Iowa stops paying for the morning after pill for rape victims
The Iowa attorney general’s office suspended its long-standing practice of paying for emergency contraception and, in rare cases, abortions, for victims of sexual assault.
Iowa law and federal regulations require the state to pay for many of the expenses that assault survivors face seeking medical help, including the costs of forensic exams and treatment for sexually transmitted infections. . Under Attorney General Tom Miller, a Democrat, the state’s victim compensation fund has also supported Plan B – the so-called “morning after pill” – and similar treatments to prevent pregnancy unwanted.
A spokeswoman for Republican Attorney General Brenna Bird, who rejected Miller’s bid for an 11th term last fall, confirmed to the Des Moines Register that payment of those fees was suspended as part of a broader review. victim services.
“Although Iowa law does not require it, the Victims Compensation Fund has already paid for Plan B and abortions. As part of its top-down and bottom-up audit of victim assistance, the prosecutor General Bird carefully assesses whether this is an appropriate use of public funds,” Bird’s press secretary Alyssa Brouillet said in a statement. “Until this review is complete, payment of these pending claims will be delayed.”
Victims’ rights advocates say they were not told about the pause in payments and said they hoped the state would eventually resume them to ensure that victims, already dealing with the trauma of their attacks, do not end up with the bill.
In a statement, Ruth Richardson, CEO of Planned Parenthood North Central States, which includes Iowa, called the decision “deplorable and reprehensible.”
What is the Victims Compensation Fund?
Under Iowa law, money from the Victims Compensation Fund is used to directly compensate crime victims and to fund programs that provide them with services and train law enforcement and agencies victim services to combat human trafficking and domestic violence.
The states Sexual Assault Exam Payment Program, which is operated by the Attorney General’s Crime Victims Assistance Division, specifically states that victims and their insurance companies should not be charged for the cost of examinations. The compensation fund covers the bills whether or not the victim chooses to report the assault to law enforcement.
Iowa Law requires the state to cover “the cost of a medical examination of a victim for the purpose of collecting evidence and the cost of treating a victim for the purpose of preventing venereal disease”, but makes no mention of contraception or the risk of pregnancy.
Money for the Victims Compensation Fund comes from fines and penalties paid by those convicted of crimes. No general taxpayer money is used for the fund.
The United States Centers for Disease Control and Prevention estimates more than half of all women in the country have experienced some form of sexual violence in their lifetime.
Under Miller, the state covered all costs for victims
Although not explicitly required, longstanding state policy is to include the cost of emergency contraception in expenses covered by the victim compensation fund, said Sandi Tibbetts Murphy, director of Miller’s victim assistance division.
“The procedures put in place by the office were … that all costs were billed directly to CVAD’s Sexual Assault Review Program and victims were not to be billed for any of this, and their insurance was not to be billed. “said Tibbetts Murphy. “…Our Compensation Specialists, they are not medical providers. Their job is to review records and cover expenses according to policies and bylaws, and whether the physician has prescribed Plan B or any other intervention , that was 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 eventually decides to resume covering those expenses.
“I am concerned for victims of sexual assault who, without proper notice, now find themselves either unable to access necessary treatment and services, or are now forced to pay out of pocket for these services, when it has been done through no fault of their own,” she said.
The victims’ aid fund also paid for abortions
Tibbetts Murphy confirmed that in rare cases the fund has also paid for abortions for rape victims.
“If there was a later need for an abortion service, coverage (was provided) for this, which was rare but provided and usually involved abortion medication, as opposed to actual treatment,” she said.
State laws governing the victim compensation fund do not directly address coverage for abortions. Although many federal laws and programs impose restrictions on the use of public funds to pay for abortions, like the Hyde Amendment that has long been included in federal appropriations bills, these limits usually have exceptions for cases of sexual assault or to save the life of the mother.
Advocacy: review contraception, abortion separately
The decision to suspend and reassess payments for contraception and abortion comes amid a broader audit of victim services Bird announced his first day in office. Bird’s office did not respond to messages asking how often the victims’ relief fund had already paid such expenses or how much had been spent.
