Iowa Gov.'s Budget Would Scrap Policy Granting Him Authority To Decide Medicaid Coverage for Abortions

May 7, 2015 — Iowa Gov. Terry Branstad's (R) proposed state Department of Human Services budget would not continue a policy that requires the governor to approve Medicaid claims for abortions on an individual basis, the AP/Columbus Republic reports.

According to Branstad spokesperson Jimmy Centers, the governor decided not to include the policy because he has not been asked to approve any such claims (Lucey, AP/Columbus Republic, 5/5).


Iowa's Medicaid program covers abortions in instances of rape, incest and fetal anomalies, as well as to protect a woman's life. The Iowa Department of Human Services in 2012 spent about $20,000 to cover 22 abortions (Women's Health Policy Report, 6/11/13).

In 2013, Branstad signed into law legislation requiring the governor to sign off on all reimbursement requests for Medicaid-funded abortions. The change was billed as a compromise in a larger health care bill that included a Democratic proposal to expand the state's Medicaid program and a Republican proposal to give Branstad authority over Medicaid abortion coverage decisions, which conservatives hoped would reduce public funding for abortion (Women's Health Policy Report, 9/12/13).

However, the University of Iowa Hospitals and Clinics, where most Medicaid-eligible abortions are performed in the state, has declined to submit any Medicaid reimbursement claims since the law's enactment and instead opted to absorb the cost of the procedures (Women's Health Policy Report, 2/20/14). The hospital said it had stopped submitting claims in an attempt to avoid political controversy (Leys, Des Moines Register, 5/5).

According to hospital spokesperson Tom Moore, the institution has performed 34 procedures that could have been reimbursed by the state's Medicaid program since July 1, 2013. He said the average cost of each procedure was $961 (AP/Columbus Republic, 5/5).

Conservative Lawmakers Might Reinsert Policy

State Rep. Linda Miller (R) said conservative lawmakers in the state House might attempt to reinsert the approval policy into the state DHS budget (Des Moines Register, 5/5). Similarly, state Rep. Matt Windschitl (R) said conservative lawmakers are "looking at ways to achieve the same goal maybe in a different fashion with language."

Meanwhile, state Sen. Amanda Ragan (D) said the state Senate will not include the policy in its state DHS budget. However, she said she expects there to be negotiations on the issue (AP/Columbus Republic, 5/5).


State Rep. Lisa Heddens (D) praised the possible end of the policy. "Having legislation saying the governor has to sign off on whether to pay for [abortion] makes it a political issue," she said.

Meanwhile, Planned Parenthood of the Heartland applauded Branstad's decision. The group said, "When a woman needs abortion care due to a heartbreaking scenario, such as a pregnancy that is not viable, pregnancy as the result of a sexual assault, or that her health is endangered by carrying a pregnancy to term, the last thing she and her physician should have to worry about is whether or not her insurance will cover the procedure" (Des Moines Register, 5/5).