The rate of Iowans without access to affordable birth control has doubled after years of cuts to family planning programs
Des Moines, IA—Thousands more Iowans today are without access to contraceptive health care and are foregoing birth control, according to a new two-year Guttmacher Institute Reproductive Health Impact Study. The study tracks the impact of Iowa lawmaker policies that cut family planning services from Iowans in 2017.
The study found that 62% percent of Iowans who received public funds for family planning did not receive contraceptive care, nearly doubling, from 32% two years prior. The share of those who didn’t use any method of birth control increased from 9% to 15% over that same time span.
The result of the sharp decline in Iowans accessing reproductive health care comes as Sexually Transmitted Infections (STIs) are skyrocketing across the state. Also, abortion rates in the state increased 42% during the two-year span of the study.
“Iowa lawmakers took away affordable birth control, and now for the first time we are seeing the data showing the impact on Iowans’ lives,” said Mazie Stilwell, Public Affairs Director of Planned Parenthood Advocates of Iowa. “Politicians who took away affordable birth control are working extremely hard to ban abortion. Iowans are suffering the public health impacts of politicians’ misguided and dangerous policies.”
The study tracked Iowans who received state-funded family planning services for two years beginning in 2018, a year after Iowa legislators gave up $3 million in federal Medicaid so they could defund Planned Parenthood, the program’s largest provider at the time. The report describes for the first time the disruptions faced by Iowans seeking care at publicly funded family planning sites since the state changed the program in 2017.
The study also found:
- Nonuse of contraceptives increased by two-thirds among Iowa family planning patients in the two years following the 2017 changes. The use of methods that are not free or require provider involvement decreased over the study period, as did patient satisfaction with their contraceptive method.
- Patients reported experiencing pervasive cost, access and quality barriers in receiving contraceptive care, and they devoted a significant amount of effort to overcome these barriers. When patients were unable to overcome barriers to access their preferred birth control method, they switched to methods that were not ideal or used nothing at all.
- Participants reported Iowa’s harmful policies enacted by lawmakers who want to ban abortion resulted in reduced hours and provider availability at clinics, as well as reduced subsidies used to help offset the cost of care and birth control. As a result, people delayed or forewent care, sometimes exposing themselves to unwanted pregnancy.
- Three of the four Planned Parenthood health care centers that were forced to close due to the defunding were concentrated in the southeastern part of the state, effectively leaving an entire region of Iowa without an affordable, accessible reproductive health care center, driving over 15,000 patients to find a new family planning provider.
Republican lawmakers said when they created the state-funded program in 2017 they would track its performance yearly. That, however, has not happened. According to the little data reported by the state, enrollment in Iowa’s Family Planning Program dropped from 6,897 in 2017 to 2,904 in 2019. Of those, only 53 percent—or 1,557—actually received services. Providers in the program dropped from 1,440 in 2017 to 112 in 2019.
Kelly Garcia, Director of the Iowa Department of Human Services, has publicly pointed to an increase in Medicaid enrollment as a reason for the sharp drop in participation. However, the jump in participation and money for family planning services under Medicaid expansion slowed significantly from 2017 to 2018, according to state data. During that one-year span, enrollment grew by only 2 percent and reimbursements increased less than 1 percent, according to a 2019 DHS report. In the state’s most recent report, enrollment in Medicaid family planning services declined by 37 percent—or 133,602 participants—from 2018 to 2019.
Meanwhile, state lawmakers who want to ban abortion last session created a costly $500,000 taxpayer funded program called “More Options for Maternal Health” that requires the Iowa Department of Human Services to contract with anti-abortion clinics, or so-called Crisis Pregnancy Centers. These centers use harmful and deceptive practices to prey on pregnant people by manipulating and preventing individuals from accessing abortion. They are not state licensed health care providers.
“Iowans’ health and fundamental freedom to decide their future and when to start a family is being jeopardized because of the narrow ideological priorities of Republican lawmakers that don’t reflect the 60 percent of Iowans who support keeping abortion safe and legal. We deserve better and must push the people representing us to not only maintain but expand affordable reproductive health care in Iowa,” Stilwell said.
Planned Parenthood Advocates of Iowa (PPAI) is an independent, nonprofit, nonpartisan organization with a mission of fostering and preserving a social and political climate favorable to reproductive health. To meet this mission, PPAI engages in lobbying, issues education, and supporter mobilization.