ANCHORAGE — State health officials are refusing to answer questions about a proposal that critics fear could restrict abortions for low-income women in Alaska. Whether that would actually be the result is unclear. People on both sides of the abortion debate say it’s difficult to determine what the proposed rule really means.
The state Department of Health and Social Services proposed the new regulation for “abortion payment conditions” in late June and is inviting public comment through July 30. Officials say it’s not appropriate for them to discuss it until then.
At issue is coverage for abortions through Medicaid and Denali KidCare, the state-federal health insurance programs for low-income Alaskans.
The state wants to require physicians who perform abortions to certify on paper whether an abortion is medically necessary. If it’s not, or doesn’t meet federal criteria, the state won’t pay for it.
In a written statement, deputy health commissioner Kimberli Poppe-Smart said the changes are needed “to avoid payment errors” and “to verify that medical assistance funds are being used in accord with the law.”
Planned Parenthood of the Great Northwest, which provides the majority of abortions in Alaska, says a shift in wording of what constitutes a medically necessary abortion is the biggest of several problems with the proposal.
A rule now on the books defines a medically necessary abortion as one that improves “a condition harmful to the woman’s physical or psychological health.” The proposed change says an abortion can be eligible for payment if “the health of the mother is endangered by the pregnancy.”
The elimination of the reference to “psychological health” appears to be a significant change that could rule out abortion coverage for many women, said Clover Simon, Planned Parenthood spokeswoman.
“You have to be suspicious, because there have been so many attacks on a woman’s right to obtain an abortion, especially poor women, in Alaska. So we have to be extra vigilant,” she said.
Health and Social Services Commissioner William Streur assured Planned Parenthood the new rule won’t affect the kinds of cases covered under an Alaska Supreme Court decision, and the organization said it hopes that is true. But the measure is so vague that the effect won’t be certain until it’s enacted, Simon said.
Sen. Hollis French, a Democrat from Anchorage who chairs the legislative Administrative Regulations Review Committee, said he’s concerned by the proposal and is looking into what’s behind it.
“It really is hard to understand why they are doing this,” French said.
Rep. Wes Keller, a Republican from Wasilla, at first applauded the state proposal, thinking it mirrored legislation he proposed this year to sharply limit what qualified for state funding. But after a closer look, he’s backing off that assessment.
“All this does is require the provider to certify the abortion is not elective,” Keller said. His bill ran into a procedural problem and died.
Besides the big worry over whether the change could impede poor women from getting an abortion, Planned Parenthood has concerns about privacy. The paper form will be sent through the mail and will include the women’s name, the date of the abortion, and whether there had been a rape or incest, as well as whether her life or health would be at risk without an abortion. While billing forms already include the patient’s name, they use codes to identify the medical procedure and aren’t as vulnerable to the information slipping out, Simon said.
Members of the Legislature have tried for decades to cut back or eliminate state funding for abortion. But the state Supreme Court ruled in 2001 the state had to fund medically necessary abortions if it funded maternity care, to avoid discriminating among pregnant women who choose different paths.
Gov. Sean Parnell, an anti-abortion Republican, two years ago vetoed an expansion of the Denali KidCare program after learning it paid for abortions. The governor did not push for the change in rules now under debate, but supports the proposal, his spokeswoman, Sharon Leighow, said. He is not discussing the matter further until the close of the public comment period, Leighow said. Neither are his top health aides, including the commissioner, Streur. State lawyers did not explain why officials cannot talk at this stage.
In the written statement, health officials said they are trying to make sure the state complies with the federal Hyde Amendment, which limits federal funding for abortion to cases of rape, incest or those in which the mother’s life is in danger. They also say the state hasn’t had a way to verify that state-paid abortions meet the criteria in the 2001 state Supreme Court decision. They didn’t explain why they are tweaking the payment rules now. The Hyde Amendment has appeared in federal budgets in one form or another since 1976.
Under the court decision, the state has to pay for abortions beyond Hyde, if they meet the “medically necessary” standard. Streur told Keller’s Health and Social Services Committee in March that the state wanted to minimize paying for elective abortions but that ultimately, the decision on whether the procedure is medically necessary rests with the doctor.
The federal government paid for no abortions in Alaska last year and may not have covered any for several years before that, according to Keller’s office.
The state spent just over one-half million dollars in general funds on abortions and related services in 2011 for 901 individuals, though all may not have gotten abortions, health officials told Keller. According to the state’s annual report on abortion, based on information from medical providers, out of 1,627 abortions performed in 2011, 623 were covered by Medicaid.
Alaska is among 17 states that cover medically necessary abortions, Planned Parenthood says. Six have certification procedures.
An abortion costs $650 in Alaska, according to Planned Parenthood.
