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Healthcare provider and patient enrollment down in Iowa family planning program

A state-run family planning program that Iowa lawmakers established last year to cut funding for Planned Parenthood and other abortion providers has seen a marked decline in patients and participating health care providers, which critics say shows it’s not working as promised by its Republican backers.

Iowa Department of Human Services data obtained by The Associated Press through a public records request show that just over 5,300 people were enrolled in the program as of March 1, compared to roughly 8,200 when it launched July 1.

“It’s just showing that the program’s not really working. It’s not getting to people who need it,” said Jodi Tomlonovic, executive director of the Family Planning Council, which receives and distributes separate federal funds to organizations that provide family planning services.

GOP lawmakers gave up millions of dollars in Medicaid funding to launch the program, arguing that the exclusion of organizations like Planned Parenthood would be offset by rural health providers who would step up to offer family planning services such as birth control, pregnancy testing and health screenings.

The newly released data, though incomplete, suggests that’s not happening.

In the first three months of the new program, there were about 950 unique health care providers participating. That figure dropped to nearly 560 the next three months, according to the data. The number of services accessed or prescriptions filled also appears to have decreased during that time, from about 2,600 to roughly 1,500.

Separate agency documents obtained by the AP show that the state has paid just $285,000 in claims to health providers from July through March, which covers most of the budget year. The human services department set aside roughly $3 million for the program.

Matt Highland, an agency spokesman, declined to discuss specifics of the latest findings, but he argued that the newly released data don’t show a complete picture and pointed out that health providers can still file claims for services provided months ago. He’s also noted that enrollment in the program’s predecessor had been declining since at least 2013, partly because people changed to coverage under the Affordable Care Act.

State Sen. Joe Bolkcom, an Iowa City Democrat, said the newly released data show it’s clear people can’t access needed reproductive health care.

“All signs are more war on women policies that place more barriers between a woman and her doctor,” he said.

Erin Davison-Rippey, a representative for Planned Parenthood of the Heartland, said the reduction in claims is troubling and questioned why health providers would wait to file claims to get paid. Planned Parenthood, which was the largest recipient of funding under the old family planning program, has closed four of its 12 clinics in Iowa since the new program launched.

“This continues to indicate that health care access for reproductive health has been significantly harmed and impacted,” she said.

Tomlonovic said the most recent numbers cannot be solely attributed to the longer-term decline caused by the Affordable Care Act. She said the latest figures followed the earlier release of Department of Human Services data to the AP that showed a nearly 50 percent drop in enrollment compared to the same period in the previous year, when the old system was still in place.

Although the department is collecting raw data, it’s not required to report on how the new state-run system is working.

In the final days of the legislative session, the co-chairman of a House committee that approves health funding said that may need to change. State Rep. Dave Heaton, a Mount Pleasant Republican, indicated that he may add language to a budget bill requiring public reporting. But legislation released Thursday appeared to exclude such instructions. The same bill does propose restoring some program eligibility, which is aimed at specifically allowing a hospital system with multiple locations to once again participate. The measure could get final approval in the next few days.

The Republican-led Legislature and governor made the switch to the new system last year even though no state or federal funding was going toward abortions in Iowa. On Wednesday, GOP lawmakers approved a so-called fetal heartbeat bill that would ban most abortions in Iowa at about six weeks of pregnancy, which would make it the strictest in the nation and would almost surely face a legal challenge if signed into law by Gov. Kim Reynolds.