce unintended pregnancies and STDs and result in better overall health outcomes. For many women, their first health care visit is at a family planning provider, which often is also their only source of health care.
Planned Parenthood has called on Congress to take action to lift the Trump administration’s gag rule on Title X. A majority of U.S. representatives have passed a budget bill that would protect Title X, including Reps. Cindy Axne, Abby Finkenauer and Dave Loebsack. But as Congress negotiates budgets to avoid another government shutdown, a majority of senators have made it clear they are not interested in advocating for the health care of the people they serve, especially those who are most vulnerable.
We are calling on Iowans to take a stand and hold their elected officials accountable. Call Sen. Joni Ernst and Sen. Chuck Grassley and let them know the Title X gag rule hurts your neighbors and community, and it is already having devastating effects.
But, also, vote.
Vote for elected officials in Washington and in Iowa who will do what’s right and support making high-quality, reproductive health care accessible to every Iowan — no matter what.
Erin Davison-Rippey is state executive director of Planned Parenthood Voters of Iowa.