DES MOINES | Legislation that would make it illegal for a doctor to perform an abortion in Iowa once a fetal heartbeat is detected won initial support Thursday after emotional and pointed testimony.
“Killing is not health care,” said subcommittee member Sen. Jason Schultz, R-Schleswig, who supported forwarding the bill to the full Senate Judiciary Committee.
The bill is viewed as a vehicle to overturn the 1973 landmark U.S. Supreme Court decision legalizing abortion.
Senate Study Bill 3143 would bar a physician from performing an abortion when tests determine a heartbeat is present unless a medical emergency exists that warrants the procedure.
Violation of the bill’s provisions would subject a doctor to a Class D felony charge carrying a five-year prison term but with no penalty for the woman.
Proponents said the measure would protect the sanctity of life, while critics argued it was an unconstitutional encroachment on informed medical decisions that should be made by a woman in consultation with her doctor without fear of government interference.
“This bill is dangerous and unconstitutional,” said subcommittee member Sen. Janet Petersen, a Des Moines Democrat who is Senate minority leader.
“This bill doesn’t just go after women,” she said. “It goes after doctors, it goes after girls, it goes after moms, it goes after grandmas, it goes after Iowa families. This bill will impact every Iowan who gets their period and every woman who doesn’t get their period. It is a direct attack on women’s health care across our state.”
However, subcommittee chairwoman, Sen. Amy Sinclair, R-Allerton, in refuting the bill was a “war on women,” argued the legislation would reduce deaths of Iowa women associated with abortion procedures.
“These are human beings," Sinclair said, referring to a fetus. "We have the responsibility to offer them the same liberty and the same rights that you and I have."
The bill advanced on a 2-1 party line vote.
Leah Vanden Bosch was among the speakers giving emotional testimony, telling the panel she likely would have killed herself if she hadn’t had an abortion.
“If you passed this bill and this was in effect when I got pregnant, I would not be sitting here today because I know I would have taken my own life,” she said. “So, if you are so concerned with life, think about the life of these women, I’m praying to the same God that you are this morning.”
Jamie Burch of Planned Parenthood of the Heartland said the bill “intentionally goes too far” and “inserts the government into the personal lives of Iowa women.”
“The motivation behind this bill is clear: to create a vehicle to challenge Roe v Wade,” Burch said. “If this bill passes and is signed into law by our governor, it will open the door to endless litigation.”
Dr. Lisa Banitt expressed misgivings about the bill, saying a fetal heartbeat may be detected as early as four weeks into a pregnancy, but situations differ among women and doctors may be at the mercy of aging ultrasound equipment and other factors that make criminal consequences problematic.
Petersen and others warned the state’s only training program on abortion — at the University of Iowa for OB/GYN doctors — likely would be shut down if the bill becomes law.
Tom Chapman, executive director of the Iowa Catholic Conference, told lawmakers the church believes life begins at conception but is “neutral” on the bill because it is “likely unconstitutional.”
“We should consider the unintended, long-term consequences that could result from our court finding a robust right to an abortion in our state Constitution, which could result in the elimination of some of the limitations we already have in Iowa,” he said.
Sen. Rick Bertrand, R-Sioux City, said in a statement that getting the issue back into the judicial system is “exactly what this bill is designed to do — challenge the courts, and start the process to take down Roe v. Wade. The time is now to go on offense, do the right thing, and lead.”
Bertrand said he was disappointed, as a practicing Catholic, with the Catholic conference’s stance and recommended the state’s four Catholic bishops rethink their position on the bill.
“Registering neutral is cowardice, and I believe does not represent what an everyday Catholic parishioner believes,” Bertrand said in the statement. “The defense of life is one of our core Catholic beliefs, and I believe that the bishops need to explain to their parishioners on Sunday why they have taken this position.”
Wellmark Blue Cross and Blue Shield is back.
A little more than a month after the Des Moines-based insurer left the state’s insurance exchange, Wellmark will return in 2019 to sell Affordable Care Act-compliant plans on and off the exchange, the company announced Thursday.
“We are predisposed to want to be in this market, so we need just enough certainty to allow us to be there and we think we now have that,” Cory Harris, executive vice president and chief administrative and legal officer, told The Gazette Thursday.
The company will offer fully ACA-compliant plans on the public exchange in all 99 counties beginning Jan. 1, 2019, “assuming there aren’t any significant changes to the Affordable Care Act,” stated a news release from the company.
Company officials said more stability in the ACA market allows Wellmark make a to return, Harris said.
“Remember last year in Washington, it was all about repeal and replace, which left our company with a lot of uncertainty about the viability about this particular market segment,” Harris said. “A lot of that has seemed to have subsided to some degree.
“That regulatory uncertainty has dissipated just enough that we think we’re able to step back in and serve the market segment that we had historically been in and we want to be in.”
Enrollment nationwide on the ACA exchange remained virtually unchanged from last year, despite efforts by President Donald Trump and other politicians to eliminate or weaken the 2010 health law. According to nationwide figures from the National Academy for State Health Policy, almost 12 million people signed up during the enrollment period for 2018 health coverage through the ACA.
Wellmark, the state’s largest insurer, had announced in April of last year it no longer would sell subsidy-eligible plans in the exchange as of Jan. 1, 2018.
High costs and an uncertain future surrounding the ACA was the driving force behind the company’s decision. It had lost about $90 million through the individual market, officials said at the time, while individuals enrolled with those plans saw a nearly 43 percent premium increase this past year.
“The decision last year to leave the individual ACA, it was a painful one,” Harris said. “That was a lot of deliberation and was not an easy decision to make.”
