Senate Committee Considering Bill Defining ‘Medically Necessary’ Abortions

Epilepsy, eclampsia, pulmonary hypertension, and sickle cell anemia. Those are all conditions where a low-income woman would still qualify for abortion coverage under a new bill being considered by the Alaska state legislature. But depression, schizophrenia, alcohol dependence and bulimia aren’t on the list. Nor are any other mental heath conditions.

Alaska’s Medicaid program pays for a few hundred abortions each year, and some lawmakers believe that a portion of those might actually be elective and shouldn’t be covered. At a hearing on Wednesday, the Senate judiciary committee considered a bill that provide a strict definition of the term “medically necessary,” and they consulted with a trio of doctors affiliated with the anti-abortion movement on where the line should be drawn.

The three medical professionals invited to testify at the bill’s first hearing laid out their case for why only conditions that endanger a women’s physical health should be covered by Medicaid.

Priscilla Coleman, a psychologist whose research focuses on abortion and depression, called in from Ohio.

“I can say with a reasonable degree of scientific and medical certainty that abortion is a substantial contributing factor in women’s mental health problems,” said Coleman. “Abortion is a particularly risky choice for women with preexisting mental illness.”

Coleman explained that her studies had shown that abortion can correlate with future depression and substance abuse, and for that reason an abortion on mental health grounds shouldn’t qualify for state funding.

But Coleman’s research has come under scrutiny from inside Alaska and beyond. The chair of the Alaska Democratic Party described her and the other doctors invited to testify as “extremists,” and the American Congress of Obstetricians and Gynecologists has previously called Coleman’s research “unreliable.” The American Psychological Association has also found fault with her research linking abortion and mental health issues.

Sen. Bill Wielechowski, the lone Democrat on the committee, questioned her on that point.

“All we get from the professional organizations are very biased, very politically driven efforts to summarize what’s available,” Coleman responded.

The other two doctors invited to testify were also supportive of the bill. John Thorp, an obstetrician from North Carolina, said that in the event of major trauma to a women or a fetus, termination of pregnancy short of massive hemorrhaging on the part of the fetus was always an elective procedure. Susan Rutherford, an obstetrician from Washington, provided the committee with a couple of other physical conditions that should be included in the bill, but also rejected the idea of a mental health allowance. Both are listed in the American Association of Pro Life Obstetricians and Gynecologists’ directory.

Sen. John Coghill, who chairs the judiciary committee and is the lead sponsor of the bill, said earlier this week that he invited the group to testify to get a medical perspective on the bill since it wasn’t going through the Senate’s health and social services committee. He also said he found the work conducted by the testifiers to be credible.

During the hearing, most of the committee members seemed receptive to the bill, with three of the five members already having signed on as co-sponsors.

But Wielechowski, an Anchorage Democrat, questioned the need for the bill. During the hearing, legislative aide Chad Hutchinson stated that the bill was necessary because its supporters had reason to believe that Medicaid is currently covering elective procedures. Wielechowski pushed him to identify a case where an abortion that was not medically necessary had been funded.

WIELECHOWSKI: Do you have any evidence of any abortions in the state of Alaska that have been paid for by Medicaid that were elective as opposed to being medically necessary.

HUTCHINSON: Sen. Wielechowski, through the chair, I believe the statistics that we quoted show that that is occurring.

Hutchinson did not name a case, but elaborated that Medicaid covers over a third of abortions in the state, and that data from the Guttmacher Institute suggested that a much smaller percentage of abortions performed nationally were done out of medical necessity.

Testimony on the bill continues next week, when Planned Parenthood is invited to testify.

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