State tackles definition of "medically necessary" abortions

JUNEAU, Alaska — The Alaska House on Thursday began debating legislation that would further define medically necessary abortions for purposes of Medicaid funding.

 

SB49 is similar to regulations that were approved by the state health commissioner and are currently subject of a lawsuit brought by Planned Parenthood of the Great Northwest. A spokesman for Planned Parenthood Votes Northwest, Erik Houser, said the case is on hold pending what happens in the Legislature.

The House version of SB49 tracks closely with the version that passed the Senate last year, but it does not include language that would allow for expanded family planning services. The bill’s sponsor, Senate Majority Leader John Coghill, R-North Pole, supported having the language removed in the House Finance Committee, calling it a mandate beyond services the state already provides. Minority Democrats plan to seek an amendment to reinstate that language, seeing those services as a way to prevent unwanted pregnancies and to reduce the number of abortions.

The House was in mid-debate when it went into recess until late Thursday afternoon, allowing time for a legislative group photo and afternoon committee hearings. The House scheduled to go back into session late Thursday afternoon.

The bill calls on the Department of Health and Social Services to fund no abortion services under Medicaid unless the abortion is medically necessary or the pregnancy was the result of rape or incest.

The bill defines medically necessary abortions as those needed to avoid a threat of serious risk to a woman’s life or physical health from continuation of a pregnancy. That could mean a serious risk of death or “impairment of a major bodily function” caused by one of 21 different conditions, such as coma, seizures and epilepsy.

It also includes what has been called a “catch-all” option: “another physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy that places the woman in danger of death or major bodily impairment if an abortion is not performed.”

The House defeated a proposed amendment offered by Rep. Cathy Munoz, R-Juneau, to add to that a psychiatric disorder that places the woman’s health at risk, in line with language in the regulations. Rep. Gabrielle LeDoux, who sponsored the House version of SB49, said experts had testified that “no mental condition would ever make an abortion medical necessary.” She also said it was a “vague and subjective term” when not diagnosed by a psychiatrist.

The Alaska Supreme Court has held that the state must pay for medically necessary abortions if it pays for other procedures deemed medically necessary. The court, in its 2001 decision, referenced bipolar disorder, saying medication needed by women with conditions like bipolar disorder and epilepsy “can be highly dangerous to a developing fetus. Without funding for medically necessary abortions, pregnant women with these conditions must choose either to seriously endanger their own health by forgoing medication, or to ensure their own safety but endanger the developing fetus by continuing medication,” the decision stated.

Supporters of the bill say they are seeking to bring clarity to the term “medically necessary.” They also say public money should not be used to pay for “elective” abortions.

Critics say the bill raises constitutional concerns and would put government between a woman and her doctor.

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