After two decades of fighting, pro-life Alaskans won a huge battle in the state. As of Feb. 2, new regulations dictate that the State of Alaska’s Medicaid program will no longer pay for abortions unless a doctor deems such abortions “medically necessary.” The regulations were proposed and will be enforced by the Alaska Department of Health and Social Services, which regulates Medicaid, and were certified by Lt. Gov. Mead Treadwell on Jan. 3.
According to the state’s Bureau of Vital Statistics, roughly 35 percent of reported 1,629 abortions performed in the state in 2012 were paid for by Medicaid, a joint state and federal medical insurance program for poor Alaskans.
The new regulations require that doctors fill out a form prior to a Medicaid-funded abortion that says that the pregnancy was the result of rape, incest or performed to save the woman’s life. A second option says that the abortion is necessary due to “impairment of major bodily functions” such as “diabetes with acute metabolic derangement or severe end organ damage,” and “renal disease that requires dialysis treatment,” and “coma.” In all, 23 options are provided.
While a handful of Democratic legislators issued blistering responses to the new rules, Republican state Sen. John Coghill, from Fairbanks, praised Gov. Sean Parnell’s “initiative on this matter.” Coghill introduced a bill last session that mirrored the regulations.
Even though the regulations go into effect on Feb. 2, the fight is far from over. The Alaska Supreme Court ruled in 2001 that such “medically necessary” restrictions for state funded abortions are unconstitutional. Josh Decker, the director of the American Civil Liberties Union of Alaska, said that the ACLU is disappointed in the rules and is “looking at all options,” including a legal challenge. If it doesn’t come from there, it will likely come from Planned Parenthood, which sent out a press release calling the decision unconstitutional.
Since 1993, the state has allowed a doctor to use his or her professional judgment to determine whether abortion is necessary. An administrative code provided guidance. The code said that a woman would be eligible to receive a publicly funded abortion if the pregnancy was a result of sexual assault, abuse or incest. It would also be covered if the procedure was necessary to prevent her death, cause her to be disabled or to “ameliorate a condition to her physical or physiological health.”
Pro-life Alaskans have chafed under the vague terms. Parnell went as far as to veto bipartisan legislation to expand health insurance coverage for impoverished Alaskan families — including more than 1,300 children — because it paid for what he called “elective abortions.” He said that without guidance about what is and isn’t medically necessary, the state will be in a perpetual state of “confusion and turmoil.”
If the federal government is asked to pick up the cost, the abortion provider must certify that the abortion was performed because of rape, incest, or because the life of the mother is at risk. At various points in history, the Legislature has tried to impose those same standards for Alaskan women.
In 2001, however, the Alaska Supreme Court ruled that although the Feds can impose such standards, the state cannot “selectively deny necessary care to eligible women merely because the threat to their health arises from pregnancy.” In other words, the state can’t decide to pay for a medically-necessary birth for one woman and deny a medically-necessary abortion to another.
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