After being shelved for nearly a year, a bill meant to limit Medicaid payouts for abortion is back – and it’s missing a component that made it more agreeable to the Legislature’s social moderates.
Last April, something unusual happened. Sen. Berta Gardner, a member of the tiny Democratic minority caucus, offered an amendment to a bill, and Republicans adopted it.
Some even spoke out in favor of it, including Sen. Lesil McGuire:
“I think this is exactly the right amendment for the right bill, because I think it allays some of the criticisms about the bill – number one – and I think – number two – it strikes that balance that many of the people in this body are trying to reach.”
The amendment was to expand women’s health services, and the bill had to do with abortions covered by state money through Alaska’s Medicaid program.
The legislation does that by defining what constitutes a “medically necessary” abortion, and requiring doctors to check off what ailment a woman suffers from a list of specific physical conditions. That list doesn’t include a mental health exception, because bill sponsors believe women and doctors could use that option to cover elective procedures.
In all, the idea behind the modified bill was to bring the number of abortions in the state in two ways: by limiting funds for abortions that bill supporters think are elective, and by increasing access to things like birth control and STD testing.
While the Senate passed the bill, the House version was put on ice. That is, until now. The House Finance Committee took the bill up again on Tuesday, and the family planning language was a point of contention. Especially for bill sponsors like Sen. John Cohill, a Repulican from North Pole.
“I prefer not to have the amendment in there.”
And Rep. Gabrielle LeDoux, an Anchorage Republican:
“That could be something that could be considered in budgetary talks, but I don’t believe that it is appropriate as an amendment to a bill that which is simply trying to define what the term “medically necessary abortion” is.”
Before debate on the bill began in earnest, the House Finance Committee voted eight to three to strip the language, mostly on caucus lines. Republican Lindsey Holmes joined Democrats Les Gara and David Guttenberg in voting to keep the family planning section.
During a break from the hearing, Gara expressed his disappointment to reporters.
“The science and the evidence is that family planning can reduce the number of abortions. By stripping that language out of the bill, they now have a bill that will increase the number of abortions.”
Democrats still plan on trying to reinsert the family planning component of the bill. The issue of family planning was discussed at length after its removal, and Finance Co-Chair Bill Stoltze suggested he would allow members to introduce an amendment on that subject as a matter of process.
But through the course of the hearing, LeDoux reiterated that she was hostile to the amendment.
“If it’s the will of the Legislature – if it’s the will of the Finance Committee – to increase funding for Medicaid, to increase funding for family planning services, then let’s talk about this in the Health and Human Services budget. There’s no need to ‘Christmas tree’ this particular bill, which is a simple bill, with discussion of family planning services.”
If the family planning language isn’t attached to this bill, it may be a struggle to get it in during the normal budget process. While the federal government would pay for 90 percent of the costs of the Women’s Health Program, the state would need to spend $1.4 million over the next two years to access those funds.
Sen. Pete Kelly, a Fairbanks Republican who is in charge of the Senate’s version of the operating budget, doesn’t believe there’s much will to add that in.
“I prefer that that’s not in there. To put it in as a budget item, I don’t see that happening,” said Kelly.
Under current Alaska law, only pregnant women and people with disabilities can access family planning services. The family planning amendment would expand access to low-income men and women who are seeking to prevent pregnancy. A report from the Guttmacher Institute estimates that would prevent 1,090 unintended pregnancies and 360 abortions.
Last year, 1,450 abortions were performed in Alaska, and 547 were covered by Medicaid.
Earlier this month, the Alaska Department of Health and Social Services made a similar attempt to define the term “medically necessary” in the context of abortion payments. Their regulations cover nearly the same conditions listed in the bill, but they also allow for a mental health exception. A judge prevented the regulations from going into effect after Planned Parent sued the state, arguing that the regulations violate a 2001 Alaska Supreme Court decision.
Watch the committee meetings courtesy of Gavel Alaska:
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