Planned Parenthood of the Heartland said Thursday it is closing four clinics in Iowa in response to a bill passed by the Iowa Legislature's Republican majority that blocks public money for family planning services to abortion providers.

Health centers will be closed in Bettendorf, Burlington, Keokuk and Sioux City that have served more than 14,600 individual patients in the past three years, said Susana de Baca, president and chief executive officer of Planned Parenthood of the Heartland. Eight health centers will remain open elsewhere in Iowa.

De Baca said the impact will be devastating for Planned Parenthood's patients who have received family planning care in those four communities. It will be hardest on people who already face barriers to access health care, especially people of color, young people, poor people and rural residents, she said.

"Defunding Planned Parenthood will set a health care crisis in motion in Iowa. We will be watching and holding politicians accountable," de Baca said.

Republican Gov. Terry Branstad signed a $1.7 billion health and human services appropriations bill last week that calls for the Iowa 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.

Planned Parenthood of the Heartland is Iowa's largest provider of abortions, although no taxpayer money is spent on abortions. The legislation cuts off about $2 million in public money to Planned Parenthood.

Jodi Tomlonovic, executive director of the Family Planning Council of Iowa, who had testified against the legislation, said the loss of services at the four health centers can't be duplicated by other Iowa medical providers. She said they lack the expertise and ability to accommodate a large number of additional family planning patients.

"We are concerned this will have a severely negative impact on family planning services," Tomlonovic said. "You will see increases in unintended pregnancies, teen births, and abortions" as well as increases in sexual transmitted diseases and cervical cancer."

But Iowa groups opposed to abortion were elated with Planned Parenthood's announcement. They predicted no reduction in health care services for women under the new legislation.

“I would say this is fantastic news for women and families in the state of Iowa," remarked Maggie DeWitte, executive director of Iowans for Life. "We would say the services and care provided by Planned Parenthood in the state of Iowa were not what women and families deserved. We have said from the very beginning that there are many, many other qualified health centers that provide comprehensive health care for women."

Jenifer Bowen, a spokeswoman for Iowa Right to Life, remarked, "The reallocation of our tax dollars, away from the abortion industry and into the hands of true health care facilities, will only empower more Iowa women."

According to the Iowa Legislative Services Agency, there were 12,219 people participating in the state's existing family planning program in December 2016.

Republicans who supported defunding Planned Parenthood said women will have access to family planning services at 221 clinics statewide that will expand coverage to rural women who must now make long drives to urban areas for family planning services. Democrats disagreed, contending the legislation will cause Iowa women to have more difficulty obtaining birth control, cancer screenings and other health care.

In Texas, a loss of state funding by Planned Parenthood affiliates resulted in a significant increase in births among low-income women who lost access to birth control, according to a 2016 study published in the New England Journal of Medicine.

Planned Parenthood's clinics in Burlington, Keokuk and Sioux City will shut down June 30, the same date that family planning services will cease at the Bettendorf center. However, the Bettendorf facility will continue to provide some limited telemedicine abortion services after June 30 until the building is sold, said Susan Allen, Planned Parenthood of the Heartland's marketing and communications director.

Planned Parenthood will continue to operate two health centers in Des Moines, along with health centers in Urbandale, Ames, Cedar Falls, Cedar Rapids, Council Bluffs and Iowa City. Over the past few years, the non-profit agency has previously closed a host of other family planning clinics throughout Iowa, citing a need for restructuring.

The state legislation signed by Branstad was supported by a coalition of 35 Iowa groups opposed to abortion that contends public funding for family planning services indirectly subsidizes abortions. The legislation represented a victory for Republican politicians who had repeatedly promised the party's rank-and-file during the 2016 election campaign that they would defund Planned Parenthood.

Sen. Janet Petersen, D-Des Moines, expressed disappointment with the clinic closings. She said the program dismantled by the state legislation was successful because it was inexpensive for taxpayers, and it helped reduce abortions and unintended pregnancies. But Sen. Jason Schultz, R-Schleswig, a supporter of the defunding law, said the previous family planning program fell short because Planned Parenthood's clinics were all in urban areas.

Allen said Planned Parenthood has provided irreplaceable services for many Iowans. In three of the four counties with health centers closing — Burlington, Keokuk and Sioux City — Planned Parenthood served 80 percent or more of the family planning patients accessing care at a publicly funded provider in 2015. Each of those three centers are also located in counties that rank in Iowa's top 10 counties for chlamydia, a sexually transmitted disease.

Planned Parenthood chose the four clinics for closure based on many factors, de Baca said. These included mission considerations such as access and need, support or opposition within communities, where donors reside, political impacts, the location of patients and patient trends. The goal was to ultimately serve as many patients and in as many communities as possible, she said.

A Des Moines Register/Mediacom Iowa Poll conducted in February found that 77 percent of 802 adult Iowans surveyed favored continued state funding for non-abortion services at Planned Parenthood, which was up 3 percentage points from February 2016. Eighteen percent did not support that funding going to Planned Parenthood and 5 percent were not sure.

The survey also found 62 percent of Republicans believed non-abortion funding should continue to Planned Parenthood, as did 62 percent of evangelical Christians.

Planned Parenthood of the Heartland has also been affected by a new state law that requires a 72-hour waiting period for women to have an abortion in Iowa at any stage of pregnancy. Planned Parenthood and the American Civil Liberties Union of Iowa have sued state officials over the law in a case pending in Polk County District Court.

Planned Parenthood officials were asked by reporters Thursday if any legal challenges were anticipated regarding the state defunding legislation, but they were noncommittal. "We will look at all of our options and weigh our legal strategies," de Baca said.