More Iowa counties poised to pay for rape victims' emergency contraception after AG balks

Following Polk County's lead, more Iowa counties are poised to pay for sexual assault victims' emergency contraceptives after the state attorney general's pause on payments for those services.

Since January, Iowa Attorney General Brenna Bird has halted the office's long-standing practice of covering the cost of morning-after pills and, in rare cases, abortion for victims of rape in Iowa.

To date, more than 160 reimbursement requests for rape victims' morning-after pills are pending, according to documents first obtained by Iowa Public Radio. These claims are submitted to the Attorney General's Office by hospitals and pharmacies that dispense these medications to victims.

The reimbursement requests total around $7,500, IPR reported.

With no clear indication of when Bird plans to make a final decision on whether to resume those payments, a handful of counties across Iowa are beginning to take up the issue to ensure those services remain free to victims, following the lead of Polk County, which voted earlier this month to provide free services for emergency contraception like Plan B, and in rare cases, abortion.

While some counties are still fact-finding the logistics of covering these services, elected officials in other counties hope to approve funding for these medications in the near future.

More: Iowa AG says pause on paying for rape victims' emergency contraception still under review

Among them is the Johnson County Board of Supervisors, which is expected to vote Thursday on a proposal to allocate $10,000 to cover the cost of dispensing emergency contraception for sexual assault victims in the county who request medication to prevent a pregnancy.

To the elected officials on the board, the cost is minimal compared to the peace of mind these services provide to victims, said Johnson County Supervisor Jon Green.

"We will get this taken care of in Johnson County," Green said.

The funding would be allocated directly to the county's Sexual Assault Response Team, which employs the sexual assault nurse examiners who conduct forensic exams and provide these medications to victims. These nurses are deployed to hospitals within the county 24/7 to care for victims in the immediate aftermath of their attack.

Johnson County's Sexual Assault Response Team has faced budget cuts the last three years, and though they hope to avoid charging patients for emergency contraception, "they do not have the funds available to absorb this cost," according to the Johnson County Board of Supervisors.

Those dollars, which would come from the county's general fund, will also help support rape victim services, the board states.

"These women are victims of a crime," said Johnson County Supervisor Lisa Green-Douglass. "The only reason this is being called into question is because A) they're women and B) the medicine is possibly preventing a pregnancy that, if it happened she couldn't get an abortion for. It has this political veneer on it that it wouldn't otherwise have if we're just looking at all of these other things that we find that don't ever get called into question."

The Attorney General's Office did not respond to requests for comment.

More: Iowa nurses fear pause on paying for emergency contraception could drive away rape victims

More local boards likely follow Polk County's lead

Sexual assault response teams across the state say providing victims with free and confidential access to emergency contraception is critical can access the care that they need, and to help women move on from their attack. They worry that forcing women to seek out and pay for their own emergency contraception could be a major barrier to some.

Victim services advocates say even if Bird decides to permanently halt payments, they will continue to provide these medications to victims without cost.

But it appears more local officials in certain parts of the state hope to fund that cause. In recent weeks, sexual assault nurse examiners across the state say they have been in discussions with other counties who are considering a similar move made by the Polk County Board of Supervisors.

The Johnson County Board of Supervisors is so far the first to follow suit. However, it's still unclear how many other counties plan to take up those costs, as some counties are just beginning to have those conversations.

That includes Story County, where its Board of Supervisors is still exploring such a move within its county. However, discussions among county officials remain in the early stages, said Supervisor Latifah Faisal.

"There’s been some informal conversations," Faisal said. "We’ve received input from different residents asking us to look into it, so we are looking into it."

Other counties have indicated they are further down the road on this issue. In Linn County, Supervisor Ben Rogers expects the board to soon take up formal discussions "in support of providing funding."

Currently, he said officials are working with the local Sexual Assault Response Team to collect information on the number of victims and the estimated cost the county could provide to fund services impacted by the Iowa Attorney General’s decision.

The board is also working with the Linn County Attorney's Office to understand the legality of providing this funding, Rogers said.

"One of our core missions at Linn County is reducing barriers and obstacles to accessing necessary and lifesaving services quickly and effectively," Rogers said. "We believe in supporting our community partners and this is an extension of that support."

Earlier this month, Polk County Board of Supervisors unanimously approved a resolution to ensure emergency contraception remains free to victims within the county.

More: Polk County will pay for rape victims' emergency contraception amid state pause

The resolution directs Polk County Crisis & Advocacy Services, which oversees the county's Sexual Assault Response Team, to pay for services that were historically paid for by the Attorney General's Office if the current pause becomes permanent.

Under this measure, medication to prevent pregnancy will be available to all those who seek help in the county, regardless of where they live, county officials say.

Of the 270 women who were victims of sexual assault that Polk County served last year, 105 of them received free emergency contraception, officials say. Last year's budget was $3,000, according to the board.

Polk County Supervisors also criticized Bird's move following their vote earlier this month, saying that the state's pause on its program puts partisan politics before women.

“It’s clear the Iowa attorney general has given women of rape and sexual assault ‘the Bird’, and it is a disgusting act of cruelness to these victims who deserve compassion & care as they cope with this trauma,” Supervisor Matt McCoy said in a statement. “Iowans deserve to know the rationale for pausing this program, and the impact that it has on sexual assault victims. The Iowa attorney general continues to stonewall the public when they request information about her cruel decision.”

Why are counties starting to pay for these services?

Earlier this year, Bird confirmed that she directed her office to pause payments for emergency contraception and abortions for victims of sexual assault using the state's victim compensation fund.

Bird, a Republican and ardent abortion opponent, has previously said that pause is part of a larger review of Iowa's victim services program, and that she was evaluating “whether this is an appropriate use of public funds."

More: Iowa stops paying for rape victims' morning-after pills and abortions

"That audit is ongoing," Alyssa Brouillet, a spokesperson for the attorney general, said in a statement last month. "Until that review is complete, payment of these pending claims will be delayed."

The state's victim compensation fund pays for out-of-pocket expenses facing sexual assault survivors who seek medical help, such as treatments for sexually transmitted infections. The fund also pays for sexual assault examinations to collect forensic evidence, regardless of whether or not they report their assault to law enforcement.

Former Iowa Attorney General Tom Miller, a Democrat who held office for 40 years before he was ousted by Bird in January, also directed the state's victim compensation fund to also pay for emergency contraception and abortions for rape victims.

According to records provided to the Des Moines Register in April, the Iowa Attorney General's Office paid $9,899.62 for 267 claims for morning-after pills, and zero dollars for abortions in 2022.

Dollars for the victim compensation fund come from fines and penalties paid by individuals convicted of crimes. General taxpayer dollars are not used for the fund.

Bird is a staunch abortion opponent. Her office is defending a new state law in court that would ban nearly all abortions once cardiac activity can be detected in the embryo, or at about six weeks of pregnancy.

Other critics have called on Bird to provide an explanation for her pause on payments for sexual assault victims' services, saying the move has put victims and victim advocates in limbo for the past several months.

Ruth Richardson, president and CEO of Planned Parenthood North Central States, said permanently ending payments for emergency contraception and abortion would have immense harm on Iowans.

"Imagine being in a space where you have just been violated in such an inhumane way," Richardson said during a recent Planned Parenthood press conference. "You want to ensure that when you are accessing services as a survivor, that your humanity is seen. The unfortunate result of what we are seeing within Iowa is that these victims of sexual assault are being victimized more than once."

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm.

This article originally appeared on Des Moines Register: Iowa counties offer funding for rape victims' morning-after pills