DES MOINES – Anti-abortion Republicans in the Iowa House are pushing their way into one of the most divisive abortion debates of the year with legislation that would make telemedicine abortions illegal in the state.
State Rep. Matt Windschitl, R-Missouri Valley, filed legislation last week to outlaw the practice, which is currently legal in Iowa but is the subject of litigation in district court.
“If I could stop all abortion in this state, I would,” Windschitl said.
Meanwhile, abortion providers have not requested reimbursements from Medicaid following the passage of legislation last year that requires Gov. Terry Branstad’s OK to release the funds. University of Iowa Hospitals and Clinics has, instead, decided to cover the cost itself.
“We have had 13 (abortions) that Medicaid probably would have covered” since the new law took effect, University of Iowa Health Care spokesman Tom Moore said.
Telemedicine is the practice of doctors prescribing medications to patients via video link, rather than an in-person examination. It’s more common in rural areas where it’s more difficult to find a doctor or specific specialists.
Last summer, the Iowa Board of Medicine approved rules that required doctors who were prescribing medications that induce abortions in patients, such as Mifepristone, to be physically present with the patient. The rule essentially made telemedicine abortion impossible.
According to the Iowa Department of Public Health, there were 2,314 medically induced abortions in Iowa in 2012 compared to 2,324 surgically induced abortions that year. The department does not designate which of the medically induced abortions used telemedicine.
Records for 2011 show that medically induced abortions occur about as often as surgically induced ones, with 2,402 of the former that year compared to 2,406 of the latter.
Planned Parenthood of the Heartland sued to stop the Board of Medicine rules from taking effect. A Polk County judge put a stay on the rules until the case is resolved.
Now, Windschitl and 18 House Republican co-sponsors propose a bill to ban the practice outright.
“I appreciate the separation of the judicial, executive and legislative branches,” Windschitl said. “As a member of the legislative branch, I’m doing what I know to be correct and right.”
Jill June, CEO of Planned Parenthood of the Heartland, said filing the bill “is certainly (Windschitl’s) prerogative,” but she called it “misguided.”
“What the polls tell is by and large the public does not want to see abortion outlawed, the public is very empathetic about those women who are being denied these services,” June said. “Do we want the government and people like Matt Windschitl, who never have to be pregnant, who never have to take birth control, to control our health care?”
The bill should have an easy go in the Iowa House, where the Republican majority has voted reliably anti-abortion. The challenge will be in the Senate, where Democrats control the chamber 26-24.
A key vote is Davenport Sen. Joe Seng, an anti-abortion Catholic who often breaks with pro-abortion rights Democrats on abortion legislation.
“I think it should be looked at in the Senate, and I would support it,” Seng said Thursday.
There’s a question, however, if the bill would make it through the Democratic-controlled committees or get called to the floor for a vote.
Asked about it, Senate Majority Leader Mike Gronstal, D- Council Bluffs, would say only, “We’re going to continue protect women’s rights to effective health care in the state of Iowa.”
Last year, a standoff over abortions paid for by Medicaid dollars ended with what both sides called a compromise: a requirement that the governor would have to sign off personally on Medicaid reimbursement for qualified abortions. Abortions qualify for reimbursement only if the birth would threaten the life of the mother, if the fetus is deformed or if the pregnancy is the result of rape or incest.
Since that time, no abortion provider has submitted a request for Medicaid reimbursement to the state, according to Iowa Department of Human Services spokeswoman Amy McCoy.
But taxpayers arguably still pay for them, at least at the publicly funded University of Iowa Health Care system.
Spokesman Moore said the 13 abortions the hospital thinks it could have submitted for Medicaid reimbursement were instead paid “out of hospital revenues.”
He said there wasn’t a change in hospital policy after the law was passed, just in the practice of how it bills for those specific abortions.
“A policy implies something more. This has just been a practice, essentially to avoid the politics,” he said, adding the system covers “tens of millions” in unreimbursed health care costs every year.
Moore said each case was the result of severe fetal anomalies or incest. The unreimbursed cost was $23,213.20.
“I think that’s improper,” June said. “It’s plainly wrong to single out these women and have them treated differently by the governor. On a whole other level of impropriety, you can put as much lipstick on it as you want, but it’s still happening because of the generosity of the Iowa taxpayers.”
By the numbers
Abortions induced by medicine are making up a greater percentage of the abortions in Iowa since 2007. The overall number of abortions in the state has been on a downward trend during that same time.
Year Total Surgical Medicinal
2012 - 4,638 - 2,324 - 2,314
2011 - 4,808 - 2,871 - 2,522
2010 - 5,393 - 2,871 - 2,522
2009 - 5,829 - 3,163 - 2,666
2008 - 6,486 - 3,719 - 2,767
2007 - 6,649 - 4,443 - 2,206
Source: Iowa Department of Public Health