DES MOINES - Catholic, anti-abortion Gov. Terry Branstad could soon find himself in an uncomfortable position: He may have to sign off on payments for every Medicaid-funded abortion in his state.
A bill requiring that authorization is sitting on the Republican's desk after moving through the statehouse. If Branstad signs it, Iowa is likely to be the only state that would have the unique requirement.
Iowa's Medicaid program covers a small number of abortions each year due to rape, incest, fetal deformity or to protect a mother's life. Currently handled by the state Department of Human Services, the Medicaid reimbursements cost the state less than $20,000 last fiscal year.
The change in who approves the payment is a result of Iowa's unusual political landscape. It is one of only three states with a divided legislature, with Republicans controlling the state House and Democrats the Senate. Blocking funds for Medicaid abortions has been a priority for some conservative Iowa Republicans in recent years, but past efforts to change the rules - as well as make some of the more sweeping abortion restrictions seen in other GOP-majority states -have failed to advance in the Senate.
But a split legislature can lead to unusual deal-making. In this case, the abortion plan was negotiated as part of a complex health care bill that included accepting additional federal dollars to expand low-income health care in the state - a key priority for Democrats. Republicans hope by putting the decision into the hands of an anti-abortion governor, fewer public dollars will be spent on abortions. Democrats say they expect no changes, but abortion rights advocates fear it could restrict access to abortions for poor women.
Branstad said he is likely to approve the legislation, which effects reimbursements after the abortions, not authorizing the procedures ahead of time.
"The number of abortions that have been funded in Iowa has been very small. I'm hopeful that can continue and even be reduced, but I take the responsibility that I've been given very seriously," Branstad said.