Iowa faces a crisis in family planning care for low-income and uninsured women and families. Throughout the state, more than 170,000 women qualify for assistance for family planning care, but have little to no access to the services they need. Organizations like Planned Parenthood, the Family Planning Council of Iowa, and other family planning agencies have worked long and hard to cover these women, but still about 100,000 are left without coverage.
The fact is that Iowa has ranked relatively low compared to other states in access to contraceptives and other family planning care. Iowa currently ranks 48th in the U.S. in access to contraceptives. Roughly half of Iowa’s counties do not have a family planning clinic that serves low-income women, and unintended pregnancies are the unfortunate result.
Though Medicaid programs exist to cover low-income women, the current program leaves many without the care they need. This is why Planned Parenthood of Greater Iowa began the Healthy Families project — a multi-year program to increase education, outreach, and access to family planning care for those who qualify for assistance, but are not being served.
The Healthy Families project conducted a door-to-door canvass to educate Iowans on this problem, and recruit supporters throughout the state. During the caucus, Healthy Families staff helped more than 960 activists submit resolutions at their precinct caucuses.
In the 2008, as part of expanding access to contraceptives and family planning services, supporters of the project attended legislative forums. The forums were an excellent opportunity for constituents to share their opinions with their legislators. Activists attended more than 61 candidate forums, made about 945 phone calls to legislators, and sent 1,200 e-mails on the need for family planning access.
The response from legislators was the creation of a state fund for family planning assistance. The rationale behind this fund is grounded in smart fiscal policy: the state can save more than $3 for every $1 invested in pregnancy prevention. Currently, the state bears the costs of unintended pregnancies through social service programs and Medicaid expenditures. Unintended teen pregnancies cost the state more than $47 million alone. Through prevention, unintended pregnancies can be reduced, and the drain on state resources can be alleviated.
The family planning line item was initially included in Gov. Chet Culver’s proposed budget, though the Legislature chose to create their own budget for the state based on prior-year receipts. Through the budgeting process, a line item for $750,000 was proposed in the Health and Human Services budget. When the issue came to debate on the floor of the Senate, a contentious anti-abortion debate, with numerous anti-choice amendments proceeded. The family planning line item already included language that would restrict use of funds for abortions, but anti-choice legislators, spurred by the Iowa Right to Life organization, equated anything related to family planning to “abortion.”
Subsequent attempts to subvert the new line item failed, including redirecting funds that were intended for prevention to so-called “crisis pregnancy centers” — centers that use intimidation and inaccurate medical information to pressure pregnant women. This was especially troubling since the line item was intended to be an investment in prevention, not an additional program to treat the problem after it occurs. The Senate did pass the line item, however including a $200,000 line item for “pregnancy counseling and support services.”
House leadership, seeking to avoid a lengthy, contentious abortion debate instead chose to remove the line item and additional $200K line. This strategy was not to kill the family planning line item, but rather to use the “conference committee” process to approve the measure. In conference, the family planning line item was restored, and the language for the additional $200K line item was made less restrictive. Both chambers approved the Health and Human Services budget, and the state fund was made law.
This is a tremendous victory for women and families in Iowa. This first step toward decreasing the shortfall of service to eligible women was a bold commitment by the Legislature. The Healthy Families project and its nearly 7,000 statewide supporters celebrated this victory. The project will continue to push forward on family planning care for women and families in Iowa, and will continue its efforts through education and outreach.