The proposed regulation still has to go through several steps before becoming finalized and could be changed or withdrawn entirely.
Comments (176)
Add commentShameful
I find this more than a little ironic, Denali KidCare paying to murder kids
"At issue is coverage for abortions through Medicaid and Denali KidCare, the state-federal health insurance programs for low-income Alaskans."
"out of 1,627 abortions performed in 2011, 623 were covered by Medicaid." wonder who paid for the other 1003 murders?
Stop using my tax dollars to fund Planned Parenthood
Stop killing kids
If you are opposed to abortion, then don't get one.
It amazes me that 40 years after the passage of Roe v. Wade, there are still those who can't accept the reality that abortion is legal in the United States and always will be as long as our Constitution is in place.
If you oppose abortion, then don't have one.
I'm further amazed at the right-wing's constant and futile attempts to chip away at a woman's right to choose, however they can.
Have they learned nothing in 40 years? If not, here's the lesson...
Every time you try to limit a woman's right to an abortion, no matter how small that limit might be, there will always be those on the other side like me, making sure you don't succeed.
We have the U.S. Constitution on our side, we have the A.C.L.U., we have Roe V. Wade Supreme Court decision and we have women.
And for men like me who can't have abortions, we join this fight as well because every attempt you make to limit someone else's Constitutional rights puts other rights in jeopardy, including mine.
If a woman or a girl wants an abortion, they will find a way to get one. No amount of laws or restricted funding will reduce that number.
Give it up already. It's been 40 years. You always lose the fight. You might win a battle or two, but you eventually lose the war.
"A civil right delayed is a civil right denied." - M.L. King, Jr.
Jo Misses the Point
Jo, you are obviously missing the point. This is about government funded abortions. There is nothing in this rule change that denies anyone an abortion. It merely states specific circumstances where the taxpayers will pay for the abortion. You're certainly willing to pony up your personal money for other people who want to kill their child. I'll spend mine elsewhere.
@ rough cut
If we funded contraception up front, and encouraged condom use instead of flawed "abstinence only" education, there would be less need for abortions.
@akjim
No, Jim, you miss the point.
If we all get to pick and choose which things our taxes pay for, then I hereby wish to deny any further funding for the military industrial complex which funds any part of the Afghan war.
And I was amused at your comment about people killing children. I bet more children died in Afghanistan and Iraq than in Alaska abortion clinics. And it's people like you who usually support those wars.
p.s., zygotes and embryos are not children. Children do not live in test tubes.
Would wave the Roe flag, or the contraception funding
How many screaming for funding of bc are aware that long before there was a Planned Parenthood here in Juneau. Public Health provided sliding scale reproductive services to women? Did you know that condoms are available at Public Health and the Teen Centers? STD testing is available at Public Health too. In case you didn't know Public Health is a State funded facility.
As for Roe v Wade. Know what Norma McCorvey, Roe, learned in the 40 years since the decision? That she was a pawn, and grateful she never had that abortion. She is Pro Life. I wouldn't swing that banner when even the poster child jumped ship.
I am not looking to decide for someone else. But I am also not looking to pay for them either. I do not think abortions should be publicly funded. If you would like to donate to a private abortion fund, knock yourself out. Honestly I would much rather see those funds going toward funding DMHDD waivers for those languishing on the waiting list. For people who were born that way. Not people who feel they cannot control their need to roll in the sheet. Guess maybe I am more evolved or more informed to the options.
@Jo
you were doing fine - I dont agree with you, but hey, until you brought the Afghan war into it. It undermined your stance because you implied that drone-scrogging Afghani kids is worse than killing kids in utero in Alaska just by shear numbers. Is that right?
@ Grendel
nice attempt at misinterpreting my words.
Killing kids isn't acceptable under any circumstances, no matter what the numbers are. Zero children have died in PP clinics.
I was pointing out the flawed logic in those that think aborting an embryo is the same as killing an Afghani child or any other child because pro-lifers constantly refer to zygotes and embryos as children. And if those same types who are appear to be so concerned about childrens' lives, they sure do seem to support a war that kills a lot of children.
And their silence on that war is deafening. And therein lies their flawed logic and hypocrisy.
Children don't live in test tubes.
Torn
I’m torn on the subject. I don’t support abortion nor do I oppose it and view it as an individual choice-the woman’s. I prefer that individuals pay for their own medical procedures and not rely on others. If the woman can’t afford an abortion then why is she having sex that could result in a pregnancy? If she can’t afford an abortion then she likely would not be able to support the child after birth and has acted irresponsibly. Children born to low income families are at a serious disadvantage to children born to higher income families.
Men have zero say in whether or not a woman has an abortion and also have zero responsibility to pay for an abortion. We don’t know if the man in question could pay or not pay for the procedure but it isn’t relevant. Men have a responsibility to pay for the child after it is born which is another subject.
