The Iowa Attorney General’s office is not currently covering the cost of emergency contraception or abortions for Iowans who are victims of rape or sexual assault, Natalie Krebs reported for Iowa Public Radio on April 7.
Iowa law requires the state’s victim compensation fund to pay for a sexual assault victim’s medical examination “for the purpose of gathering evidence,” as well as any treatment “for the purpose of preventing venereal disease.” Under longtime Attorney General Tom Miller, that fund also covered the cost of abortion services or Plan B, medication that prevents ovulation and therefore pregnancy if administered soon enough following unprotected sex.
In a statement provided to Iowa Public Radio, spokesperson Alyssa Brouillet said Attorney General Brenna Bird “is carefully evaluating whether this is an appropriate use of public funds” as part of a broader review of victim assistance programs. Payment of “pending claims will be delayed” until Bird completes her review.
“BEYOND CRUEL”
ACLU of Iowa executive director Mark Stringer said in a written statement, “It is beyond cruel for the state to take away much-needed sexual assault medical care from Iowans.” He called it “unconscionable” for the Crime Victim Assistance Division to stop funding care “as part of some bureaucratic review,” and said Bird “needs to resume this emergency care now before more women are hurt as a result.”
Being sexually assaulted is traumatic for survivors and the State of Iowa simply must do the right thing by them. This includes helping victims put their lives back together and assist them on the road to recovery. Instead, this decision penalizes and re-victimizes them.
Government assistance can never undo the harm that these survivors have faced. But the State of Iowa, and specifically Attorney General Bird, must keep our promise to crime victims — that we will help them when they are in their time of need. There is no room for politics during a crime victim’s emergency. We strongly urge Attorney General Bird to rescind this unfair and disturbing withdrawal of emergency medical services for women and help our people be as healthy and safe as possible.
In a statement to Iowa Public Radio, Planned Parenthood North Central States CEO Ruth Richardson described Bird’s decision as “abhorrent,” adding that “Sexual assault survivors shouldn’t have to worry about how they are going to cover the cost of health care after being assaulted. Survivors should be able to get the health care they need, and which survivors have relied on for years.”
A PATTERN OF QUIET MOVES
Although Bird has proclaimed her “pro-life” beliefs on many occasions, her staff have avoided publicizing several of her efforts to reduce access to abortion.
For instance, news releases from the Attorney General’s office often highlight Bird’s multi-state legal actions. But they have never mentioned that she joined Republican counterparts to support a lawsuit seeking to reverse the Food and Drug Administration’s approval of mifepristone, a widely used medication for abortion and miscarriage care. A U.S. District Court judge in Texas ruled on April 7 to invalidate the FDA’s action from the year 2000. If allowed to take effect, the ruling could make medication abortions harder to obtain even in states where reproductive rights are guaranteed.
Similarly, Bird’s office did not announce that she co-signed a letter with other attorneys general to discourage large pharmacy chains from mailing abortion medications. One of the targeted companies, Walgreens, subsequently told Bird it will not dispense mifepristone in Iowa, even though state law does not restrict use of the drug and allows abortion up to 20 weeks of pregnancy.
The crime victim compensation page on the Attorney General’s website does not indicate any change in the reimbursement policy for sexual assault victims. Nor has a press release announced that change.
Bleeding Heartland filed a public records request with the Attorney General’s office in mid-February, seeking copies of the past and current policies on reimbursing victim medical and prescription costs in sexual assault cases. The request also sought related memos or emails involving Bird, Chief Deputy Attorney General Sam Langholz, and John Gish, the former Washington County attorney whom Bird tapped to lead the Victims Services Division.
At this writing, the Attorney General’s office has not provided any of those documents. Brouillet has not explained the seven-week delay, but told me in an April 4 email, “We are continuing to look into your request and should have a response here soon.”
Bird has boasted about one of her abortion-related moves: her decision to represent Governor Kim Reynolds and the state in a case seeking to reinstate a 2018 abortion ban. Private attorneys handled that work last year after Miller said he could not “zealously assert the state’s position.”
A Polk County District Court rejected the state’s motion to dissolve an injunction on the 2018 law, which would prohibit nearly all abortions after about six weeks since the last menstrual period. The state appealed, and the Iowa Supreme Court is scheduled to hear oral arguments on April 11. Briefs filed in that case are available here.
UPDATE: A Des Moines Register article by William Morris and Michaela Ramm quoted Sandi Tibbetts Murphy, who led the victim services division in recent years under Miller.
“The procedures that the office had were … that all costs were billed directly to the sexual assault exam program at CVAD and victims were to receive no bills for any of that, nor was their insurance to be charged,” Tibbetts Murphy said. “… Our compensation specialists, they’re not medical providers. Their job is to review the records and cover the costs in accordance with the policies and statutes, and if the doctor prescribed Plan B or any other intervention, that’s what was covered.”
Tibbetts Murphy, who resigned at Bird’s request after the new attorney general took office, said the policy predated her tenure as head of the division, and that she hopes Bird ultimately decides to resume covering those expense[s].
“My concern is for the victims of sexual assault, who, with no real notice, are now finding themselves either unable to access needed treatment and services, or are now being forced to pay out of their own pocket for those services, when this was done at no fault of their own,” she said.
Tibbetts Murphy said it was “rare” for a sexual assault victim to need an abortion later, but when that occurred, the victim compensation fund covered the cost.
Beth Barnhill, executive director of the Iowa Coalition Against Sexual Assault, told the Register she’s urging Bird’s office “to not consider emergency contraception and abortion as the same, because emergency contraception is not the same as abortion [….] if a rape survivor had access to emergency contraception, then they would potentially not have to make that difficult decision about a pregnancy.”
SECOND UPDATE: The Iowa Coalition Against Sexual Assault and Iowa Coalition Against Domestic Violence issued a joint statement on April 10. Excerpts:
The Iowa Sexual Abuse Examination Payment Program (SAE) covers the cost of forensic examinations provided to victims of rape and sexual abuse and is funded from the victim compensation fund. Forensic exams are essential to prosecution of sexual abuse crimes, to collecting evidence that can help identify offenders and prevent them from harming multiple victims, and to improving access to medical care for victims. Ensuring victims are not responsible for the cost of a forensic exam or for medications required due to the assault is key to encouraging victims to undergo this extremely invasive medical exam as soon as possible after a violent assault. The majority of forensic exam costs paid for by Iowa’s state victim compensation funds are for juvenile victims of sexual abuse. (CVAD Annual Report, pp.6-7)
Victims of rape and child abuse have an acute need for timely access to health services, including contraception to prevent unintended pregnancy and abortion care. Cost should never be a barrier for rape victims seeking medical care. Using offender accountability victim compensation funds to cover the cost of forensic exams, incentivizes victims to undergo an invasive exam that can help prevent offenders from victimizing others and enhance access to medical care for crime victims. This is a good public policy and consistent with medical ethics and standards of care. We always urge policymakers to help support crime victims by eliminating barriers to accessing support services and to avoid policies creating new ones. And in this instance, we urge AG Bird to enhance access to services and healing for rape victims.
Disclosure: The ACLU of Iowa is representing Laura Belin, Bleeding Heartland, and other plaintiffs in an open records lawsuit against the governor’s office.
Top image: John Gish (left) and Brenna Bird at a campaign event in Washington, Iowa on October 13, 2022. Cropped from a photo first posted on Gish’s public Facebook feed.