Senate Finance tries to tighten abortion rules

Posted: Wednesday, April 24, 2002

JUNEAU (AP) -- The Senate Finance Committee approved a bill Tuesday tightening the rules for state funding of abortions.

Senate Bill 364 is a response to some lawmakers' frustration with a Supreme Court decision requiring the state's Medicaid program to pay for medically necessary abortions for poor women.

The court ruled last year that the state may not deny funding for medically advised abortions for poor women if it provides other pregnancy-related services for poor women.

Sen. Pete Kelly, R-Fairbanks, said state regulations interpret medical necessity too loosely.

Opponents of the bill said Kelly's attempt to tighten the language ties doctors' hands and could leave out women with serious health problems.

Current regulations define therapeutic abortions, which are covered by Medicaid, as those necessary ''to prevent the death or disability of the woman, or to ameliorate a condition harmful to the woman's physical or psychological health.''

Kelly said that definition could include a woman who's ''stressed out'' because she's pregnant.

''We're just trying to narrow that up because, let's face it, psychological health is as broad a term as you could possibly get,'' Kelly said.

The definition in Kelly's bill would allow state-funded abortions:

-- for a woman with a physical health problem that is caused or aggravated by the pregnancy and that would ''seriously endanger'' the woman's health if an abortion were not performed.

-- for a woman who needs medication to treat a psychological illness if that medication would be ''highly dangerous'' to the fetus and if the health of the woman would be endangered if she did not take the medication.

-- for pregnancies resulting from rape or incest.

Jennifer Rudinger of the Alaska Civil Liberties Union said the new definition is too tight and uses adjectives that are vague and unworkable.

''What is highly dangerous as opposed to dangerous or very dangerous?'' Rudinger asked.

The language also requires doctors to certify that something ''would'' happen when they seldom can be that certain of an outcome, she said.

A diabetic woman with a 50 percent likelihood of suffering kidney failure if she carries a pregnancy to term would not be covered, Rudinger said.

Dr. John Middaugh, the state epidemiologist, cited similar concerns as he spoke against the bill on behalf of the Department of Health and Social Services.

''The language doesn't recognize the necessity to respect the uniqueness of each patient,'' Middaugh said.

He said he does not believe elective abortions are being paid for by the state.

Nancy Weller of the Division of Medical Assistance said the state paid $326,923 for 577 abortions in the fiscal year that ended June 30, 2001, including six cases of pregnancies resulting from rape or incest.

Kelly said he doubts that many poor women had serious health problems warranting state-funded abortions.

Kelly has tried for several years to limit state funding of abortions and has been thwarted by court decisions.

Last year he at one point added language to the budget that would have killed the entire Health and Social Services budget if a judge forced the state to spend money on abortions. The language was later amended out of the budget.

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