Jo you make the point that we can’t choose what we pay for in taxes. I disagree this proposal is exactly that. We as a state are choosing on how to spend our taxes. I do agree an individual has very little discretion, if any, to determine how we spend taxes.
As far as contraception goes it is often available free at health centers in the form of condoms and other services such as exams have income levels so that the poor can receive the appropriate care.
Let's all scream about our
Let's all scream about our tax dollars funding abortions, which prevent zygotes and fetuses from BECOMING people, while many more of our tax dollars fund drone strikes and wars that kill hundreds of thousands of innocents abroad.
It makes perfect sense and isn't hypocritical or ill-informed at all.
so sick of this....
the religious right wants to control people who are not of their faith. Period. It's not about helping women, preventing unwanted pregnancies, or helping children. And now, under the red herring of "funding" - they also want to put personal, perhaps painful information in the mail - - we're really just one step away from a scarlet "A", now, aren't we?
If it were, every anti-abortion person would be volunteering at shelters, have foster kids in their home, be donating to and working with young mothers. The people waiving religious signs at Planned Parenthood would instead be using their time for the things I just mentioned. But a very, very miniscule
number of these people actually do anything constructive.
Instead it's just 'I don't like abortion so you can't get one, but you also can't get any education in school or preventative measures to ensure you don't get pregnant, then once you have the precious baby, to heck with you and the child, because I'm also against any kind of 'welfare' for a single, unwed mother kicked out of her house at 15 after being raped by her uncle.'
It would be laughable if it weren't so evil and twisted and completely irrational.
BTW, for Jo and others - I made a plege to myself that every time I see the religious picketing, I pull in and give Planned Parenthood $5. I hold up the bill on the way by the picketers. I did so on Wednesday. I encourage others to join me.
If it hoots like a grouse, it's probably a grouse...
We all know what this is about. Payment regulation is a red herring. This is about lying for Jesus.
And it looks like 2012 is trying to be a repeat of 2011. In 2011, states enacted 162 provisions regarding reproductive health. 49% of those provisions sought to restrict access to abortion services.
Red herring tactics about a complex subject are not the best ways to reach satisfying and lasting solutions.
Mike
@ Swimmergirl
Like I said before I don't oppose nor support abortions but I do oppose the people who demonstrate in front of Planned Parenthood. It is their right to demonstrate but it is in poor taste.
@ Jo, once more
I understand now: more children have died in Afghanistan and Iraq than in Alaska abortion clinics. Then your response muddled me (I'm easily muddled by the logic on this topic because I'm predisposed to think it reeks of convenience, and I'm slow);
1. terminating zygotes and embryos is okay;
2. because they arent real people yet, dont have a voice;
3. and besides, they're unwanted, inconvenient, or unviable anyway;
4. and furthermore, it's the woman's choice!
Nevermind the science, that wont get us anywhere. What bothers me about the comparison is that Afghani, Iraqi, Pakistani, and even Somali kids are for the most part collatoral damage - unintended; but walking into PP in JNU is a very deliberate choice.
Where the comparison works in your favor, Jo, is that neither the ripped apart Pakistani kid nor unborn Alaskan had any say in the matter. Never got a chance to grow up and tell someone thanks for not killing me.
I don't think.....
you have to get quite so detailed about the funding question, although it is a good point. Conservative wishes to decrease any kind of 'welfare' funding, which affects children and single mothers, is also telling.
I think it's ok to make the basic point: We all live in a collective. There will ALWAYS be a multitude of things that individuals disagree with that are legal for the collective, and funded by taxation, directly or indirectly. The list is practially endless - no matter what is funded by taxes, I bet there is someone or a group who is opposed to it for some reason.
It is simply not necessary for everyone to agree on everything that their taxes are spent for - particularly when they are not directly injured in any way by the expenditure of said taxes.
Everyone doesn't have to agree
Everyone doesn't have to agree how to spend the funds only the majority has to agree(or more in the case of certain legislation).
It is a poor argument to say that just because we don't agree with something we should pay for it because we pay for something else we support that others oppose.
Example:
John supports buying red crayons.
Jane opposes buying red crayons.
Jane supports buying green crayons.
The government bought red crayons so the government must buy green crayons.
AKnut - I agree
that they have a right to picket. I applaud your willingness to post that you are torn on the subject - it certainly is much more complex than the 'then just don't have sex' folks would like to believe.
My plege is simply about putting my money where my mouth is - I believe 'freedom of religion' includes people's right to NOT be subjected to someone else's religious 'rules'. I particularly disagree with the religious oppression of women. So I support Planned Parenthood for the women who may not be able to afford birth control or an abortion. And, I think if enough people held up a few dollars so the protesters could see they were actually helping Planned Parenthood by being there, they might find something more useful to do, like volunteer at the AWARE shelter, or foster a child.
