Abortion Providers: Restrictions
Restrictions on Who May Provide Abortion Services
Iowa prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed to practice medicine and surgery in the state or a licensed osteopathic physician and surgeon may provide abortion care. Iowa Code Ann. § 707.7 (Enacted 1976; Last Amended 1996).
Iowa’s post-viability abortion restriction states that no abortion may be provided after the end of the second trimester unless necessary to preserve the woman’s life or health. The physician must make every reasonable medical effort, not inconsistent with preserving the woman’s life, to preserve the life of a viable fetus. Iowa Code Ann. § 707.7 (Enacted 1976; Last Amended 2009).
NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortions so long as they contain adequate exceptions to protect the woman’s life and health. NARAL Pro-Choice America opposes Iowa’s law because it is unconstitutional to the extent that it prohibits pre-viability abortion by defining viability at the end of the second trimester. A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside of a woman’s body. Roe v. Wade, 410 U.S. 113, 163 (1973). Because viability is a point that varies with each pregnancy, states may not declare that it occurs at a particular gestational age. Colautti v. Franklin, 439 U.S. 379, 388-89 (1979).
Abortion Bans Throughout Pregnancy: Procedure Ban
Iowa has an unconstitutional and unenforceable ban that outlaws abortion procedures as early as 12 weeks. Iowa Code Ann. § 707.8A (Enacted 1998).
A court held that Iowa’s ban is unconstitutional because it imposes an undue burden on women seeking abortion care and has issued a permanent injunction prohibiting its enforcement. Planned Parenthood of Greater Iowa, Inc. v. Miller, 195 F.3d 386 (8th Cir. 1999), cert. denied, 530 U.S. 1274 (2000). The U.S. Supreme Court held that a similar ban that has no exception to protect a woman’s health and that bans more than one procedure is unconstitutional. Stenberg v. Carhart, 530 U.S. 914 (2000).
Iowa’s unconstitutional law makes any abortion procedure that falls within a broad definition a felony punishable by imprisonment up to 10 years and a fine of $1,000 to $10,000. The law has an exception if an abortion is necessary to preserve the life of a woman endangered by a physical disorder, physical illness, or physical injury. Iowa Code Ann. § 707.8A (Enacted 1998).
There is also a Federal Abortion Ban, which applies nationwide regardless of state law. The federal ban prohibits certain second-trimester abortion procedures and has no exception for a woman’s health. In April 2007, the U.S. Supreme Court upheld the ban, making it the first time since Roe v. Wade that the court has upheld a ban on a previability abortion procedure. Click here to read more about the Federal Abortion Ban.
No state measure.
No state measure.
Insurance Coverage & Abortion
Supports Insurance Coverage of Contraception
Iowa law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.
What is required? If a health-insurance plan provides coverage for outpatient prescription medication or devices or outpatient services, it must provide coverage for Food and Drug Administration-approved prescription contraception and outpatient contraceptive services.
To which insurance plans does the law apply? Individual and group health-benefit plans issued or renewed on or after July 1, 2000, except for certain limited benefit plans, that provide coverage for outpatient prescription medication or devices or outpatient services.
Does the law provide additional protections for women? Yes. An insurer may not: (1) deny eligibility because of a covered individual’s use or potential use of contraception, or outpatient services; (2) provide monetary payment to encourage a covered individual to accept less than the minimum benefits required by this law; (3) penalize or limit reimbursement of a health-care professional because he/she prescribes contraception; (4) provide monetary or other incentives to induce a health-care professional to withhold contraception from a covered individual; or (5) impose any deductible, coinsurance, or copayment for contraception that differs from those imposed for any other outpatient medication, device, or service under the plan.
Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage? No.
May an individual obtain a health-insurance policy that excludes contraceptive coverage? A person who holds an individual heath-insurance policy or contract may refuse the coverage required by this law.
Iowa Code Ann. § 514C.19 (Enacted 2000).
Low-Income Women & Abortion
Restricts Low-Income Women’s Access to Abortion
Iowa prohibits public funding for abortion for women eligible for state medical assistance for general health care unless: (1) the continuation of the pregnancy would endanger her life; (2) the fetus is physically deformed, mentally deficient, or afflicted with a congenital illness; or (3) the pregnancy is the result of a rape reported within 45 days of occurrence; or (4) the pregnancy is the result of incest reported within 150 days of occurrence. Iowa law requires the governor to decide on a case-by-case basis whether women meet the criteria above and thus if Medicaid funds can be used to cover abortion services in these instances. Iowa Admin. Code r. 441-78.1(17) (Enacted 1985); Iowa Dep’t of Human Servs., Medicaid Provider Manual: Physician Services, Coverage and Limitations Physician Services, E-68, E-69, E-74 (July 2014), at https://dhs.iowa.gov/sites/default/files/Phys.pdf. 2016 Iowa Acts Ch. 1139.
Young Women & Abortion
Iowa law restricts young women’s access to abortion.
Is the law enforceable? Yes. A federal trial court held that this law is constitutional. Planned Parenthood of Greater Iowa, Inc. v. Miller, No. 4-96-CV-10877 (S.D. Iowa Oct. 16, 1997).
Who is considered a minor? A young woman who is under the age of 18 and has never been married.
What is required – parental consent or parental notice? Notice.
Who must be notified? One parent.
Are there other trusted adults who may be notified instead? Yes, a grandparent, but the grandparent may be subject to a civil lawsuit if s/he accepts notification.
