JUNEAU, Alaska — A divided House Finance Committee advanced an abortion funding bill Thursday over concerns that it did not address expanded family planning services and chipped away at a woman's access to an abortion.
The vote was 6-5. Republican Reps. Mia Costello, Cathy Munoz, Mark Neuman, Steve Thompson, Tammie Wilson and Bill Stoltze voted in favor; Democratic Reps. Les Gara, David Guttenberg and Bryce Edgmon, and Republican Reps. Lindsey Holmes and Alan Austerman voted against.
SB49, from Sen. John Coghill, R-North Pole, seeks to further define what constitutes a medically necessary abortion for purposes of Medicaid funding. Earlier this week, the committee voted to remove language that called for the state to provide expanded women's health and family planning services. That language was added on the Senate floor last year, but Coghill did not support keeping it in, calling it a mandate beyond services the state already provides.
Currently, childless adults do not qualify for Medicaid. State Health Commissioner Bill Streur has said about 14,000 Alaskans could be eligible for reproductive health and family planning services if they were expanded as contemplated under the Senate language.
Stoltze, a committee co-chair, ruled out of order an effort by Gara to amend the bill to restore the language, saying the committee had already decided the issue. Gara, of Anchorage, vowed to raise the issue again on the House floor.
The bill calls on the Department of Health and Social Services to fund no abortion services under Medicaid unless the abortion is medically necessary or the pregnancy was the result of rape or incest.
The bill defines medically necessary abortions as those needed to avoid a threat of serious risk to a woman's life or physical health. That could mean a serious risk of death or "impairment of a major bodily function" due to one of 21 different conditions.
It also includes what has been called a "catch-all" option: "another physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy that places the woman in danger of death or major bodily impairment if an abortion is not performed."
The bill's language is similar to that of regulations approved by Streur. But the regulations also define an abortion as medically necessary if the woman has a psychiatric disorder that places her in "imminent danger of medical impairment of a major bodily function" if an abortion is not performed. The regulations are being challenged in court as unconstitutional by Planned Parenthood of the Great Northwest.
The Alaska Supreme Court has held that the state must fund medically necessary abortions if it pays for other procedures deemed medically necessary for people in need. Coghill has said he is simply trying to clarify what "medically necessary" means.
Supporters say public money should not be used to pay for "elective" abortions. Jean Bramer, an obstetrician from Fairbanks, testified earlier this week that in her experience, the number of medically necessary abortions should be relatively low. Medicaid in fiscal year 2013 paid for about 500 abortions in Alaska.
Neuman, of Big Lake, said he supported having descriptive language in the law surrounding medical necessity. But critics of the bill say it puts government between a woman and her doctor.
Guttenberg, of Fairbanks, said if the state wants to reduce the number of abortions, "then the simplest way, the most immediate way, is you prevent them from happening. We've eliminated that consideration in this bill."
Gara said the bill sets up a situation that will leave fully intact access to an abortion for some women but not others. He also expressed concern that it could creation a situation where women seek unsafe abortions.
Holmes, of Anchorage, raised questions about the bill's list of medical conditions and said she was uncomfortable telling a doctor that the list in the bill was the right list.