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DES MOINES -- A nearly $2 billion state health care budget bill that included some politically charged policies was signed into law Friday by Gov. Kim Reynolds.

The sweeping budget bill funds state departments covering health care, public health, veterans affairs, and aging Iowans.

When lawmakers debated the budget, most disagreement was not over funding, but rather some policies included in the bill.

One such provision says state and local governments are not required to cover gender reassignment surgery under the state’s Civil Rights Act.

Republican lawmakers previously passed legislation banning the use of public funds for gender reassignment surgery sought by transgender individuals. That was struck down by Iowa courts, which cited the state’s Civil Rights Act that includes transgender individuals as a protected class.

The new legislation writes into state law that the Civil Rights Act does not require government bodies to cover the surgery.

“This narrow provision simply clarifies 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 new law likely will also be challenged in court.

Daniel Hoffman-Zinnel, executive director of One Iowa Action, in a statement described the provision as “cruel and outdated language that enshrines discrimination in Iowa law.”

One Iowa Action is a nonprofit organization that advocates for LGBTQ Iowans.

“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 said. “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.”

The health care budget bill also contained a provision that would bar Planned Parenthood from helping to fund state sexual education programs.

Statehouse Republicans in previous years stripped state funding to Planned Parenthood over their objections that the women’s reproductive health care provider performs abortions.

Statehouse Democrats, during debate of the budget bill, decried the lack of a funding boost or policies to address the private management of the state’s $5 billion Medicaid program.

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