AKnut - after majority....
I would also put "or the Supreme Court".
Let's not forget that "majority rules" isn't always the best measure either - if it were African Americans might still be segregated in the south.
I think the 'red crayon' argument doesn't work for me because what we are talking about is a basic right, by a woman, to have control over her own body. The circumstances of a pregnancy are as varied as the number of women who are pregnant, so a blanket assumption is difficult to make.
In this country, we hold that everyone is entitled to equal protection under the law, which means that if you can't afford a lawyer, taxes provides one. And we hold that being poor shouldn't prevent people from accessing basic needs - food is provided through taxes, basic health care, education, housing, etc. etc. Trying to curtail abortions for only those who can afford it is not providing equal protection under the law.
I think it's a mistake to try and paint any woman having an abortion as one who's happily skipping down to the clinic - which many on this board try to do. As with any protection, a few people are going to abuse it. But we also have to think about people who are outside of our own experience when providing services - should someone who's poor be denied because they are poor? Should someone who's raped be denied because they didn't "abstain"?
Grendel, by "science"
do you mean, the science of education and birth control - a much preferred option to abortion, and also opposed by the conservatives?
@SG
no, I mean the micro-biology that tells us the zygote has the complete chromosonal makeup to determine everything about the unborn child, at least physically.
forget I said anything. Get a puppy; they're easy.
Oh, Grendel. I wouldn't bring
Oh, Grendel. I wouldn't bring up biology to support your argument; it doesn't. A zygote or fetus' PHYSIOLOGY is very different from a developed human being's. But of course these superficial differences are irrelevant. What is relevant is the presence of an individual mind. And that presence is lacking.
In a hundred years, this won't even be an issue. Our descendants will all look back at the silly backwards folk who used political arguments to justify institutionalized misogyny.
Jo, Swimmer, Should we also
Jo, Swimmer,
Should we also pay for non-medically necessary things like liposuction, breast implants, hair plugs, etc?
Roughcut...Good Point!
good morning 2P
I honestly cant tell if you're being witty or you're back on the mescaline.
Persnickety,Misogyny?...You
Persnickety,
Misogyny?...You do realize that half the fetuses aborted are male right?
Yes, misogyny
You do understand that it is only American women that are subjected to government oversight of their bodies, right? Men are free to do with their bodies what they will, including spreading their "seed" without being forced to deal with any of the consequences.
No one to date has responded to this statement: There is no difference between the state forcing a woman to have an abortion or forcing her to have the baby. None. The government gets to have the final say.
Also, let's deal with the actual issue in the article. No tax payer monies are used for elective abortions. So, those of you who are against government funding of any kind for this procedure, this is what you're actually saying: let the woman die if necessary. At least be honest about it.
noroad.....
......viagra, vasectomy.....
heck, let's keep going - operations to open enlarged arteries wouldn't be "necessary" if people took care of themselves, or were Buddhist vegetarians.
If you're a Christian Scientist, NO medical care is "necessary" - so let's stop paying for ANY of it with tax dollars. Hey, religion comes first, right?
Speaking only for myself and
Speaking only for myself and as a conservative who is pro-life, I am not against other women getting abortions in the United States of America. I don't like it, and if I was ever in a situation to "convince" a female (young or older) not to get an abortion, I would do everything within my means to discourage it.
What I think gets the ire up of conservatives is Planned Parenthood. They were founded by a radical, eugenics endorsing female and today they are nothing more than a political appendage of the progressive left. They receive state and federal funding and then lie about how the funds are spent.
Do you ever hear abortion without Planned Parenthood - no. The ordinary conservative (and we're not all religious zealots) is disgusted with the prominence and political power that PP has enjoyed for decades. Within the last couple of years they've been busted with their lies and now the truth is out.
Truth always wins. PP is struggling to keep up their image and they're losing. Hopefully, they will just go away eventually. We will still be left with abortion but I have no doubt that there are plenty of private doctors' offices that will step up to provide the service.
Have all the abortions you want, ladies, but I will pray for the lost souls.
BTW, Mike and p, explain to all us cretins when the soul, which makes us different from a goat, enters the body.
Watch how a human face forms in the womb and convince me that there isn't a Creator...
http://www.youtube.com/watch?v=wFY_KPFS3LA
@Calypso: first explain how
@Calypso: first explain how you're different from a goat.
@Lat58
I dont youtube -- too addictive. I could spend hours watching my favorite former-soviet figureskaters when they were young and precious, before they developed a vodka habit.
yup Grendel
I had you pegged for a commie lover.