Posted June 27, 2022 by Veronica Stafford
"A splintered Iowa Supreme Court overruled Planned Parenthood of the Heartland v. Reynolds (2018), Iowa’s equivalent of Roe and Casey. Over the dissent of two justices, the court in Planned Parenthood of the Heartland v. Reynolds (2022) found that, as of June 17, 2022, no Iowa state constitutional protection of abortion rights exists either."
On June 24, 2022, the United States Supreme Court released its opinion in Dobbs v. Jackson Women’s Health Organization overruling Roe v. Wade and Planned Parenthood of Southeast Pennsylvania v. Casey. In doing so, the Court found that there is no federal constitutional protection for abortion, and, therefore, any protection of abortion rights must come from the states. Just a week prior, a splintered Iowa Supreme Court overruled Planned Parenthood of the Heartland v. Reynolds (2018), Iowa’s equivalent of Roe and Casey. Over the dissent of two justices, the court in Planned Parenthood of the Heartland v. Reynolds (2022) found that, as of June 17, 2022, no Iowa state constitutional protection of abortion rights exists either.
Yet, in its opinion, the Iowa Supreme Court falls short in both its legal conclusions and its acknowledgment of factual realities for Iowa women. It ignores the public-focused purpose of the single-subject rule, that men and women are similarly situated prior to pregnancy, and that due process protections at their lowest still require a factual showing of some purpose served by the law at issue. In this way, rather than a victory for Iowa women, Planned Parenthood of the Heartland v. Reynolds (2022) leaves us asking, what about Iowa women now?
Justice Mansfield, writing for the majority in Planned Parenthood of the Heartland v. Reynolds (2022), first asserts that the law at issue survives single-subject rule scrutiny. Under Iowa Constitution article III, § 29, “[e]very act shall embrace but one subject, and matters properly connected therewith; which subject shall be expressed in the title.” To embrace one subject, “all matters treated [within the act] should fall under some one general idea and be so connected with or related to each other, either logically or in popular understanding, as to be part of . . . one general subject.” In evaluating the title and subject of the law at issue, the Iowa Supreme Court afforded great deference to the legislature and determined that the title and subject passed the requirements of the single-subject rule.
But the single-subject rule does not exist to provide additional protection for the Iowa Legislature. Rather, it serves to “[keep] Iowans fairly informed of legislation up for consideration.” The single-subject rule ensures that Iowans are on inquiry notice of bills up for debate before the Iowa Legislature and affords them the opportunity to speak with their legislators, attend the debates in the Iowa House of Representatives and Iowa Senate, and to voice their approval or disapproval. It also provides an additional check on the actions of Iowa Legislators and should prevent them from passing unfavorable legislation unnoticed.
By failing to acknowledge this purpose of the single-subject rule, the Iowa Supreme Court approved of the Iowa Legislature passing an abortion-related bill in the middle of the night, with less than eight total hours of debate, on the very last day of the 2020 Legislative Session. But, as evidenced by the protests in Iowa after the Supreme Court released its Dobbs opinion, Iowans voice their opinions on abortion. Rubber stamping this quick passage of controversial legislation robbed Iowans, and Iowa women specifically, of an opportunity to prevent a restriction on abortion access in their state. It also gave legislators a pass and an escape from any repercussions for their actions until the next election.
The majority in Planned Parenthood of the Heartland v. Reynolds (2022) also finds no violation of the equal protection clause of the Iowa Constitution, as it does not believe that men and women are similarly situated for the purposes of the law at issue. The equal protection clause in the Iowa Constitution—Article I, Section 6—requires that general laws “shall have a uniform operation” and the General Assembly “shall not grant to any citizen or class of citizens, privileges or immunities, which, upon the same terms shall not equally belong to all citizens.” The equal protection clause has served as a countermeasure to sexism and has guaranteed “the right of women to be equal participants in society.” In Planned Parenthood of the Heartland v. Reynolds (2022), however, the majority found that because men do not require abortion care, laws related to abortion care are not subject to equal protection.
But men and women are similarly situated for the purposes of the law at issue if we look only one step farther back: to before a woman becomes pregnant. For, the choice to engage in activities that can lead to the need for abortion care is evenly shared by men and women. Only the resulting necessity to continue the pregnancy or to choose to terminate it falls exclusively on the woman. By starting the timeline for analysis at this incorrect point, the Iowa Supreme Court makes equal protection inapplicable, a slippery slope to finding no need to ever rely on equal protection for equality between men and women. The Iowa Supreme Court here also insists on abortion as a woman-only issue by only analyzing its effect on the pregnant woman. If, as the majority states, some women incorrectly believe that they must choose not to bear children in order to fully participate in society, even more women will feel so after the Iowa Supreme Court lets men off the hook for the results of joint actions.
Lastly, the majority determines that due process does not offer a basis for ruling differently, as after it overruledPlanned Parenthood of the Heartland v. Reynolds (2018), the Iowa Supreme Court no longer needed to look for narrow tailoring of the law at issue. Instead, the Iowa Supreme Court remanded the case back to the district court for a determination of whether the undue burden test or rational basis test should apply. However, as Justice Appel points out in his dissent, even under rational basis review, a party seeking that the court uphold a law must still demonstrate that the law advances some legitimate governmental interest. The opinion of the Iowa Supreme Court fails to do so, and instead only relies on a study from Utah to assert that the law at issue does anything to prevent abortion. If the district court applies rational basis review, the law at issue here should fail.
