Last Friday, Iowa Gov. Kim Reynolds (R) signed a budget bill containing a provision that allows local governments or state agencies to refuse to use public dollars, including Medicaid funds, for transition-related surgeries for transgender people.
The provision, which was added by Republican lawmakers at the last minute, amends the state’s Civil Rights Act to clarify that government officials are not required to pay for gender confirmation surgery.
“This narrow provision simply clarified that Iowa’s Civil Rights Act does not require taxpayer dollars to pay for sex reassignment and other similar surgeries. This returns us to what had been the state’s position for years,” Reynolds spokesman Pat Garrett said in a statement.
The provision was added in response to an Iowa Supreme Court decision issued in March that found that the state’s previous ban prohibiting the use of Medicaid dollars for transition-related care was unconstitutional under the section of the Civil Rights Act prohibiting discrimination against people based on sexual orientation or gender identity.
The lawsuit in the original case involved two transgender Iowans who sued after being denied coverage for gender confirmation surgery, even though both had been diagnosed with gender dysphoria and the surgery had been deemed medically necessary.
The American Civil Liberties Union of Iowa noted in a statement that the newly passed provision only affects “public accommodations” — which includes Medicaid — under the Civil Rights Act.
“The law did not amend or alter any other section of the Iowa Civil Rights Act or impact other government funding of transgender care, such as that provided to state employees or prisoners,” the ACLU of Iowa said in a statement.
Other LGBTQ rights groups condemned Reynold’s decision not to use a line-item veto to remove the provision, which will now be used to deny care to transgender individuals.
“It’s deeply disappointing that Gov. Kim Reynolds is caving to the pressure from some radical lawmakers in the Iowa Senate, instead of protecting the rights and dignity of transgender Iowans,” JoDee Winterhof, HRC’s senior vice president of policy and political affairs, said in a statement.
“Gov. Reynolds had the option to line-item veto this provision and leave the rest of the funding bill intact, but she did not,” Winterhof added. “This sends a strong message that she is not working for all of her constituents and a craven desire to please Iowa’s most extreme lawmakers. As a native Iowan, Iowa deserves better — and different — leaders.”
Studies of states where gender confirmation surgery is covered by Medicaid funds have not reported significant cost increases, despite claims by conservatives that covering such transition-related procedures are overly expensive.
“We are deeply disappointed that Gov. Reynolds has ignored medical experts, Iowa business leaders, cost analysis data, and the many transgender Iowans and allies who shared their stories with her to sign this bill into law,” Daniel Hoffman-Zinnel, the executive director of LGBTQ rights group One Iowa Action, said in a statement accusing the governor of tarnishing the state’s reputation as a place that values fairness and equality.
“By signing this cruel legislation into law, Gov. Reynolds has told every transgender Iowan that they are second-hand citizens and unwelcome in our state,” Hoffman-Zinnel added. “Make no mistake, this law threatens people’s lives. It also won’t stand up to legal muster, and will stick taxpayers with the bill for ensuing lawsuits. Today is a shameful day to be an Iowan.”