Beth Barnhill, executive director of the Iowa Coalition Against Sexual Assault, said her organization was unaware of the change until the registry seeks comment, and that she also hopes the State will decide to continue its payment policy.
“I hope they do, because we want survivors to have as many options as possible,” Barnhill said.
But she also said she was urging the attorney general’s office to consider paying for emergency contraception separately from abortions, a more politically controversial procedure.
“I hope they really consider (my comment) not considering emergency contraception and abortion as the same, because emergency contraception is not the same as abortion, and I know that it’s quite often confused in public discourse,” she said. “But if a rape survivor had access to emergency contraception, she potentially wouldn’t have to make that difficult decision about pregnancy.
“If you want to alleviate the trauma of survivors, we would definitely want to make it available.”
Major health systems ignore payment pause
It’s unclear whether health care providers or the victims themselves are bearing the cost of providing these over-the-counter drugs since Bird suspended payments. The registry was unable to confirm whether individual victims received bills, and Barnhill said she had not heard of such reports from any of her organization’s member agencies.
The typical cost for a dose of Plan B is around $50 at retail pharmacies. Other options, including generic morning after pills available to buy online, usually cost less – around $15 to $25.
Officials from UnityPoint Health and University of Iowa Hospitals and Clinics told the Register earlier this week that they had not been notified of the pause in victim compensation. Asked about the potential impact, UIHC officials did not respond.
UnityPoint Health and MercyOne both declined to comment.
Planned Parenthood officials called the decision “odious,” saying it “further demonstrates the politicians’ crusade against the health and rights of Iowans.”
“Survivors of sexual assault shouldn’t have to worry about how they’re going to cover health care costs after they’ve been assaulted,” Richardson, regional CEO of Planned Parenthood, said in a statement. “Survivors should be able to get the health care they need and that survivors have relied on for years. It is deplorable and wrong that the state government is depriving victims of health care, and it is essential that the Attorney General immediately resume funding health care.
Bird policies reflect greater anti-abortion push
Since taking office, Bird — a vocal opponent of abortion – reversed the approach to abortion policies under his predecessor. She has signed on to represent Gov. Kim Reynolds in his lawsuit to implement the state’s “fetal heartbeat” law, a ban on abortions after six weeks of pregnancy that has been blocked in court. Miller had refused to uphold the law during his tenure.
Recently, Bird announced its intention to join a multi-state trial against the US Food and Drug Administration if it allows large drugstore chains to start selling abortion pills by mail. She has also writes to Walgreens and other big companies warning them not to sell abortion pills in Iowa. And his office has supported a lawsuit in Texas which seeks to revoke FDA approval for the abortion-inducing drug mifepristone.
The moves come as most Iowans continue to support legal abortion. A new Iowa poll last month 61% of Iowa adults say abortion should be legal in most or all cases, while 35% say the procedure should be illegal in most or all cases.
These results mirror the results of an October poll in Iowa that found that 61% of Iowa adults support legal abortion in most or all cases, compared to 33% who said that it should be illegal in most or all cases.
Federal health officials have took action distinguish emergency contraceptives from abortion pills. Morning after pills do not induce abortionand instead work as a backup contraceptive to prevent pregnancy from occurring.
Still, reproductive rights advocates have raised concerns that Republicans in some states may take steps to restrict morning-after pills in their efforts to reduce abortion. Since the Supreme Court overturned Roe v. Wade, at least two states have proposed banning certain contraceptive drugs, including emergency contraception. However, neither policy came to fruition.
Republicans in Iowa have taken no such action. In fact, Reynolds has pushed a proposal in the state legislature to allow Iowans 18 and older to receive a contraceptive from pharmacists without a prescription.
William Morris covers the courts for the Des Moines Register. He can be contacted at [email protected]715-573-8166 or on Twitter at @DMRMorris.
Michaela Ramm covers health care for the Des Moines Register. She can be reached at [email protected]at (319) 339-7354 or on Twitter at @Michaela_Ramm.
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