Abortion ban fails pro-child, pro-family agenda

By Sean Finn and Samantha Tamborski, Common Good Iowa

Overwhelmingly, Iowans desire the freedom to determine if and when they bring children into the world. And yet Iowa legislators convened in Des Moines last week to quickly pass a six-week abortion ban — under the pretense of protecting children and families — that ignores public will as it actively works against child and family well-being. If it survives court tests, this law will ban the vast majority of abortions, impinging on the rights of Iowans to choose if and when to have children and escalating economic hardship for families.

We’ve seen repeatedly since last year’s Dobbs decision how draconian abortion bans in other states have limited doctors’ ability to provide needed pregnancy-related treatments, like managing miscarriages and fetal abnormalities. State governments imperil the health of pregnant residents by preventing doctors from using safe and well-researched methods.

And early evidence suggests some doctors are choosing not to practice in states with such restrictions.[1] Iowa already has the lowest coverage of OB/GYN specialists in the United States, and nearly a quarter of Iowa women live in “maternity care deserts,” communities with no or extremely limited maternity health care.[2] Most are located in rural Iowa and include some counties with the highest levels of child poverty – such as Appanoose, Decatur and Davis in southern Iowa.[3]

Policies that worsen access to care are also likely to exacerbate disparities in pregnancy outcomes. In Iowa, Black women have a maternal mortality rate 3 to 4 times higher than white women.[4] Three of four abortion patients in 2014 were poor (below 200% of poverty). People who struggle to access effective long-term contraceptive methods — often due to cost and location — will need to work even harder to seek such care. This issue affects than just young singles, too. Fifty-nine percent of abortions in 2014 were obtained by patients who are parents.[5]

In practice, Iowa’s ban will create two tiers of abortion access. Iowans with means are likely to retain access to abortion, despite a far more stressful, expensive process. They will manage to get time off work to travel to a state where abortion is legal, find care for their children and navigate any required waiting period. It is for lower-income Iowans — who are unlikely to have the job flexibility or financial resources — that abortion will become inaccessible.

This can’t be the end of the story. Iowans must work to restore this critical human right. We also need to redefine what it means to be pro-child and take real steps to do right by Iowa kids and their families.

A true pro-child and family policy agenda

A policy agenda for Iowa that is genuinely pro-child and pro-family is one that extends opportunity, not one that restricts rights. Here are a few timely elements of such an agenda:

Extend Medicaid coverage for new moms and young children

Right now, Iowans who get access to Medicaid because they are pregnant lose that coverage, which covers postpartum checkups, mental health screenings and counseling, just 60 days after giving birth. That’s well before they have fully recovered and postpartum health risks have subsided. Iowa is one of only three states that have taken no steps to apply a federal option to expand Medicaid postpartum coverage up to 12 months, leaving approximately 6,000 new moms without full-year coverage each year.[6]

The 12-month postpartum option is available to states until at least April 2027,[7] and Iowa legislators should approve postpartum expansion as their first piece of business next session.

Iowa should also follow the example of a growing number of states and put plans in place to offer continuous Medicaid coverage for children from birth through age 5. Guaranteeing Medicaid for the first five years assures kids can get preventive care, development screening, vaccines, and other doctor-recommended services they need to start school ready to learn. It also reduces expensive ER visits and helps parents stay focused on getting their kids to the doctor without worrying about whether visits will be covered one month to the next.

Enact paid family leave

About 1.4 million workers in Iowa — 4 of every 5 — do not have paid family leave through their jobs. As required under the Family and Medical Leave Act of 1993, large employers, including the state of Iowa, currently allow eligible employees up to 12 weeks of paid or unpaid leave within the 12 months following the birth or placement of a child. But almost two-thirds of Iowa workers have no access to leave of any kind — paid or unpaid.[8]

The State of Iowa should institute a paid leave program that enables state employees to withstand the financial burdens of pregnancy and childbirth without the fear of being unable to return to work, and then develop a program to extend paid leave to non-state employees.

Enhance family financial stability

More than 1 in 10 Iowa children live in poverty and experience food insecurity each year.[9] Many more fall above the extreme federal poverty level, but still cannot make ends meet without support. The state has a powerful set of policy tools it should use and improve:

• Expand both the state Earned Income Tax Credit and Child and Dependent Care Tax Credit, and enact a fully refundable state Child Tax Credit to support the needs of children.

• Expand quality, affordable child care and preschool so working parents can work and every child can experience enriching early learning, including continuing to expand Child Care Assistance entrance eligibility and reimbursement rates.

• Increase eligibility for SNAP to better reflect the prevalence of food insecurity and what it really takes to meet basic needs on wages alone.

Sean Finn is a Policy Analyst at Common Good Iowa and Samantha Tamborski is working as a graduate student intern from the University of Iowa School of Urban and Regional Planning.

Front-page website photo courtesy of Shawn Harmsen.