Iowa Republicans have made a mess of family planning. Will they fix it?

The Register's editorial
·4 min read
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Anti-abortion legislators and Gov. Kim Reynolds have enacted a parade of policies in Iowa that focus mainly on punishing abortion providers.

Ensuring the availability of reproductive health care — from providers better aligned with this anti-abortion vision — has seemed to be a secondary goal.

Iowa is seeing the results of these priorities. As predicted, ever since Statehouse Republicans cut off Planned Parenthood from government money in 2017, fewer people have received subsidized counsel and care. More surprising is that the state can’t manage to get its purported “pro-life” alternatives off the ground.

The state could go in three directions from here.

  • Leaders could do nothing and leave Iowans in need of services flailing.

  • They could acknowledge the statistics and try to understand why Iowans are not visiting anti-abortion reproductive care providers.

  • Or they could allow experts including Planned Parenthood to resume their proven work helping Iowa families.

That last, and best, direction isn’t likely, given that Republican leadership has invested a lot of time and energy into trying to deceive people into thinking that abortion is all Planned Parenthood does. But pretending that there’s no major problem should not be palatable either.

Iowa family planning history: How we got here

Two major actions have led us to where we are today:

  • Six years ago, the Republican-controlled Legislature removed Iowa from the federal family planning network and set up a state version that would not allow funding to reach clinics that provide abortions.

  • Over the past two years, the Legislature has tried to put money toward a program called "More Options for Maternal Support," or MOMS, intended to assist crisis pregnancy centers that are not medical clinics and steer girls and women away from considering abortion. Abortion rights advocates correctly pillory crisis pregnancy centers for misleading women about abortion, but MOMS raised the prospect at least of some material assistance – donated baby items, for instance – reaching girls and women in need.

The results: Reproductive care that doesn't measure up

How have those actions worked out?

  • The state family planning network is an underused disaster. The number of people obtaining services through it dropped 83% from 2017 to 2021, the Register’s Michaela Ramm reported. That’s hundreds fewer people every year getting help with birth control, pelvic exams and other services. The number of abortions in the state — presumably the statistic that matters most to Republicans — has increased. Data on sexually transmitted diseases is a bit of a mixed bag, but syphilis cases have risen substantially.

  • Iowa can’t even get MOMS off the ground. Two rounds of bidding for a nonprofit agency to administer it have failed. State officials deserve some faint praise on this point: They appropriately rejected a bidder this year because it wasn’t able to meet the state’s standard for data collection. Documenting how MOMS money is used is, indeed, a rock-bottom expectation, particularly in light of widely reported fraud and other misspending associated with a similar program in Texas that had relatively few guardrails. The state will continue trying to run a MOMS network itself, for now.

Iowa Republicans make it harder for girls and women to find help

All this has happened against the backdrop of anti-abortion decisions from the Trump administration and then from the U.S. Supreme Court. The Iowa Supreme Court also flip-flopped and removed abortion protections. The Legislature then passed a law banning almost all abortions; it’s on hold while it’s reviewed in court. Meanwhile, the state Board of Medicine, which is required to prepare rules to enforce the law should it take effect, is considering language that uses political, not medical, terminology, and would require doctors to assess, perhaps in an adversarial manner, whether a pregnancy is the result of rape or incest.

The collective effect of all these Republican policies has been to make help harder to find, period.

What Iowa Republicans are offering — a family planning network that ostensibly offers reproductive health care except for abortions and a network of pregnancy resource centers that excludes proven health care procedures — is vastly inferior to what was available here before 2017 and to what remains available in much of the country. Elsewhere, leaders recognize and celebrate Planned Parenthood’s expertise in averting unplanned pregnancies and providing competent, nurturing care.

The Iowa systems aren’t delivering as advertised, not even close. Neither network is providing even these reduced services in a meaningful way. Nor is the state spending any money to help Iowans learn about the family planning services that remain available.

What Iowa really needs to do to foster the best outcomes for women and for children is to reverse course and take advantage of all family planning providers. Given that unlikelihood, the state at the very least must puts more effort into actually connecting its family planning network and MOMS with Iowa families who need help.

— Lucas Grundmeier, on behalf of the Register editorial board

This editorial is the opinion of the Des Moines Register's editorial board: Carol Hunter, executive editor; Lucas Grundmeier, opinion editor; and Richard Doak and Rox Laird, editorial board members.

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This article originally appeared on Des Moines Register: Iowa needs to reverse course after disastrous family planning policies