Analysis of S.B. 217.

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Analysis of S.B. 217.41

Lesley James

Briar Cliff University

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I. Background
a. Origination of the policy
b. Problems that made the policy necessary
c. Legislative history of the policy
II. Description of the Problem
III. Policy Description
a. How it is expected to work
b. Who will be covered
c. Agencies involved
d. Opportunities the policy will provide
IV. Policy Analysis
a. Are the goals just and democratic
b. Political feasibility and economic feasibility
c. Fiscal analysis
d. Do the goals of the policy contribute to greater social equality
e. Do the goals positively affect the redistribution of income, resources, status
f. Do the goals contribute to a better quality of life for the target population
g. Are the goals consistent with the values of professional social work

Origination of the policy

Senate Bill 217.41 was introduced to the Iowa Senate by Senator Amy Sinclair (R-

District 14) on January 9th, 2017 and referred to Judiciary. S.B 217.41 is an act relating to the

establishment of a state family planning services program and a discontinuation of the Medicaid

family planning network waiver. The bill states,

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The department of human services shall discontinue the Medicaid family planning

network waiver effective July 1, 2017, and shall instead establish a state family planning services

program. The state shall replicate the eligibility requirements and other provisions included in

the Medicaid family planning network waiver as approved by the centers for Medicare and

Medicaid services of the United States department of health and human services in effect on June

30, 2017, but shall provide for distribution of the family planning services program in

accordance with this section.

1.Distribution of family planning services program funds shall be made to eligible

applicants in the following order of priority:

a. Public entities that provide family planning services including state, county, or local

community health clinics and federally qualified health centers.

b. Nonpublic entities that, in addition to family planning services, provide required

primary health services as described in 42 U.S.C. {254b(b)(1)(A).

c. Nonpublic entities that provide family planning services but do not provide required

primary health services as described in 42 U.S.C. {254b(b)(1)(A).

3. Distribution of family planning services program funds under this section shall be made in a

manner that continues access to family planning services.

4. Distribution of family planning services program funds shall not be made to any entity that

performs abortions or that maintains or operates a facility where abortions are performed. For the

purposes of this section, "abortion" does not include any of the following:
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a. The treatment of a woman for a physical disorder, physical injury, or physical

illness, including a life endangering physical condition caused by or arising from

the pregnancy itself, that would, as certified by a physician, place the woman in danger of death.

b. The treatment of a woman for a spontaneous abortion, commonly known as a

miscarriage, when not all of the products of human conception are expelled.

5. Family planning services program funds distributed in accordance with this section shall not

be used for direct or indirect costs, including but not limited to administrative costs or expenses,

overhead, employee salaries, rent, and telephone and other utility costs, related to providing

abortion services. ( Iowa Legislature,2017)

Leading up to the introduction of this bill, many Iowan Republicans seeking election

last fall promised voters they would halt public funding to Planned Parenthood if they were

elected. GOP lawmakers have repeatedly tried in recent years to block the appropriation of

money for Planned Parenthood, but they had been overshadowed by Senate Democrats who held

the majority. That political barrier was removed in November when Republicans won control of

the Senate by outing 6 Democratic incumbents while retaining a majority in the Iowa House.

(Andrusko, Feb. 2017)

Republican Iowans are focusing on using taxpayers money to pull the funding away

from clinics who perform abortions.

After bring introduced on January 9th, 2017 the bill moved rather quickly. According to

Iowa Legislature, committee and subcommittee recommended passage on January 31,2017. On

February 2,2017 the bill was passed by the senate and given to the house for consideration.
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House representatives heard information regarding the bill on February 6th 2017 and passed the

subcommittee on the House side on February 14,2017.

Senate Bill 217.41B will restrict government funding to clinics who perform abortions

when not medically necessary.

Senate Bill 217.41 will not eliminate completely eliminate tax funding to planned

parenthood . Federal programs will still continue for teen pregnancy and prevention programs.

This bill will not eliminate family planning services for needy Iowa women. In 2016 nearly 3

million dollars was spent in combination with state and federal monies. This bill will redirect this

money towards programs to assist with birth control services, pap test, STD screenings, which

are all services currently covered. The goal is to spread this money across the board in other

clinics, away from Planned Parenthood or any other entity that performs abortions. This law does

not change the laws regarding abortion. Currently tax money does not cover elective abortions.

There will be no change related to that. This bill does not limit or restrict a woman from seeking

out or obtaining an abortion. It is a measured attempt to balance the reproductive health care

needs of Iowas working poor with the objections of taxpayers to tangibly subsidize these services

through shared facilities.

Family planning services will be provided by health care providers who will also be

able to examine the womans overall health, and identify needs that may otherwise go unnoticed.

The added benefit of this alone is enough to support this bill.

The funding level for the new Family Planning program is expected to completely fund

the program. Prioritizing clinics will not be an issue unless funding is exhausted. All Medicaid
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approved providers will be able to provide care to Iowans and the expanded group of providers

will ensure patients find a primary care provider while seeking reproductive health care.

