Iowa sexual assault nurses react to Iowa AG resuming Plan B payments

Left: Iowa Attorney General Brenna Bird standing at a podium in her office with microphones pointed at her. The AG's symbol, a star with the scales of justice, is on the wall behind her. She's clearly speaking. Right: SANE nurse Jessica Clayton, a blond woman in glasses, is in her office looking slightly to the left of the camera, wearing a neutral expression.

Left: Iowa Attorney General Brenna Bird in her office. Photo: Ty Rushing Right: SANE nurse Jessica Clayton in her office. Photo: Nikoel Hytrek

By Nikoel Hytrek

June 4, 2024

Iowa SANE nurses say they’re relieved Iowa Attorney General Brenna Bird will reimburse medications like Plan B and they aren’t bothered by new requirements.

Iowa Sexual Assault Nurse Examiners (SANE nurses) now have a heavy weight lifted from their shoulders.

For more than a year, Iowa Attorney General Brenna Bird, an anti-abortion Republican, has refused to compensate hospitals and pharmacies for emergency contraception—also known as the morning-after pill or by the brand name Plan B.

The medication is routinely prescribed to rape survivors as one of several preventative medications for post-assault treatment and a single pill can cost $40-50, which adds up.

But on Friday, Bird announced her office would resume payments and reimburse the nearly 400 claims that have accumulated in her office during the audit.

“I am thrilled to hear they will be reinstating these payments,” said Katy Rasmussen, a SANE nurse in Johnson County. “Emergency contraception is a key part of the medical forensic exam and victim-survivors should not have to suffer further by having to pay for this medication.”

When rape survivors show up to hospitals, SANE nurses conduct forensic exams and prescribe medications to prevent sexually transmitted infections, HIV and pregnancy.

Rasmussen told Starting Line in April that her facility was absorbing the cost themselves and relied on the Johnson County Supervisors approving $10,000 to purchase emergency contraceptives in September 2023.

“This will be one less thing for both patients and for SANE/SART programs to worry about,” said Rasmussen, who said they are already struggling for funding.

Iowa law requires the attorney general’s office, through the Sexual Assault Examination Payment Program, to pay for the exams, tests, and preventative medications survivors need. For 40 years, emergency contraception and abortions were also included, though not required by Iowa law.

The AG’s office halted payments for Plan B and occasional abortions because of an audit on victim services programs Bird started when she took office in January 2023. No other preventative medication was affected.

Bird confirmed that her office will reimburse requests made during the hiatus.

According to the audit report, when providers send their claims to be reimbursed they will be required to certify “that the prescription was to prevent ovulation and not to prevent implantation of an embryo.”

SANE nurses said that won’t affect them because it’s irrelevant.

“To me, it seems an unnecessary addition and a lack of knowledge as to how the medication works,” Rasmussen said.

Emergency contraception prevents or delays ovulation, it doesn’t cause abortions and Rasmussen said there’s no evidence it prevents implantation.

“If that is what they want then that’s how we will order it. If that is what we have to say and it will make them feel better, then that’s what we will do,” said Jessica Clayton, a SANE nurse in Mason City.


Clayton said she was more concerned that abortions won’t be reimbursed, even though the situation is rare. In fact, Bird said there was only one request that came in during the audit.

“There should be an exception to patients who become pregnant after an assault. Especially for incest cases and minors. But really anyone that was assaulted should have that choice,” Clayton said.

Bird said Iowa law requires that public funds are never used for abortion, but the reimbursements don’t—and have never—come from public funds.

The money comes from the Crime Victim Compensation Program, which is funded by criminal fines paid by convicted criminals.

In the audit report, Bird revealed the political reason why abortion won’t be covered.

“Iowans have made their position on public funding of abortions clear through the votes of majorities they elected to both the [Iowa] House and [Senate], each of which voted down a proposal to have our office pay for abortion,” the audit states.

However, a solid majority—61%—of Iowans say abortion should be legal in all or most cases, according to polling from 2023.

Still, SANE nurses said they’re glad they don’t have to worry anymore.

“The announcement of both Plan B approval and an increase in SANE compensation provides reassurance to SANE [nurses] and victims across the entire state,” said Shannon Knudsen, a SANE nurse who serves Polk and Story counties.

“Providing services and access to care to anyone who experiences sexual assault is our ultimate priority; ensuring their health and safety, reaffirming their autonomy to be in control of their own body through the healing process is essential,” she continued.

  • Nikoel Hytrek

    Nikoel Hytrek is Iowa Starting Line’s longest-serving reporter. She covers LGBTQ issues, abortion rights and all topics of interest to Iowans. Her biggest goal is to help connect the dots between policy and people’s real lives. If you have story ideas or tips, send them over to [email protected].


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