William Petroski

bpetrosk@dmreg.com

The Iowa Senate gave final approval Thursday night to a $1.77 billion Health and Human Services budget bill that blocks state funding to Planned Parenthood and other clinics that provide abortions. The measure now heads to Gov. Terry Branstad, who is expected to sign it.

Senate File 515 was approved on a 28-21 vote with Republicans casting all the yes votes. The Health and Human Services budget represents nearly a quarter of the state's spending and funds programs such as Medicaid, the Department of Public Health and the Department of Veterans Affairs. In total, the bill proposes spending for 2018 that is $28 million less than it was in 2017 and $134 million less than it was in 2016.

The bill calls for Iowa's Department of Human Services to discontinue the federal Medicaid family planning network waiver, foregoing about $3 million in federal funding. Instead, the state will use about $3.3 million to recreate its own family planning network so that it can prohibit the funding of clinics that provide abortions.

Sen. Janet Petersen, D-Des Moines, unsuccessfully proposed an amendment that would retain the Medicaid family planning network. She contended the Republican-sponsored plan for family planning services will cost Iowa taxpayers millions of dollars more and will provide less family planning services to Iowans. She also predicted it will be more difficult for women to obtain reproductive health care services

Sen. Mark Costello, R-Imogene, the bill's floor manager, said the new family planning services program will serve more locations across Iowa and will expand access to women.

Petersen disagreed, saying Costello's claim was not true. "Let's not get rid of a program that works, that reduces the number of abortions," she said. Petersen's amendment was defeated on a 29-20 vote.

According to the Iowa Legislative Services Agency, there were 12,219 people participating in the existing family planning program in December 2016. Republicans have said women will have access to 221 clinics statewide that will expand coverage to rural women who must now make long drives to urban areas for family planning services. Democrats have disagreed, contending the bill will cause Iowa women to have more difficulty obtaining birth control, cancer screenings and other health care.

Suzanna de Baca, president and chief executive officer of Planned Parenthood of the Heartland and Planned Parenthood Voters of Iowa, issued a statement Thursday night urging Branstad to veto the health and human services bill. However, Branstad expressed support in his Condition of the State speech in early January for eliminating taxpayer funding to organizations that perform abortions and he is almost certain to approve the measure.

De Baca said the vote Thursday night was consistent with what has happened throughout the 2017 session, but she vowed not to give up.

"I have a message for these lawmakers who have so willingly and recklessly ignored and rejected the will of their constituents – the very people who put them in office: You can knock us down, but you will not defeat us, and you will not make us go away," de Baca said. "We are still here. We will rise again. We will stand strong. We will remember every action you took to harm the people we serve. Our neighbors, our friends, our families. We will make our voices heard and we will hold you accountable for the harm and the hurt you have caused, the futures you have irreparably damaged – the lives you have shortened. This fight is far from over.”

Maggie DeWitte, executive director of Iowans for Life, praised lawmakers for passing the bill Thursday night and she said she "absolutely" will be urging Branstad to sign the legislation and the provisions regarding family planning funds.

"We wholeheartedly support it. We feel that these funds can be better utilized at community health centers," DeWitte said. Thirty-five organizations opposed to abortion have established a coalition in support of the legislation.

In debating the overall health and human services spending bill, Costello told the Senate that the budget was not easy to develop. "We tried to put together essential services for the most vulnerable Iowans. I want people to know that I do care about people. I feel for their situations. I want to help as many people as I can to do as well as they can. I believe that my fellow Republicans care about needy people, the elderly, that we are trying to serve under this bill. We did the best that we could with the resources that we had."

Sen. Matt McCoy, D-Des Moines, expressed concerns about cuts to the Iowa Department of Human Services, and said he is worried about children falling through the cracks who require protective services.

Costello responded, "We would like to have more staff. We don't have a lot of money. But I have been assured that is one area that will not be cut."

But McCoy said he was skeptical saying, "I don't believe a thing that DHS says." He charged the Legislature has failed to do its job in providing oversight of programs needed to protect vulnerable children from child abuse, and additional cuts in DHS field services will only make the problem worse.

Sen. Tim Kraayenbrink, R-Fort Dodge, who with his wife, Sally, have taken care of 22 foster children, spoke in defense of DHS workers.

“I think people have to know that DHS is a wonderful group of people who do a wonderful job of taking care of troubled children," Kraayenbrink said.

Sen. Amanda Ragan, D-Mason City, contended that the health and human services budget falls far short of what is needed.

Ragan said cuts in family planning will result in more unintended pregnancies, more risky births, and more teenage mothers. Cuts to disease prevention will mean more preventable diseases — particularly tobacco related diseases — will not be addressed, she added. Fewer long-term care ombudsmen will mean fewer Iowans get the services they deserve and need, she said. In addition, a denial of support services to keep older persons in their homes will push more of them sooner into more expensive nursing home care, she said.

Ragan also said the budget bill budget singles out Iowa hospitals for drastic cuts, even though they are often economic engines in rural communities.

"Iowans expect their Legislature to make great laws setting priorities to protect kids, seniors, vulnerable Iowans, and all of our families. This horrendous budget falls far short of that goal," Ragan said.

Sen. Mark Segebart, R-Vail, said that if Democrats had been in the majority this session they would have faced similar needs for budget cuts because of a shortfall in state revenue. "While this is not the best thing in the world, where are we are going to find the money?" he asked. His remarks were echoed by Sen. Julian Garrett, R-Indianola, who noted that he had repeatedly cautioned in past years that Democrats were spending too much money.

The spending reductions for the upcoming state fiscal year have been forced by a $250 million budget shortfall this year. Lawmakers made $118 million worth of cuts to programs and services in an effort to cover the gap, and they borrowed another $131 million from the cash reserve funds with a promise of paying it back within two years.

During debate on the budget bill, Democrats offered a proposal to evaluate the state's Medicaid managed care program, but a vote was not permitted on the amendment because of Senate rules. Democrats also unsuccessfully tried to to pass an amendment seeking a legislative interim study on establishing a facility for older individuals who are aggressive, combative, require dementia-specific care or have other unmet psychiatric needs. Sen. Rita Hart, D-Wheatland, cited concerns about the case of an elderly sex offender who sexually assaulted an older patient at a private nursing home in Pomeroy in 2011.