Like most states led by Democratic vs. Republican governors, the abortion rights landscape promises to be very different between Iowa and Illinois if Roe v. Wade is overturned this summer, as expected — likely illegal in Iowa, status quo in Illinois.

During Women’s Health Month and Mental Health Awareness Month, the Illinois Department of Healthcare and Family Services (HFS) on Thursday affirmed its commitment to covering abortion care for all Medicaid customers in the state of Illinois.

As a freedom of choice state, Illinois is one of only 16 states that go beyond federal Medicaid limits and use state funds to cover abortions for people enrolled in Medicaid, according to a Thursday release. The department covers both surgical and medical abortion services.

Theresa Eagleson is director of Illinois Department of Healthcare and Family Services.

“In this state, when we say that healthcare is a right and not a privilege, that includes the right to make reproductive health decisions – full stop,” said HFS Director Theresa Eagleson. “Every woman in our state deserves comprehensive and affordable access to health care, including abortion if that is the right decision for her. The choice to carry a baby to term is a physical, emotional, and economic one for the involved woman and those she trusts alone.”

Illinois state law (Public Act 101-0013) affirmatively provides a right to reproductive healthcare, including abortion and maternity care. This state law ensures access to abortion services even if Roe v. Wade were overturned.

The department has issued a notice reminding Medicaid-enrolled healthcare providers about the state’s coverage for abortion services.

Health plans required to mention abortion

Additionally, the department has issued a notice to Managed Care Organizations (MCOs) that help administer Medicaid that they are contractually required to include information on abortion service coverage in their member handbooks. The department instructed MCOs that call center staff and care coordinators must be prepared to answer enrollee questions about their abortion service coverage, including the continuation of this coverage even if Roe v. Wade were overturned.

To ensure access to abortion services, the department has previously raised the rate it pays health care providers for abortion services.

Medicaid health insurance for pregnant women

HFS has two programs for pregnant women regardless of US citizenship or immigration status, for incomes up to 213% of the federal poverty line:

  • Medicaid Presumptive Eligibility (MPE) offers immediate, temporary coverage for outpatient healthcare for pregnant women. The department has worked to add more eligible health care providers into the MPE program
  • .Moms & Babies covers healthcare for women while they are pregnant and for 12 months after the baby is born, regardless of whether the pregnancy ended as a result of birth, miscarriage, or abortion and regardless of whether the individual signed an adoption agreement. Moms & Babies coverage is the full Medicaid benefit package. This includes coverage for hospital care, including labor and delivery, primary and specialty care, and prescription drugs.

These two programs give pregnant women the care they need to keep them and their babies healthy. Providers can enroll pregnant women into MPE coverage to access services immediately. People can apply for Moms & Babies with or without MPE coverage.

Moms & Babies can cover up to three months of coverage retroactively. This includes covering individuals who are no longer pregnant when they apply, but who were pregnant at any time during the three months prior to the date of application. Individuals with coverage under Moms & Babies stay covered with full Medicaid benefits for 12 months postpartum, regardless of how the pregnancy ends.

People covered under the state’s Health Benefits For Immigrant Adults program who become pregnant can transition to coverage under the Moms & Babies program.

Iowa looks to ban abortions

Iowa Gov. Kim Reynolds was among a dozen Republican governors who signed onto an amicus brief in 2021 asking the court to overturn its decisions in Roe v. Wade and Planned Parenthood v. Casey.

Iowa Governor Kim Reynolds (WHO 13)

On Tuesday, May 3, she said “the right to life” is “the most important freedom.” 

“As we await the Supreme Court’s final ruling, our mission remains as clear as it has ever been,” she said in a statement. “We are fighting to defend the most important freedom there is: the right to life.”

Democrat Deidre DeJear, who is running against Reynolds in the 2022 gubernatorial election, tweeted about the leaked draft Monday night, May 2.

“Tonight women across our nation are angry and they are scared. I see you. Let this soak in tonight … because tomorrow we don’t mourn, we get back to work to ensure that every Iowan has access to the health care and reproductive care that they need,” she wrote.

Demonstrators protest outside of the U.S. Supreme Court Tuesday, May 3, 2022 in Washington. (AP Photo/Jose Luis Magana)

The group Pro Choice With Heart is holding a “Defend Roe” rally at the Iowa State Capitol, Des Moines, on Sunday, May 15 at noon.

“Come out and demand the Supreme Court we have safe, and legal accessible abortion,” the Facebook event page says. “Right now the Supreme Court in the United States is debating Roe v. Wade. Roe is the only protection women have to control their own bodies in the USA.”

If Roe is overturned, the group says three things will happen:

1. Women will not have access to healthcare and will die and be permanently harmed from “back street” abortions. Restricting or making abortion illegal doesn’t stop them – it just stops safe ones.

2. Miscarriages will be investigated. When abortion is illegal that means that every pregnancy loss must be investigated to ensure the “crime” of abortion didn’t happen.

3. The rich will still have access to abortion.

A recent NPR piece said that about half of all states plan to ban or severely limit abortions in a post-Roe world.