The decision affected 21,400 of the company’s policyholders — about 1.6 percent of its more than 1.66 million Iowa members — who then no longer had coverage through Wellmark at the start of 2018.
Wellmark’s exit left three insurers on the Iowa exchange — Medica, Aetna and Gundersen Health Plan.
Aetna departed Iowa’s individual insurance market in April 2017, leaving Medica as the only statewide provider of ACA-compliant plans — health plans that cover certain “essential benefits” dictated by the federal law.
Gundersen sells in only five of Iowa’s 99 counties.
“We think it’s good for the market to have choice,” said Medica Vice President of Individual and Family Business Geoff Bartsh in an email to The Gazette Thursday. “Medica is very proud of our commitment to Iowa and our decision to stay in the market for 2018.
“But Iowa’s individual insurance market should work better for consumers than it does today, including having more choices. We are committed to working with others on solutions to this end.”
Wellmark pivoted from its previous decision to leave Iowa’s exchange after policyholders, Gov. Kim Reynolds and Iowa Insurance Commissioner Doug Ommen “asked Wellmark to offer individual and family coverage in this market,” Thursday’s new release from Wellmark stated.
In a guest column published June 4, 2017, in The Gazette, Wellmark Chairman and Chief Executive Officer John Forsyth said there were certain aspects of the market that needed to be addressed to “allow Wellmark and other carriers to re-enter the health insurance market in Iowa.”
Three of those aspects were:
l Ensuring a viable risk pool by bringing more people with varying degrees of health into the market.
l Tightening the rules that allow individuals to purchase insurance after they become ill.
l Requiring subsidies based on age and income to attract more diversity into the member pool.
The market “is still imperfect” and a lot of the items Forsyth set out have yet to occur, Harris said, but a firmer footing is enough for the company to return to a market “we need to be back in.”
“We’re hopeful that these things will come into being because we think there’s still ways that the ACA can still be improved, but we’re not going to let perfect be the enemy of the good,” he said.
Last year, Wellmark worked with the state to pursue the Iowa Insurance Division’s stopgap measure, an appeal for a federal waiver that aimed to stabilize the individual market by attracting young, healthy enrollees.
State officials withdrew the proposal in October after no approval came from federal leaders.
“Although federal law was not flexible enough to provide the relief needed to implement the measure, we remain committed to finding a solution,” the Wellmark release stated.
Iowa Insurance Commissioner Doug Ommen told The Gazette last month he had no plans to file the stopgap measure again, adding that the solution needs to come from the federal level.
Harris said Wellmark is not working on any proposals specifically, such as the stopgap measure, but remains receptive and hopeful for similar initiatives.
DES MOINES | Establish state funding levels for public schools now; address inequities in the school funding formula later.
That was the message state lawmakers in the Iowa House sent across the Iowa Capitol to their colleagues in the Senate on Thursday, as Republicans in command continued their work on setting public school funding for the 2018-2019 school year.
The chambers have agreed on increasing public school funding over the current year by 1 percent, which would result in more than $3.2 billion in statewide funding, an increase of roughly $32 million.
The chambers have not agreed on how to address inequities in the school’s funding formula. Some districts have higher transportation costs, which means they have a smaller share of funds to spend on the classroom than other districts. And some districts are able to spend more per student than others.
The Senate on Wednesday attached to the school funding bill their plan to address the transportation funding issue.
The House on Thursday rejected that plan; House leaders said they prefer to address the funding formula’s inequities in separate legislation, and that the Senate plan does not appropriately tackle the issues.
Rep. Cecil Dolecheck, who leads the House’s education budget committee, said the Senate proposal addressed a “very much needed concern,” and pledged the House will offer its proposal in legislation next week. He said the House plan will prioritize funding for districts with the largest transportation costs.
“I give you my word we will address this issue,” Dolecheck said, adding that he has been working on the transportation funding issue for 20 years. “I’m excited we’re at the point we can get something done.”
Although she respected his word, Rep. Mary Mascher, D-Iowa City, called the Senate proposal a “bird in the hand” for Democrats who have been pushing to address transportation costs, especially for large rural districts, as well as the per pupil inequity issue in Davenport and other districts.
“I’d rather have this one than the promise we’ll do something next week,” she said.
Rep. Todd Prichard, D-Charles City, also found it “troubling that when given an opportunity that we can’t have a proposal that is acceptable.”
However, Rep. Cindy Winckler, D-Davenport, said she respected the effort Dolecheck and others were making by working on Senate File 455 to solve those issues.
“The dilemma we are in is whether or not what is promised to us today will actually come before us on the floor of the House,” Winckler said. “I will take a leap of faith and support the intent the majority party has.”
House Minority Leader Mark Smith, D-Marshalltown, wondered why the House and Senate Republicans hadn’t worked out their differences before bringing the school funding bill to the floor.
The House voted 57-37 to defeat the Senate-amended version of the school funding bill. Thirty-six Democrats and Rep. Norlin Mommsen, R-DeWitt, voted for it. Winckler joined 56 Republicans to defeat it.
That sends the school funding bill back to the Senate, which adjourned Thursday for the weekend before considering the updated version. Because the House rejected the Senate plan that included the transportation funding, the Senate must approve the new plan without the transportation funding before sending the bill to Gov. Kim Reynolds for her approval.
By failing to agree on the school funding bill Thursday, Republicans missed the deadline that they wrote into law a year ago that requires K-through-12 public school funding be set within the first 30 days of the legislative session.
“We did our job,” Rep. Walt Rogers, chairman of the House education committee, said with a shrug.