State family planning services decline 73 percent in fiscal year as $2.5M goes unspent
By Tony Leys and Barbara Rodriguez, Des Moines
Iowa’s new family planning program is providing fewer services like contraception one year after state lawmakers excluded Planned Parenthood clinics and other abortion providers from receiving funding, recently released state data show.
The program, which launched in July 2017, is paying for fewer than a third as many birth-control pills, hormonal implants and related services as its previous version.
“This is exactly what we were concerned would happen — that people who need this program would not get enrolled and would not get services,” said Jodi Tomlonovic, executive director of the Iowa Family Planning Council, a private nonprofit group that distributes federal money for family planning services.
But Iowa’s main health agency said the state needs more data to understand the scope of changes to the program.
Iowa Department of Human Services said the new program covered a total of 970 family planning services from April through June of 2018, according to data requested by the Des Moines Register. That was a 73 percent decline from the 3,637 services covered in April through June of 2017, the last three months of the previous family planning program.
The new data also shows the number of patients enrolled in the program has fallen by more than half. Enrollment was 8,570 in June 2017, the last month of the previous program, and dropped to 4,177 in June 2018 under the new program.
The family planning program’s main goal is to help poor and moderate-income Iowans obtain contraception. Legislators voted in 2017 to bar participation by any agencies that also provide abortions.
Because of the change, the state had to forego $3 million annually in federal Medicaid money. Opponents said they feared the change would make it harder for Iowans to obtain birth control, which could lead to more unintended pregnancies.
Mark Anderson, chairman of the Iowa Council on Human Services, said this week he was troubled by the numbers. Anderson is a Lutheran minister from Waverly who opposes abortion but supports making birth control readily available. He contends preventing unintended pregnancies reduces the demand for abortions.
“I understand it’s counter-intuitive to say that by closing Planned Parenthoods, which provide abortions, you might wind up with more abortions,” he said.
The council that Anderson leads provides advice to the Iowa Department of Human Services. The council initially voted in June 2017 to reject the change in Iowa’s family planning program. But two days later, the council voted to go along with the change after a state lawyer said a “no” vote would not block the new program but could make it harder for the public to use.
The 2017 change in Iowa’s family planning program was one of a string of victories by abortion foes at the new Republican-controlled Statehouse. Their accomplishments also included last spring’s passage of a “fetal heartbeat” law, which would ban most abortions. The law, which would be the nation’s strictest abortion limit, is on hold amid a legal challenge.
Lawmakers said they didn’t want to provide support to Planned Parenthood, which had been the largest family planning service provider. Proponents of the change predicted other healthcare providers would offer comparable birth control services.
Planned Parenthood leaders said the 2017 change cost the agency $2 million per year in public money. They announced in May 2017 they were closing clinics in Bettendorf, Burlington, Keokuk and Sioux City because of the funding loss.
Members of the human services advisory council have continued to raise concerns about the change. In a meeting last week, Anderson asked Human Services Director Jerry Foxhoven for an update on how the new family planning program is working.
Foxhoven acknowledged the number of people using the new program had dropped.
Foxhoven alluded to tweaks the Legislature made this spring. The main change was to allow UnityPoint Health clinics that don’t provide abortions to resume participation in the family planning program. The entire UnityPoint system was previously barred from the program because some of the system’s hospitals provide a few abortions.
“It’s a little premature for us to say, ‘Is that going to get us back to where we were before?’ We certainly think it’s going to move us greatly in that direction,” Foxhoven said. He said he hoped that by the end of the year, use of the program would rebound to where it was originally.
The 2017 change in the state’s family planning program was signed by then-Gov. Terry Branstad, a Republican who opposes abortion. Branstad’s Republican successor, Gov. Kim Reynolds, stands by the change, spokeswoman Brenna Smith said Tuesday.
“Taxpayer money should not be used to fund organizations that provide abortion services,” Smith wrote in an email to the Register.
The new Department of Human Services documents show the state spent $737,111 of the $3.3 million the Legislature set aside for the family planning program in fiscal year 2018.
Department spokesman Matt Highland said health care agencies have up to a year to submit bills for services, so the total spending for the past fiscal year could still rise. He said any leftover money could be shifted forward into the current fiscal year.
Critics have noted that the new program’s list of approved family planning providers contains listings for agencies that don’t offer contraception. For example, at least 74 of the 695 providers now listed are part of the Mercy health system, a Catholic organization with strict limits on contraception services.
Planned Parenthood of the Heartland spokeswoman Becca Lee said she hopes the new statistics encourage legislators to reverse their 2017 decision. “They have an obligation to the people they serve to fix the mess they made,” she said.
A February 2018 Des Moines Register/Mediacom Iowa Poll found that 71 percent of Iowa adults wanted the state to restore non-abortion funding to Planned Parenthood clinics.
More recently, an Iowa Poll in October found a majority of Iowans believe that abortion should be legal in most or all cases.