What is the process for providing notification? A young woman may not obtain an abortion until at least 48 hours after written notice is provided in person or by certified mail by the attending physician to a parent or grandparent. The 48-hour period begins to run at noon on the next day on which regular mail delivery takes place. Parental notice is not required if the parent authorizes the abortion in writing. If the minor notifies a grandparent in lieu of a parent, the minor must submit in writing to a physician her reason for not notifying a parent as well as her reason for notifying a grandparent. In addition, the notice form must state that grandparents may be subject to civil action if they accept notification and that they may refuse to accept notification.
May the parental mandate be waived if a young woman is a victim of rape or incest? Yes, if the young woman declares that she is a victim of reported sexual abuse.
May the parental mandate be waived if a young woman is a victim of child abuse? Yes, if the young woman declares that she is a victim of child abuse and such abuse has been reported or that the parent is named in a report of child abuse.
May the parental mandate be waived if a young woman’s health is threatened? Yes, but only if the attending physician certifies in writing that a medical emergency exists. A medical emergency is defined as a medical condition of the pregnant woman that necessitates an immediate abortion to preserve her life or for which a delay will create a "risk of serious impairment of a major bodily function."
May the parental mandate be waived under any other circumstances? Yes, the young woman may try to obtain permission from a judge.
If a young woman must obtain permission from a judge, what is the process? She must secure a court order stating either that she is mature and capable of giving informed consent or that parental notice is not in her best interests.
Are there other significant requirements under the law? Yes. Before providing abortion care to a young woman, a physician must offer, and obtain written certification that she has been offered, written decision-making materials, including a workbook and a video presentation that includes information about her options, including continuing the pregnancy to term and retaining parental rights, adoption, and abortion. The video must explain that public and private agencies are available to assist the young woman with any alternative chosen and that the "father" is liable for child support. The written decision-making materials must include information about the options described in the video including the agencies and programs available to provide assistance to the young woman in parenting a child, information on adoption and abortion, information regarding the "father’s" liability for child support, and other support options. To the extent possible and at the discretion of the young woman, the person "responsible for impregnating" her must be present for the viewing of the video and the receiving of the written decision-making materials. In addition, the young woman is to be encouraged to choose a responsible adult also to be present.
Has a court considered the constitutionality of this law? Yes. A court denied both a temporary restraining order and a preliminary injunction, allowing the law to remain in effect. Planned Parenthood of Greater Iowa, Inc. v. Miller, No. 4-96-CV-10877 (S.D. Iowa Oct. 16, 1997).
Other information about the law: None.
Iowa Code Ann. §§ 135L.1, .6 to .8 (Enacted 1996; Last Amended 1997), 135L.2, .3 (Enacted 1996; Last Amended 1998).
Insurance Coverage & Contraception
No state measure.
Low-Income Women & Contraception
Supports Low-Income Women’s Access to Contraception
Iowa provides increased access to reproductive-health-care-services through a Section 1115 family-planning waiver. The waiver allows the state to cover family planning services for women enrolled in Medicaid who would otherwise lose coverage postpartum and for women over the age of 12 and under the age of 45 with incomes at or below 300 percent of the federal poverty level. Additionally, enrollees must be (1) U.S. citizens or persons who meet the state’s defined immigration requirements and (2) Iowa residents.
Beneficiaries of family-planning coverage available through the waiver are not required to pay premiums or co-payments for covered services. Covered services include: medically necessary services and supplies related to birth control; pregnancy prevention and preventive services, including contraceptive management with a variety of methods, patient education, counseling, and referral as needed to other social services and health-care providers; contraceptive counseling and information; contraceptive supplies, devices, implants and prescriptions; office visits, consultations, examination and medical treatment; laboratory examinations and tests; voluntary sterilization; HIV blood screenings/STI testing in conjunction with a family-planning encounter.
The waiver is set to expire Dec. 31, 2016.
Iowa Family Planning Network, Project No. 11-W-00188/7, at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ia/ia-family-planning-network-ca.pdf.
No state measure.
Other Important Issues
No state measure.
Crisis Pregnancy Centers
No state measure.
Refusals & Guarantees
Refusals of Medical Care
ABORTION REFUSAL CLAUSE
Iowa allows certain individuals or entities to refuse to provide abortion services.
To whom does the refusal clause apply? Individuals and hospitals that are not controlled, maintained, and supported by a public authority.
What does the refusal clause allow? Allows individuals who object on the basis of religious beliefs or moral convictions to refuse to participate in medical procedures that result in an abortion that does not constitute emergency medical treatment of a serious physical condition necessary to preserve the woman’s life. A person may not discriminate against any individual in any way, including employment, licensing, education, training, or granting of hospital privileges or staff appointments, for participating or refusing to participate in an abortion not necessary in an emergency to preserve the woman’s life.
Allows hospitals that are not controlled, maintained, and supported by a public authority to refuse to permit an abortion not necessary to preserve the woman’s life. The refusal of a non-public hospital to permit abortion may not be a basis for civil liability or other recriminatory action.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? Yes, during emergency medical treatment of a serious physical condition necessary to preserve the woman’s life.
Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.
Does the law provide a mechanism for women to otherwise obtain specific reproductive-health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.
Iowa Code Ann. §§ 146.1, .2 (Enacted 1976).
Counseling & Referral Bans
No state measure.