Last week, Iowa Governor Terry Branstad signed a bill expanding Medicaid in the state. As part of the deal, however, Republicans were able to bury a provision within that gives Branstad the power to personally decide if a woman can have abortion coverage.

In what is the first rule of it’s kind, women who need an abortion if their lives are in danger or are victims of rape or incest must seek final approval from the Republican Governor before Medicaid will cover the cost of the procedure. If the Governor denies approval, the bill for the cost will be sent to the woman.

According to the Des Moines Register:

Under current policy, the Department of Human Services already reviews claims for Medicaid funding of abortion services, scrutinizing documentation to ensure the procedure was performed in a case of rape, incest, fetal abnormality or to save the life of the mother — the four reasons for which reimbursement is allowed under state and federal law. That review occurs after the abortion has been performed, when the billing process is initiated. With the bill’s passage into law, that process likely still will occur. And a final decision will again come after an abortion has been performed. But instead of the final call being rendered by the Medicaid medical director, the democratically elected and politically accountable governor will decide.

In other words, instead of a health care professional, the anti-choice Governor will get to make the final call on who gets abortion coverage. Even though Branstad has no medical training or health care experience or investigative training, he gets to be the person who makes the final call as to whether or not a woman was raped or had a life threatening pregnancy that required an abortion. And considering the fact that Republicans have a problem believing that women get pregnant through rape, it’s extremely likely that Branstad will deny rape victims coverage of their abortions.

Just the idea that a Governor is personally in charge of making individual health care decisions for women should give Republicans the shivers. After all, the GOP is supposedly paranoid about government invading our privacy, right? Not only is this a serious breach of privacy, it’s incredibly creepy. Branstad, and therefore his fellow conservatives, now have access to the names of every woman with Medicaid coverage who gets an abortion. One man with a political agenda has the power to decide if a woman was raped or not, and he has no medical training whatsoever. It’s totally unprecedented and completely outrageous. But there’s more.

Even though the Governor may decide to send expensive medical bills to women, it’s more likely that hospitals will have to absorb the costs because the women affected cannot afford to pay. If doctors can’t get paid for performing necessary abortions that are constitutionally legal, they may decline to do so in the future, meaning women will have nowhere to turn to get the care they need. That in-turn will lead to unsafe back alley abortions by unqualified professionals, which will lead to the deaths of many women who are desperate to end an unwanted pregnancy. And those costs absorbed by the hospital will be passed along to other patients through higher health care costs.

Republicans are obsessed with ending abortion and they absolutely despise the poor. They have access to the names of these women who seek and abortion through Medicaid and they can claim that rape victims weren’t really raped and make them pay for the abortion. It’s a sickening reality in the state of Iowa and hopefully the courts will see how ridiculously unconstitutional this law is.