But several of the federally qualified health centers could feasibly serve as alternatives, so I called a few of them to ask if they could pick up those extra patients. The problem was, no one I spoke with could give me a definitive answer, because they were all very unclear about what the new state-run program would entail.
“We’ll respond, we just don’t have a clear plan or strategy in place other than trying to get clear information,” said Ron Kemp, the CEO of Community Health Centers of Southeast Iowa. The Planned Parenthood in Burlington, Iowa (population 26,000), serves 198 IFPN patients, and a nearby Planned Parenthood in Keokuk, Iowa (population 11,000), serves 96, according to figures from Planned Parenthood of the Heartland. Lawmakers had listed Kemp’s health centers as alternatives to those two Planned Parenthoods.
“We have some capacity,” he told me, cautiously. “We don’t know the funding volume, we don’t even know all the equipment, but we’re committed to do that.” Accepting an influx of new patients seeking pelvic and breast exams, as well as contraceptives like IUDs and implants, will require new equipment and an evaluation of provider capabilities and specialization, Kemp said. “We’ll figure out a way to adapt, and expand capacity if that’s what comes in the door… sometimes that takes longer than we would like it to.”
Ted Boesen, the CEO of the Iowa Primary Care Association, a non-profit organization comprised of clinics like Kemp’s across the state, was equally cautious: “They're assuming we're the alternative...but we're waiting to see what kind of a scale it is.” Boesen said he can’t “buy in” until Republicans respond to his questions about the new state-run family-planning program. Kemp also characterized interactions with GOP lawmakers as “limited,” telling me, “If there had been more detailed discussions, we might be able to be more further along.”
That uncertainty is a key problem in the debate: Natoshia Askelson, an assistant professor in the College of Public Health at the University of Iowa, told me that providers are still in the dark about basic details on how program will be run, like what contraceptives will be provided or whether there will be enough providers for displaced patients. The new program is also supposed to be entirely state-funded, instead of relying mostly on federal funds, which the IFPN waiver currently does through a federal matching program.
Askelson is “very concerned” about that. “[Iowa is] not in a position right now where we can afford things the federal government would pick up the tab for otherwise.” She believes SF2 could very well be ruining a good thing.
Scrapping the IFPN waiver limits the choices of patients in two ways: First, it shortens the list of provider options. It tells patients they can no longer go to the local Planned Parenthood if they want their reproductive-health services to be covered. Boesen, the Iowa clinic spokesman, admitted that was one of his main concerns. “Those gals…for generations, that’s been a safe place for them to go,” he told me, “so everybody’s wondering how we can provide that.”