Suzanna de Baca, the president and CEO of Planned Parenthood of the Heartland, said the loss of funding from the IFPN waiver forced it to close four of the 12 health centers it operates in the state by the end of June. De Baca announced the closures in a press release, warning that “defunding Planned Parenthood will set a health care crisis in motion in Iowa.” And the move, which will displace more than 14,600 patients, has local health centers scrambling to figure out how to fill the gaps.

I wrote about the projected consequences of this kind of legislation back in March, when the family-planning waiver was a standalone bill called Senate File 2. Lawmakers who supported the bill didn’t want government funds going to Planned Parenthood and other providers that facilitate abortions, and they suggested that the nearly 4,000 patients who visited Planned Parenthood under the family-planning waiver could instead receive care at federally qualified health clinics.

At the time, those clinics told me they weren’t sure how they could take on those patients. They weren’t able to provide the long-acting reversible contraception that Planned Parenthood has readily available—things like IUDs and contraceptive implants. Ted Boesen, the CEO of the Iowa Primary Care Association, said then that he couldn’t “buy in” until he got answers from Republican lawmakers about funding.

But now, the IFPN waiver has been eliminated, and with it, roughly $2 million of Planned Parenthood’s funding. Four clinics are closing, which will displace nearly 15,000 patients, instead of the expected 4,000. “This is hot off the press. Everybody is trying to absorb,” Boesen told me this week. “Nobody likes to see this happen; the health centers in the communities certainly don’t.”

Boesen said it’s his mission to make sure those patients find care elsewhere, but he added that Planned Parenthood offers a “unique brand” of care. “We’re gonna do our level best to replace it, but there’s some dimension of that that isn’t replaceable.”

De Baca said the organization had been preparing for this eventuality for weeks, and told me they used a set of four factors to determine which clinics would be shuttered: patient numbers and access; community support, including the local donor base and the community’s fundraising capability; political support; and finally, the financial health of the clinic.

In the end, the organization chose to close its three remaining locations in southeast Iowa—Keokuk, Burlington, and Bettendorf—and Sioux City in Western Iowa. All but the Keokuk clinic provided abortions, but, Planned Parenthood noted, the Bettendorf clinic will continue to provide them indefinitely, even after it stops the rest of its services.

Siouxland Community Health Center is a federally qualified center in Sioux City that Republican lawmakers listed in March as an alternative for Planned Parenthood patients. “It would have been nice for legislators to maybe reach out to us to see if this is something we could provide,” Brendyn Richards, Siouxland’s director of development and advocacy, told me.