DHS will utilize the same delivery method for transitioning into the new Family

Planning Program. They will use the same MOU process with providers as they have used in the

past. They will use the same process for patient access that currently exists. According to DHS,

the new program will improve access to eligibility for family planning and family planning

related services and will increase the number of Iowans receiving family planning services.

Transitioning to this new program will increase the services women will be able to find

in more rural areas. There will be increased access and a broader scope of availability of family

planning services when allocating this funding through the new program. This plan intends to

provide a higher level of funding than what is currently offered. The same rules for qualifying

still stand for both the providers and the patients. The only thing that changes here is that

providers who also provide abortions will be excluded from eligibility. If a provider who

performs

abortions wishes to receive funding under the new family planning program, they could simply

discontinue offering those services in their facilities and continue to receive funding. This bill

does not close clinics; women will not go without care, screenings, and services. They will be

receiving those services where they live in conjunction with their broader health care needs.

According to Legislative Services Agency (2017) this bill directs the Department of

Human Services to discontinue the Medicaid Iowa Family Planning Network waiver beginning

July 1, 2017. In place of this waiver, a state Family Planning Services Program will be

implemented. Background of this bill: the IFPN allows men and women to be enrolled in
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Medicaid to receive family planning services only. This program is in essence, a form of limited

insurance coverage. Program eligibility will remain the same. The Iowa Legislative Bureau

predicts the following:

As of December 2016, there were 12,219 individuals participating in the IFPN.

IFPN Waiver expenses are projected to be $3.4 million in FY 2018. Of that amount,

$482,035 are State dollars and $2.9 million are federal dollars.

It is assumed the $482,035 in State funding will continue to be used to fund the new

Program.

The Federal Medical Assistance Percentage (FMAP) rate for the IFPN is 90.00%

federal and 10.00% State. The administrative FMAP rate for the IFPN is 50.00% federal and

50.00% State.

The State Family Planning Services Program will be required to set up a new

administrative system to manage the Program, which is anticipated to cost $200,000 annually.

Under the new Program, the State will be responsible for 100.0% of the costs.

The Bill takes effect upon enactment and is to be implemented July 1, 2017. Due to

the federal requirements of phasing out the IFPN taking at least seven months, it is assumed the

new Program will take effect after the intended start date beginning November 1, 2017.

Persons eligible for IFPN as described by Iowa Department of Human Services (2017)

are women whose pregnancies and deliveries were covered by Medicaid will have family

planning services covered by Medicaid for an additional 12 months without having their
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eligibility re-determined. Men and Women, ages 12-54, who are legal residents of Iowa and

Whose income is up to 300% of poverty are eligible, non-U.S. citizens if they qualify, and men

and women who are not enrolled in traditional Medicaid or the Iowa Health and Wellness Plan.

In determining IFPN eligibility, the households countable monthly income shall not

exceed the amounts shown in the chart below for a household of the same size.

In an article on WHO13 news (2017) a reporter states, A procedure that ends a life, in

our minds, is not healthcare, said Loraditch. Rally-goers say their message is for women

dealing with unplanned pregnancy. Id like women to understand that if they have an unplanned

pregnancy its not the end of the world. There are crisis pregnancy centers that can reach out and

help, there are churches in Des Moines that can reach out and help, and all they need to do is

ask, said Rhonda Phillips. I pray for them to choose life instead of death, its a very tough

decision, said Sonya Kokemuller. Those protesting also say they need the money currently

going to Planned Parenthood to be spread out across the state. I live in a rural community. We

dont have a Planned Parenthood there, where do all those women go to get care? said Phillips.

The abortion debate can get fiery, emotional, and even angry at times. Those who stood for their

beliefs Saturday say they did so in kindness. I recognize that I cannot possibly understand what

goes through the heart and mind of a woman that feels like theyre in that kind of position, and

the only thing I could hope to say to someone in that position is 'we love you, we love you and

the choices that youve made regardless of what they are,' said Loraditch.

This bill is a very emotional and controversial one. I believe overall the goals of Iowans

pushing forward are of the best interest of those involved.

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REFERENCES

"Iowa Department of Human Services." Iowa Family Planning Network (IFPN) |

Iowa Department of Human Services. N.p., n.d. Web. 12 Mar. 2017.

Petroski, William. "Iowa House advances bill blocking Planned Parenthood

funding." Des Moines Register. N.p., 14 Feb. 2017. Web. 12 Mar. 2017.
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Agency, Iowa Legislative Services. "Iowa Legislature - BillBook." Iowa

Legislature - BillBook. N.p., n.d. Web. 12 Mar. 2017.

Petroski, William. "Showdown nears on Planned Parenthood funding in Iowa

Legislature." Des Moines Register. N.p., 21 Jan. 2017. Web. 12 Mar. 2017.

"Iowa legislators Advance Bill to Defund Planned Parenthood Abortion

Company." LifeNews.com. N.p., 16 Feb. 2017. Web. 12 Mar. 2017.

ProgressIowa. "Sen. Sinclair Closing Remarks on SF2." YouTube. YouTube, 02

Feb. 2017. Web. 12 Mar. 2017.