When America celebrates its 250th birthday this year, it will also mark the day a 2025 provision, which cut off Medicaid funding to Planned Parenthood, is set to expire. Part of the One Big Beautiful Bill Act, the provision made it impossible for patients with Medicaid to use their federal health insurance at Planned Parenthood clinics—effectively defunding Planned Parenthood nationwide.
Even if funding is restored on July 4, the damage across the country and in Iowa is done: Four of the state’s six Planned Parenthood clinics closed from the combined effects of the Medicaid and Title X defundings.
Nationally, 23 Planned Parenthood clinics have closed as a result of the bill, and half of those were in the Midwest—including Indiana, Iowa, Michigan, Missouri, and Ohio.
Medicaid does not cover abortions as a rule, so the provision—passed by Congressional Republicans, including Iowa’s Rep. Randy Feenstra, Rep. Ashley Hinson, Rep. Mariannette Miller-Meeks, and Rep. Zach Nunn, and Sen. Chuck Grassley and Sen. Joni Ernst—was going after low-income Americans seeking a host of other medical services, from cancer screenings to preventative care.
“These attacks are making it harder for Iowans to get access to just the basic healthcare services they need,” said Ruth Richardson, President and CEO of Planned Parenthood North Central States.
What happened in Iowa after the cuts
Americans were already struggling financially this time last year when the Medicaid cuts began.
“The fallout from the defunding is happening during a broader healthcare affordability crisis,” said Kierra B. Jones, Senior Policy Analyst for the Center for American Progress. “Across the country, families are already struggling with rising medical costs, provider shortages, hospital closures, and uncertainty around Medicaid. Defunding health centers and reducing access to trusted providers only makes those challenges worse.”
But as clinics learned they wouldn’t receive Medicaid payments, they had to make changes.
“In the months after we were defunded from Medicaid, we lost 46% of our patients in Iowa who depend on Medicaid,” Richardson said.
The fallout from the cuts continues
Anti-abortion groups would have voters believe that every individual who goes to Planned Parenthood is seeking an abortion, but Richardson said most patients going to the clinics are seeking vastly different care, including preventative care, cancer screenings, STI testing and treatment, annual wellness visits, and contraception.
“What we’re seeing right now in Iowa is an increase in cancer and STIs as well,” she said, adding that there have been increases in maternal and infant mortality rates in the state over the last several years, which were all compounded in 2018 when Planned Parenthood lost funding from a family planning program through Title X.
“All of these things together really show the impacts of what happens when there’s bans and attacks on healthcare,” Richardson said.
What’s next for Medicaid funding?
It’s looking increasingly likely that Planned Parenthood will be able to once again use Medicaid funds as of July 4, but that sudden reversal won’t be much help, experts say—especially considering that the health centers that didn’t close were forced to reduce services in many cases or lay off staff.
“You can’t flip a switch and rebuild a healthcare network overnight,” Jones said. “Even if funding is restored, communities may continue to experience the impacts of defunding long after. At a time when Americans are already facing rising costs and barriers to care, disruptions to care have real consequences.”
In the meantime, Richardson said they’re trying to remind current and former patients about the expiration date of July 4, when they can once again accept Medicaid.
“There’s an incredible amount of work that is going to need to be done to address the manufactured chaos that has been caused for people across the US,” Richardson said.
“Those delays in treatment can be devastating to people’s health.”
As voters in Iowa and across the country head to the polls in November, Jones said they should be reflecting on access to care.
“Nationally, voters should ask themselves, ‘Are people able to get the healthcare they need, when they need it, and at a price they can afford?’” she said. “The fundamental question for voters is whether elected leaders are making health care more accessible and affordable, or less.”
