Republican lawmakers in Iowa have filed a petition demanding that the state immediately stop reimbursing low-income rape and incest victims for abortions through Medicaid. If the rule is implemented, it will conflict with federal law and could jeopardize the state's entire $1.8 billion annual Medicaid grant.
The petition for emergency rulemaking, initiated by Rep. Dawn Pettengill (R-Mount Auburn) and signed by 41 Republican representatives, asks the Iowa Department of Human Services to amend its rules and withhold Medicaid money to women who are seeking abortions as a result of rape, incest or severe fetal anomalies. Such abortions are "in conflict with the express language and intent of the laws enacted by the General Assembly and signed by the Governor," the petition claims.
Rep. Lisa Heddens (D-Ames), a ranking member of the House Health and Human Services Appropriations Subcommittee, said she opposes the petition because it "revictimizes" women.
"Look who it's going to affect: low-income women who are seeking medical attention for situations of rape and incest," Heddens told HuffPost. "You are re-victimizing the woman who is a victim of a serious crime and cannot afford that health care because she is poor."
A Republican nurse on the subcommittee, Rep. Linda Miller (R-Bettendorf), said she is mainly concerned about stopping funding for abortions in cases where the fetus is physically or mentally deformed, although she also opposes abortion funding for rape and incest victims. She said there are "many different foundations and non-public sources for these women to use" in lieu of Medicaid.
The Republicans' request would directly violate the Hyde Amendment, which says that while states cannot use their federal Medicaid dollars to pay for abortion care except in cases of rape, incest, and when a woman's life is in danger, the state must allow victims to use Medicaid in those three circumstances. If a state violates that rule, the Center for Medicare & Medicaid Services (CMS) has the authority to cancel its Medicaid contract.
The Iowa Department of Human Services has until August 10 to reply to the petition, but DHS spokesperson Roger Munns said he doesn't know what the agency's response will be. "Federal Medicaid moneys may be jeopardized, but we can't get any closer than that without information from CMS," he said.
Miller said the Republicans who signed the petition hadn't come up with a plan to help low-income Iowans pay for health care in the event that the state loses its Medicaid contract.
"That's what we'll have to figure out," she said. "You have to take it one step at a time."
Under the Hyde Amendment, a state can use its own Medicaid money to cover abortion in extra circumstances, such as when there are fetal anomalies or when a woman's health, but not her life, is jeopardized by the pregnancy. Iowa had been using its state Medicaid money to reimburse low-income women whose fetuses had certain severe, life-threatening anomalies, in addition to covering rape and incest victims.
Since July 2011, Iowa has used Medicaid to reimburse 22 women for abortion care, according to DHS. Two were for rape victims, five were to save the life of the mother, and 15 were for fetuses with severe deformities, such as the absence of a brain or cranium.
Jill June, president of Planned Parenthood of the Heartland, said she finds it "unconscionable" that Iowa Republicans would rather jeopardize all of the state's Medicaid money than help a handful of low-income women in special circumstances pay for abortion care each year.
"What will happen to the hundreds of thousands of poor people in Iowa who depend on the Medicaid program if these legislators are successful in driving this extreme agenda?" she said. "They need to answer that question."
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