JUNEAU -- An emotional and divided House committee on a slim, one-vote margin passed a bill Thursday defining a "medically necessary" abortion.
A different version of the measure, Senate Bill 49, already passed the Senate. Now the House Finance Committee with its 6-5 vote agreed to send the bill to the full House.
The committee earlier this week took out the one element that Democrats and some Republicans liked: an expanded family planning program that some said would reduce abortions and unwanted pregnancies.
Sponsors say the measure doesn't restrict abortions but rather was an attempt to define which ones the state would pay for through the Medicaid program. The Alaska Supreme Court ruled in 2001 that since Medicaid covers prenatal care, it also must pay for medically necessary abortions to avoid discriminating against women who chose different paths. But opponents said that the measure will in fact limit the choices of poor women.
Rep. Bill Stoltze, the committee co-chairman, called for a roll call vote. Those voting in favor of the bill, all Republicans, were: Stoltze of Chugiak, Mia Costello of Anchorage, Mark Neuman of Big Lake, Cathy Munoz of Juneau, Steve Thompson of Fairbanks and Tammie Wilson of North Pole.
All three Democrats on the committee including one who is aligned with the GOP-led majority were joined by two Republicans to oppose the measure. They were: Les Gara, D-Anchorage, David Guttenberg, D-Fairbanks, Bryce Edgmon, D-Dillingham and a member of the GOP majority, Lindsey Holmes, R-Anchorage, and Alan Austerman, R-Kodiak.
Austerman, the other committee co-chairman, said he's always been pro-choice.
"While I fully acknowledge the efforts of the sponsors of this bill to define what is going on, and I fully recognize that today this is not a debate about pro-choice, my concern is and always has been efforts by pro-life to cumulatively move towards their goal," Austerman said. That's problematic, he said.
Holmes, a Democrat-turned-Republican last year, said she was disappointed the committee took out the family planning element, which would have allowed single men and women who otherwise didn't qualify for the Medicaid insurance program to receive coverage for contraception, sexually transmitted disease testing and treatment, and family planning visits.
As to the bill itself, "I understand we're not talking about the basic idea of pro-life, pro-choice here," Holmes said. "We're talking about funding. This is the finance committee. We're talking about who pays and what services."
But the committee didn't hear detailed testimony about the medical conditions that would certify an abortion as necessary, she said. The list of 21 conditions, plus a blanket category for other physical disorder or illness, is precise and technical: renal disease that requires dialysis treatment, eclampsia, pulmonary hypertension, severe congenital or acquired heart disease, class IV.
"I don't really know what all this stuff in here is and isn't. I don't know if we hit the nail on the head," Holmes said. She said she wasn't comfortable telling a doctor "this is the right list."
Neuman, a pro-life conservative, said he researched the medical terms, asking his wife as well as doctors.
"I tried to find out what they mean as best as I could," he said. Maybe the measure will save lives and maybe not, he said.
"I do support this bill. I think it is necessary that we do have some descriptive language in our statutes," Neuman said.
Costello and some of the other bill supporters said the Legislature should look further into the family planning program. She said she wanted adoption to be part of that debate.
"Adoption is one outcome of an unwanted pregnancy," Costello said. "I was adopted. My brother was adopted."
Wilson at an earlier hearing pushed for information on how the health insurance system for state employees determines abortion coverage. Mike Barnhill, deputy administration commissioner, told her that the state requires all procedures to be medically necessary and that patient records may be reviewed. An abortion for the patient's convenience would be denied, he said.
Of seven insurance claims for abortions in 2010, six were denied and one was reviewed and determined to have been a miscarriage, not an abortion, Barnhill said at Tuesday's hearing.
Wilson said Thursday she thought Medicaid should mimic the state insurance program.
"I'm still concerned that we're going down a trail in which we are going to get sued," she said. But others said the detailed list in the bill was a better approach.
Gara and Guttenberg tried Thursday to reinsert the family planning element. The original bill by Sen. John Coghill, R-Fairbanks, did not include the expanded program but it was added in on the Senate floor.
Stoltze ruled the Democrats out of order since the committee stripped out family planning on Tuesday when it took up a substitute bill.
"You're guaranteeing more abortions, not less," Guttenberg said.
The committee meeting took a turn when Stoltze allowed Coghill to testify after the legislators began debating the measure. Guttenberg questioned that. Stoltze said he wanted the senator to relay information about how the bill related to mental illness.
Coghill said the Alaska Mental Health Trust Authority told him if a women was involuntarily committed for psychiatric treatment, she would qualify for a state-paid abortion under the blanket provision of the bill. He said later that the situation qualified as a serious physical condition because the woman would be at risk of harming herself or another person.
Coghill says he simply is trying to stop the state from paying for elective abortions.
"Next, a vote of the full House," his office tweeted.
Reach Lisa Demer at firstname.lastname@example.org or 952-3965.