JUNEAU -- A House panel struggling with a contentious bill to limit state funding to those abortions deemed "medically necessary" on Tuesday took up a new version that wiped out a provision for expanded family planning services. Some contend the change could lead to more abortions and unwanted pregnancies in Alaska.
The abortion measure made its first appearance this year in a committee hearing that turned testy at times. The House Finance Committee spent the bulk of its work day on Senate Bill 49, sponsored by Republican Sen. John Coghill of Fairbanks and passed last year by the Senate.
Rep. Bill Stoltze, R-Chugiak and committee co-chairman, repeatedly ordered Rep. Les Gara, D-Anchorage, to reshape his questions, at one point banging his gavel and calling a pause in the meeting. Stoltze said he was concerned about the potential for litigation and didn't think it fair for Gara, and occasionally others, to make a strong statement and then ask a state official "to validate it."
With the elimination of the expanded family planning program, Senate Bill 49 and House Bill 173, sponsored by Rep. Gabrielle LeDoux, R-Anchorage, are again identical twins.
Both Coghill and LeDoux told the Finance Committee Tuesday they merely want to bring "clarity" to the question of state Medicaid payments for medically necessary abortions.
They insisted their bills don't amount to new abortion restrictions but rather are an attempt to distinguish state-funded medically necessary abortions from elective procedures that women could pay for themselves.
"I see this bill as neither a pro-life or a pro-choice bill but simply a fiscal bill," LeDoux told the committee.
Most of those who testified Tuesday argued that the bills would restrict abortion for poor women. Lawmakers were told to expect costly litigation, more unintended pregnancies and scary back-alley or self-abortions if the legislation passes. Of the 20 members of the public who testified, 17 opposed the bill.
The legislation would limit state payments to situations in which pregnancy would put the woman's life in danger or her physical health at risk due to serious conditions including heart disease, diabetes with complications, and coma. The state wouldn't pay for any abortions related to psychiatric issues.
A new state regulation that almost echoes the language of Coghill's bill -- adding only narrow consideration of a psychiatric disorder -- is on hold as a result of a court challenge brought by Planned Parenthood of the Great Northwest.
Anchorage Superior Court Judge John Suddock earlier this month ruled the new rule was too restrictive because the psychiatric disorder would have to threaten "medical impairment of a major bodily function if an abortion is not performed."
Pediatrician George Brown of Douglas told the committee that the bills aim to impose personal values on the most contentious public policy issue since the abolition of slavery.
"Laws which deny personal choices about health care add more stress to individuals," Brown said. "Persons who have never been pregnant or who can never be pregnant cannot really understand these particular stresses."
Rep. Mark Neuman, R-Big Lake, said he took exception to that as a father. He said he was very involved in his children's lives and wanted to do more to protect "unborn children."
Another doctor, obstetrician Jean Bramer of Fairbanks, said statistics show far more abortions are being performed in Alaska than what would be considered medically necessary. The Legislature is right to take on the issue, she said.
Because Alaska's Medicaid program pays for maternity treatment, it also must cover the costs of a medically necessary abortion, to avoid discriminating against women who choose different paths, the Alaska Supreme Court ruled in 2001.
The state in 2013 began requiring medical providers to certify that an abortion was medically necessary in order to receive state reimbursement through the Medicaid insurance program, or to attest it met even stricter criteria for federal funding.
Several who testified warned the legislation would bring new litigation.
"There's no reason to waste legislative time and energy and the money associated with that time and energy on these bills while the court is in the process of deciding this very issue," Jessica Cler, spokeswoman for Planned Parenthood Votes Northwest, the group's advocacy arm, told the committee.
Coghill said during a break Tuesday that the Legislature has an obligation to give direction to the state Health and Social Services Department on a tough issue. "We're the policy-making body," he said. Regulations usually come after a law is passed, not before. "I think this is the better venue," he said.
Susan Schrader of Juneau told the committee that no matter what Coghill and LeDoux said, they are trying to limit abortion just like measures that define "personhood" or that require ultrasounds or waiting periods before an abortion.
The way to reduce abortion and lower state costs, she said, is through an expanded family planning and birth control Medicaid program.
"And you just stripped it out of the bill," Schrader said.
On the committee, two Democrats, Gara and David Guttenberg, along with Republican Lindsey Holmes opposed abandoning the family planning provision. They were outnumbered by the eight who voted to take it out: Finance Committee co-chairmen Stoltze and Alan Austerman as well as members Neuman, Mia Costello, Bryce Edgmon, Tammie Wilson, Cathy Munoz and Steve Thompson. All are Republicans except Edgmon, a rural Democrat who is organized with the GOP majority.
Coghill said the state already pays for family planning services.
That's misleading, state Sen. Berta Gardner, D-Anchorage, said Tuesday. She surprised herself last year when she was able to insert the family planning element on the Senate floor only to see the House panel yank it back out Tuesday.
"It's a sad day for poor women," Gardner said.
The axed provision sought to create a new Medicaid program providing birth control, testing and treatment for sexually transmitted diseases, and an annual family planning visit for single women and men who otherwise didn't qualify for Medicaid, which generally only covers families with children, pregnant women and disabled people.
It would reduce costs, abortions and unintended pregnancies, Gara said in arguing to keep it in.
Holmes noted that Coghill had referred to the responsibility of women for family planning.
"What I hope the senator meant to say is it's the responsibility of the woman and the man," Holmes said.
"I think he clearly meant to say that," Stoltze said. "It was an incredible oversight on his part."
"Duly corrected," Coghill said.
Bill Streur, health and social services commissioner, told the committee that about 14,400 Alaskans would qualify for Medicaid family planning, though he didn't know how many would actually sign up. If their benefits were limited to family planning services, the cost would average about $800 each a year. Medicaid pays about $630 for an abortion, he said.
Needy Alaskans also can get care at community health clinics, which offer family planning, Streur noted.
The Finance Committee likely will finish its work on the bill later this week, Stoltze said.
Gara and Guttenberg plan to try to reinject the family planning program.
Last year in Alaska, there were 1,450 abortions reported to the state. Medicaid paid for 547 of them.
Reach Lisa Demer at firstname.lastname@example.org or 952-3965.
By LISA DEMER