On April 19th, the Iowa House of Representatives approved a budget that cuts off all state funding from Planned Parenthood and any other clinic that provides abortions. The Senate passed a similar bill just days earlier. These bills will go into effect as soon Iowa’s governor, Terry Branstad, signs it.
The Department of Health and Human Services now faces a drop of $28 million for 2018.
While Planned Parenthood is not entirely funded through government stipends, 40% of Planned Parenthood’s funding comes through Medicaid, a federal and state funded health insurance provider. The new budget plan cuts off this source of revenue as long as Planned Parenthood continues to provide abortions. And while no public funds are used to pay for abortions, except in cases of rape, incest, or where the mother’s life is at risk, this 40% cut means cutting things such as Planned Parenthood’s ability to provide birth control, STI testing and treatment, HIV testing, transgender services, and pregnancy testing.
The bill will also affect private clinics who offer abortions, such as the Emma Goldman clinic in downtown Iowa City. The clinic receives most of it’s funding through fees for services, and patients often pay through Medicaid. Because Medicaid will no longer cover abortions, patients will have to turn to other insurance providers. As of 2017, there are 88 insurance plans offered by 4 insurance providers in Iowa, none of which will cover elective abortion.
Jennifer Price is the director of the Emma Goldman Clinic. After the November election, Price has become even more concerned with the state of women’s health, and the country’s attitude towards it.
“Access to affordable, comprehensive reproductive and family planning services is a human right,” Price said.
Nationally, if the Republican Party succeeds on its promise to repeal and replace the Affordable Care Act, women will face greater challenges when it comes to accessing health care. The ACA currently prohibits insurance companies from denying coverage based on gender and prohibits them from charging higher premiums for women. It also requires coverage for contraception without out-of-pocket costs.
These are all issues that Iowa City are very familiar with, according to Ally Hanten, the teen parent coordinator at UAY.
“We serve teens that are under the age of 23 in Johnson County that are pregnant and that are parenting,” Hanten said. “ We do home visits with them, teach them about child development, parenting skills, and connect them to the resources that they might need.”
Planned Parenthood is more often than not one of those resources, for things like birth control, contraceptives, and STI testing.
“We’ve had young women come to us who are pregnant, have a baby, and don’t want to get pregnant again, they can go to Planned Parenthood for that,” Hanten said. “We’ve had young young men come here who need free condoms or STI testing, they can go to Planned Parenthood for that.”
Quite often these people are under 18, and might be in a situation where billing their parents insurance is not an option.
“We don’t ever encourage them not to talk to their parents,” Hanten said. “We always want them to include their parents in that conversation, but sometimes there’s not a parent around to have that conversation with. Sometimes that’s not a safe thing to do.”
In these cases, Planned Parenthood can be of help to adolescents who are not in a position to talk to their parents and do not have the finances to get help on their own.
“So Planned Parenthood is really nice because it’s a sliding fee scale, so if they don’t have insurance, or they don’t want to bill their parents insurance, they can go there and get access to STI testing, and birth control and annual exams,” she said. “If they don’t feel comfortable talking to their parents about birth control, it’s a really nice resource for them to have access to.”
Sarah* is a junior at City High who is in this situation.
“My family is very Catholic and very anti-abortion, and they associate [abortion] with Planned Parenthood a lot,” she said.
When Sarah thought about going on birth control, she encountered numerous obstacles. Her family, who she describes as “very anti medication” and “anti birth control, unless it’s 100% necessary,” were resistant to the idea. Her medical doctor, too, didn’t want to prescribe Sarah anything. Sarah’s friends offered to get birth control for her, but she remains unsure as to what she will do going forward.
“I had no idea about what was available to me,” Sarah said. “I had no idea at all, about their sliding fee scale, about anything.”
This lack of awareness is something that worries Ally Hanten, who sees teens every day who are unsure of what their options are.
“When we talk about eliminating something like planned parenthood we are sending this larger message of this is not an okay thing to talk about, that it’s not an okay thing to access, and that shuts down conversations,” Hanten said. “If we can’t talk about it we can’t educate people.”
Sarah is in agreement that a more comprehensive education regarding birth control and the functions of Planned Parenthood is key.
“I think that there should be more education about this issue,” she said. “I’m very thankful that my friends kind of took my under their wing and offered to get me anything I need. But If I didn’t have those friends I think I could be in a really bad situation, or someone like me could be in a really bad situation where they feel really scared and trapped.”
Birth control and other contraceptive measures are increasingly one of the most popular services provided by Planned Parenthood. It accounts for 63% of what they offer, whereas abortion services only accounts for 5%. And nationally in 2016, two thirds of teenagers who received IUDs and implants did so on federally subsidized funds.
“As someone who would never have [an abortion] I feel that it is really important that people have access to preventative measures,” Sarah said. “When family circumstances or government, makes it harder and harder and harder for you to prevent getting pregnant, it makes it really frustrating as someone who is morally against the alternative.”
*Name changed to protect anonymity of student