But, outside of the courts’ opinion, what about Iowa the factual realities of women? Even more, what about, as Justice Appel puts it in his dissent, the factual realities of Iowa women and the men that support them?
In 2018, the Iowa Supreme Court highlighted factual findings of Iowa women’s access to abortion here: “Sixty-six of Iowa’s ninety-nine counties do not have an OB/GYN. Only 7.6% of family medicine physicians perform pregnancy ultrasounds in their offices. Because a handful of medical practitioners serve large geographic areas, patients—especially rural patients—must often wait between two to six weeks to see an obstetrician.” “Financial hurdles can be extraordinary, and many women are delayed in obtaining the procedure simply due to the time it takes to tap their resources, determine how much money they can raise, arrange for time off work, and find child care.”
In 2022, these realities have not changed. Women make up just over half of Iowans, 50.2%, but bear the entire burden of abortion care, and one in four women in Iowa will require abortion care during her lifetime. Likewise, after over two years of enduring the COVID-19 pandemic, we know that COVID-19 has had a disproportionately severe impact on those with low socioeconomic status. We also know that women comprise the majority of those in poverty, and that COVID-19 impacted poor women especially. As schools, daycares, and offices have closed, women here have taken on a significantly larger proportion of homeschooling, childcare, job losses, and household responsibilities than men. There are no signs that this shift farther away from equality between men and women is going away. Thus, stripping away constitutional protection for the right to abortion at this moment hits especially hard.
So, what about Iowa women now? And what are we to do? Without federal constitutional protection for abortion access, and with protection under the Iowa Constitution also recently taken away, we have a lot of work to do. It is time for us to get going.
 No. 19-1392 (U.S. Sup. Ct. June 24, 2022).
 410 U.S. 113 (1973).
 505 U.S. 833 (1992).
 Dobbs, at 5 (“We hold that Roe and Casey must be overruled. The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision. . .”).
 Planned Parenthood of the Heartland, Inc. v. Reynolds, 915 N.W.2d 206 (Iowa 2018). This case concerned Senate File (SF) 471, codified at Iowa Code § 146A (2018). 87th Gen. Assemb. (Iowa 2017). SF 471 imposed a seventy-two-hour waiting period between informational and procedural visits to a licensed physician for an abortion. The Iowa Supreme Court struck down SF 471 as an unconstitutional violation of due process and equal protection.
 Id. at 237 (“Autonomy and dominion over one's body go to the very heart of what it means to be free. At stake in this case is the right to shape, for oneself, without unwarranted governmental intrusion, one's own identity, destiny, and place in the world. Nothing could be more fundamental to the notion of liberty. We therefore hold, under the Iowa Constitution, that implicit in the concept of ordered liberty is the ability to decide whether to continue or terminate a pregnancy.”).
 Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 88 (Iowa June 17, 2022) (Christensen, C.J., concurring in part and dissenting in part) (“I would not overrule [Planned Parenthood of the Heartland v. Reynolds (2018)], which would necessarily result in my conclusion that the 24-hour waiting period at issue is unconstitutional.”); Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 90 (Iowa June 17, 2022) (Appel, J., dissenting) (“I would affirm the holding of [Planned Parenthood of the Heartland v. Reynolds (2018)] that a woman’s liberty interest in reproductive autonomy is a fundamental right under article I, section 9 of the Iowa Constitution; the State may regulate only upon a showing of compelling state interest and only if the regulation is narrowly tailored to advance that interest.”).
 Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 (Iowa June 17, 2022).
 Id. at 7 (“Accordingly, after carefully considering the parties’ arguments, we decide that [Planned Parenthood of the Heartland v. Reynolds (2018)] can and should be overruled.”).
 Iowa Const. art. III, § 29. See also Western Int'l & Nat'l Union Fire Ins. Co. v. Kirkpatrick, 396 N.W.2d 359, 365 (Iowa 1986) (outlining the subject and title requirements of Article III, § 29).
 Long v. Bd. of Supervisors, 142 N.W.2d 378, 381 (Iowa 1966).
 The law at issue here is Amendment H-8314 to House File (HF) 594. 88th Gen. Assemb. (Iowa 2020). It is a verbatim adaptation of SF 471, the law at issue in Planned Parenthood of the Heartland v. Reynolds (2018), except that it replaced the seventy-two-hour waiting period with a twenty-four-hour waiting period.
 Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 6–7 (Iowa June 17, 2022) (“On the single-subject rule, we conclude that a limit on abortion and a limit on withdrawing life-sustaining procedures both pertain to the subject of “medical procedures,” as stated in the bill’s title. Therefore, no violation of the single-subject rule took place.”).
