While efforts stalled to pass legislation restricting access to abortion medication earlier in session, the bill was brought back and advanced Tuesday by a House Appropriations subcommittee.

House File 2563 would require medications that can induce abortions, including mifepristone, to be administered or prescribed in person. This proposal would limit the ability of Iowans to receive these medications through telehealth and mail-order medication providers outside the state.

The measure went through the House Health and Human Services subcommittee and committee earlier this session, but failed to come up for floor debate. While this meant the proposal seemed unlikely to survive thesecond “funnel” deadine of the 2026 session, it was referred to the appropriations committee before the deadline, keeping it eligible for consideration.

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Representative Devon Wood, R-New Market, said she planned to move forward with an amendment introduced earlier in the session to strike requirements for doctors who dispense these medications to share information about the possibility of “reversing the intended effects of a chemical abortion” — information medical professionals said was not supported by science.

Though the proposal was changed, Republicans and advocates supporting the bill said the measure would benefit Iowans by restricting “black market” abortion medication that could harm individuals who take the drug.

“I think we really do need to take a serious look at at making sure that access to medication like this is not from an unlicensed, unregulated source from who knows where,” Wood said.

While Democrats and other reproductive health care access advocates said they supported this change eliminating the potential spread of misinformation, speakers at the subcommittee said the measure would still potentially restrict Iowans from receiving needed health care. Dane Schumann with the American College of Obstetricians and Gynecologists said the bill as written could have unintended consequences related to access or reporting requirements for other drugs that can be used to induce abortions, but which are primarily used for other purposes.

“I know that that might not be the intent of the propagators of the bill to have for example, misoprostol, which is a drug that’s used for stomach ulcers, to be reported,” Schumann said. “… It could be used for abortifacient purposes, it’s also used to induce labor and deal with women who are having trouble with postpartum bleeding. But so we just have, some, you know, some suggested changes around that in order to alleviate that concern and not have that unintended consequence, that I don’t think anybody here (intended.) The other concern we have is with a drug called methotrexate, which we swept into the abortifacient drug definition, when that drug is used to treat an ectopic pregnancy.”

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But some supporters of the bill said people seeking these medications needed more medical input before pursuing medically induced abortions. Lori Stiles, an ultrasound technologist, said she has encountered many women who received inaccurate information about the medication they were taking.

“I cannot tell you how many women I saw — middle of the night, callbacks, or any other time of the day — who had used an abortion pill and were absolutely blindsided at how it played out,” Stiles said. “… I have seen that, and I applaud the informed consent part of this for sure, because those women were absolutely not informed.”

Kyrstin Delagardelle, public affairs director for Planned Parenthood Advocates of Iowa told lawmakers medical experts have agreed that abortion-inducing medication is safe and effective, and said the proposal “ignores decades of science, medicine and patient experiences.” She said that providers like Planned Parenthood already have a process for informing patients about the process and impacts of medication, including follow-up appointments after the medication has been used.

“Health care decisions, including abortion, should be guided by medicine and science, not determined by politicians,” Delagardelle said.

Representative Heather Matson, D-Ankeny, said she did not agree with arguments that the bill was aimed at restricting potentially illicit or harmful medication.

“If this bill was just about medication by mail, this bill would look very different (than) what is in front of us today,” Matson said. “There is a lot of language in here that is fear-mongering language around trauma. There are already a tremendous number of safeguards in place around medication abortion. I will certainly have a conversation with anybody who wants to talk about making sure that if medication is coming into the state by mail, that it is being done so in a safe way. But that is not just what this bill is about.”

The measure advanced through the subcommittee. If brought to the House floor, the amendment introduced by Wood is not the only potential change lawmakers would consider during debate. Representative Zach Dieken, R-Granville, also introduced an amendment to the bill to classify abortion as homicide, and enact criminal charges for terminating a pregnancy, with exceptions for miscarriages and when a medical procedure is performed to save the life of the mother.