JUNEAU — The Alaska Senate on Tuesday passed a bill that would define what constitutes a “medically necessary” abortion for purposes of state funding.
Supporters of the measure said public money should not be used to pay for “elective” abortions, but critics said the bill puts the state between a woman and her doctor and is unconstitutional.
“This bill will be struck down,” said Sen. Hollis French, D-Anchorage.
The measure passed 14-6. Voting against it were two members of the GOP-led majority, Sens. Bert Stedman, R-Sitka, and Dennis Egan, D-Juneau; along with minority Sens. Johnny Ellis, French, Berta Gardner and Bill Wielechowski, all Anchorage Democrats.
Notice of reconsideration was served, meaning the bill could be voted on again before going to the House. The Legislature is scheduled to adjourn Sunday.
The bill, SB49, seeks to define what abortions Alaska must pay for under the state Medicaid program. It calls on the Department of Health and Social Services to fund no abortion services under the program unless the abortions are medically necessary or the pregnancy was the result of rape or incest.
The measure would define medically necessary abortions as those needed to avoid serious risk to a woman’s life or physical health. That could mean a serious risk of death or “impairment of a major bodily function” due to such things as epilepsy, congestive heart failure, coma or renal disease that requires dialysis.
Payment would not be made for “elective” abortions.
The Alaska Supreme Court has held that the state must fund medically necessary abortions if it pays for other procedures deemed medically necessary for people in need. The state has adopted regulations in which doctors, for purpose of payment, must certify that an abortion was medically necessary. But the bill’s sponsor, Sen. John Coghill, said the court left legislators to decide what “medically necessary” means. Coghill, R-North Pole, said he is simply trying to provide clarity to that.
French took issue with the fact that the bill makes no mention of mental health, something the court specifically referred to in its 2001 opinion. Coghill said lawmakers heard from a number of experts and doctors, and there was disagreement on that topic.
Coghill said he agreed that the issue should be decided between a woman and her doctor. But he said, “when you’re asking other people to pay for it, you’re asking them to be included in that decision, too.”
“And, so, if it’s purely elective, that should be between the doctor and a woman, between the person and their checkbook,” he said. “If it’s truly medically necessary, we as a people, we want to step up and say, ‘We’re here to help.’”
Coghill, who acknowledged he doesn’t agree with abortion in any case, said the bill represented a “reasoned policy call.”
Wielechowski said he worried about women being forced to disclose they’ve been victims of rape or incest.
Sen. Pete Kelly, R-Fairbanks, said he was a bit disturbed by discussion about the Legislature’s relationship with the courts and the suggestion the state would be in violation of a court order if this bill passed. He said the Legislature makes the laws, and “we need to stand up for our branch of the government.”
The bill was amended on the floor to ask the department to make women’s health services available under the state Medicaid program. Three of the Senate’s four female members — Republicans Lesil McGuire and Anna Fairclough and Democrat Berta Gardner, who carried the amendment — spoke in favor of that amendment.
Coghill said he served notice of reconsideration to more closely review the amendment. He said it’s possible that some of the language may need to be tightened.
Failed amendments included a proposal to expand a health insurance program for low-income children and pregnant women. Gov. Sean Parnell had vetoed an expansion of the Denali KidCare program in 2010, saying it paid for abortions.
Treasure Mackley, political director of Planned Parenthood Votes Northwest, said in a statement that the Legislature has better things to do in the last days of session than deal with an “unconstitutional and unnecessary bill that seeks to put politicians, not doctors, in charge of women’s private medical decisions.”