The Alaska State House opened debate on a bill putting limits on state Medicaid payments for abortions on Thursday, only to shelve it and delay a final vote to Sunday.
The bill requires abortion providers to sign a statement that a procedure is “medically necessary,” and it defines that term to include only physical conditions – not mental ones. Advocates of the bill believe the state is paying for elective abortions under the current law, while critics argue that the bill restricts abortion access for poor women.
The version that the Senate passed last year also included a provision establishing a women’s health program, which made the bill more palatable to moderate Republicans. That program would have allowed low-income single women to access birth control and family planning services, with those services largely paid for by the federal government.
A House committee stripped that language in March with support from an influential conservative advocacy group, but the issue of family planning became a major focus of debate during the amendment process.
Rep. Gabrielle LeDoux, the Anchorage Republican carrying the bill, signed on to an amendment signaling the Legislature’s intent “to continue” funding women’s health services in the state. The amendment, which passed 35-5, does not commit the Legislature to expanding services in any way. A handful of Democrats opposed the measure because they did not believe it to be substantive, and they instead tried to reintroduce the original family planning language that would have compelled the state to establish a new program immediately.
LeDoux spoke against the Democrats’ amendment, arguing that the state already provides women’s health services through public health clinics.
“Other than putting contraceptives in the drinking water, I mean we’ve done just about everything we can do as far as family planning services.” LeDoux said on the floor.
The Democrats’ amendment failed on a 22-18 vote, with four Republicans – Lindsey Holmes of Anchorage, Cathy Muñoz of Juneau, Alan Austerman of Kodiak, and Paul Seaton of Homer — breaking ranks with their party.
Sen. Berta Gardner, an Anchorage Democrat who offered the original family planning language last year, thinks the amendment to simply continue funding women’s health services is not a compromise measure, but a fig leaf.
“It means nothing,” said Gardner in an interview. “It’s just like a little ‘P.S.’ but without the force of law.”
While the family planning amendments prompted the most discussion on the floor, the amendments that showed the greatest strife on the bill dealt with the lack of mental health exception.
One amendment added that exception back in, which would have allowed women receiving medication for psychiatric disorders to qualify for abortion coverage because of the pregnancy risk that creates. That failed 21-19, with Mike Hawker of Anchorage joining the bloc of Republicans seeking to alter the bill. The other amendment would have allowed for a mental health exception only in cases where suicide is likely. That failed 20-20, picking up support from Republicans Charisse Millett of Anchorage and Eric Feige of Chickaloon.
Once the amendment process wrapped up, the bill pulled from consideration and tabled until Sunday. House Speaker Mike Chenault acknowledged that the outcome would be close.
“You can see it’s kind of a divided issue,” said Chenault after the floor session. “It always is, it always has been.”
Chenault added that final consideration was not being delayed because of any uncertainty over the bill’s ability to pass. The bill was moved so that legislators with scheduled absences could be present for a vote.
Last year, the Department of Health and Social Services introduced regulations that are nearly identical to the bill language, but include the mental health exception. Those regulations are now the subject of a lawsuit, and a judge has put a stay on them until the courts determine if they comply with the equal protection clause of the Alaska Constitution.
If the bill passes, it will be sent to the governor’s desk for his signature, and then, most likely, to the courts.