Imagine being a twenty-something year old woman, caring for a toddler, working to make ends meet, and finding yourself facing an unintended pregnancy. Who would you want to talk to? Your partner? Your doctor?  Maybe your friends? Siblings? Parents? Religious leaders? Would you want this guy to have a say in what you can and cannot do?

Last week, the Governor of Iowa indicated that he will sign the state budget, which includes a provision giving him the final decision making authority over who can and cannot receive Medicaid funds to cover the cost of an abortion. He will now have the authority to review each and every individual’s case separately. Since 1976, federal law has restricted Medicaid coverage of abortion. While the language has changed a bit over time, it currently states that Medicaid cannot cover abortion except when the women’s life is at risk, or if the pregnancy is the result of rape or incest. Each state must comply with the federal law and must at least provide coverage of abortions in those circumstances. Iowa goes beyond federal law, and also provides state Medicaid coverage of abortion in cases of fetal anomalies. Physicians providing abortions in these cases have been required to certify that an abortion meets the exceptions.  

But now Iowa has decided to take the decision away from women and their doctors and give it to the Governor. Now, what if that same woman realizes that it doesn’t matter what her doctor, partners, faith, or parents say, and that instead, her medical care is subject to the whims of the Governor? If she does not want to disclose her personal information to the highest elected official in the state, it is not hard to imagine that she will second-guess her decision to obtain the procedure.