 William J. Yost, Note, Before a Bill Becomes a Law—Constitutional Form, 8 Drake L. Rev. 66, 67 (1958). Long, 142 N.W.2d at 382 (“It was designed to prevent riders from being attached to bills that are popular and so certain of adoption that the riders will secure adoption, not on their own merits, but on the merits of the measure to which they are attached.”).
 State v. Iowa Dist. Ct., 410 N.W.2d 684, 687 (Iowa 1987) (emphasizing the need to put “legislators and citizens alike on inquiry notice” for subjects up for debate and passage by the legislature); Western Int'l & Nat'l Union Fire Ins. Co. v. Kirkpatrick, 396 N.W.2d 359, 364–65 (Iowa 1986) (“The purpose of the requirement is to guarantee that reasonable notice is given to legislators and the public.”).
 The goal of the single subject rule “is to prevent such tricks in legislation that the Constitution forbids.” Chicago, R.I. & P. Ry. Co. v. Streepy, 224 N.W. 41, 43 (Iowa 1929). “It was designed to prevent riders from being attached to bills that are popular and so certain of adoption that the riders will secure adoption, not on their own merits, but on the merits of the measure to which they are attached.” Long v. Bd. of Supervisors, 142 N.W.2d 378, 382 (Iowa 1966).
 See Iowa BillBook, HF 594, Iowa Legislature. On top of that, the discussion of Amendment H-8314 lasted a few minutes, and after a Representative raised the point, the Speaker of the House admitted that the topic of the amendment was not germane to the topic of the bill it attached to. After this admission, a Representative moved to suspend the rules to consider the amendment, and this motion passed. Because Amendment H-8314 was an amendment to an amendment on a bill that had already passed subcommittee, it was also not the subject of committee or subcommittee meetings or public debate.
 See, e.g., William Morris & Katie Akin, Anger, 'Absolute Despair', Hope among Protesters Marching in Des Moines Against end of Roe v. Wade, The Des Moines Register (June 24, 2022). See also Nick Rohlman, Protesters Rally Against Roe Reversal in Cedar Rapids, The Gazette (June 24, 2022).
 Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 62 (Iowa June 17, 2022) (citing State v. Treptow, 960 N.W.2d 98, 104 (Iowa 2021) (“The first step in our equal protection analysis is to determine whether the challenged law makes a distinction between similarly situated individuals with respect to the purposes of the law.”)).
 Iowa Const. art. I, § 6.
 Planned Parenthood of the Heartland, Inc. v. Reynolds, 915 N.W.2d 206, 245 (Iowa 2018).
 Planned Parenthood of the Heartland v. Reynolds (2022) at 63.
 Id. at 64.
 Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 64 (Iowa June 17, 2022) (“Hence, all we hold today is that the Iowa Constitution is not the source of a fundamental right to an abortion necessitating a strict scrutiny standard of review for regulations affecting that right. For now, this means that the Casey undue burden test we applied in [Planned Parenthood of the Heartland v. Reynolds (2018)] remains the governing standard. On remand, the parties should marshal and present evidence under that test, although the legal standard may also be litigated further
 Id. at 168 (Appel, J., dissenting).
 Id. at 13 (citing Sarah C.M. Roberts et al., Utah’s 72-Hour Waiting Period for Abortion: Experiences Among a Clinic-Based Sample of Women, 48 Perspectives on Sexual & Reprod. Health 179 (2016)). Compare with Planned Parenthood of the Heartland v. Reynolds (2018), 915 N.W.2d 206, 243 (Iowa 2018) (“The overwhelming weight of the evidence demonstrates that requiring all women, regardless of decisional certainty, to wait at least seventy-two hours between appointments will not impact patient decision-making, nor will it result in a measurable number of women choosing to continue a pregnancy they otherwise would have terminated without the mandatory delay.”).
 Id. at 89 (Appel, J., dissenting).
 Planned Parenthood of the Heartland, Inc. v. Reynolds, 915 N.W.2d 206, 218 (Iowa 2018).
 Id. at 219.
 United States Census Bureau, Quick Facts: Iowa, July 1, 2021.
 Even the majority in Planned Parenthood of the Heartland v. Reynolds (2022) acknowledges this uneven distribution of the need for abortion care in its equal protection analysis. Planned Parenthood of the Heartland v. Reynolds (2022), No. 21-0856 at 62 (Iowa June 17, 2022).
 Rachel K. Jones & Jenna Jerman, Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014, 107 Am. J. Pub. Health 1904, 1907 (2017).
 Max Fisher and Emma Bubola, The Poor are Harder Hit by the Spread of Disease, N.Y. Times, Mar. 16, 2020, at A10.
 See Jessica Semega, Pay is Up. Poverty is Down. How Women are Making Strides., United States Census Bureau (Sept. 10, 2019).
 Patricia Cohen, Recession’s Toll on Women Points to a Lasting Setback, N.Y. Times, Nov. 18, 2020, at A1.
 Amanda Taub, For Mothers, the Virus Is Only Widening a Gap at Work, N.Y. Times, Sept. 27, 2020, at A10 (“[P]rogress toward gender equality may be the latest in a long list of casualties of the coronavirus pandemic.”).
Photo Courtesy of Michael Leland, Iowa Public Radio