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 commentakangel - you mean....
"couple" - don't you?
I wonder how it would go over if there were a law requiring the man named as the father to pay for 1/2 of the abortion, since the "irresponsible woman" shouldn't be entitled to medicare for it?
@swimmergirl
Yes, I apologize, I wrote that quickly. I did mean irresponsible couples. My bad! Thank you for correcting me.
Edited!
lvmykyk - the government...
subsidises transportation for the poor, including bus service, train service, and vouchers.
Just sayin.
So by your logic, people who can't afford one shouldn't be given a public defender either - they committed a crime - irresponsible.
People with Type II diabetes or obesity = lazy, irresponsible.
Someone who walks out in front of a car by accident = irresponsible (didn't look both ways, made a mistake....mistakes aren't allowed.....)
@lvmykyk: you're being
@lvmykyk: you're being incredibly obtuse. Going without plastic surgery (except reconstructive) results in no detriment to the individual in question. Going without an abortion results in a child. When it comes to unwanted pregnancies, a child is usually not a good thing.
Furthermore, I don't know if you've ever had sex, but it's a little more important to most people than transportation. Reproduction is, after all, our most powerful instinct after survival.
Here's the real problem with your, and other people's, argument, though: people are going to have unprotected sex. There will be unwanted pregnancies which are detrimental to those directly involved and to society as a whole. We can either moralize and try to make the world fit our ideas of perfection (which always seems to work out SO WELL), or we can come up with real world solutions. It just so happens we already have a real world solution, and maybe if you people would stop setting up road blocks everywhere you can, we could work on cultural and contraceptive issues as well to prevent the need for abortion in the first place.
newlife -
you are going to be really busy then, deciding what people who get food stamps are going to have for dinner, how much homework people who have kids in public school are making their kids do, and runnign the life of anyone on welfare, or who's kids are receiving public assistance.
Don't worry, swimmer. Turns
Don't worry, swimmer. Turns out some of my tax dollars also go towards funding our courts, so I've revoked NewLife's right to free speech as well.
If only St. Augustine
had had fewer issues with women and his own sexuality, we would have a fundamentally different western world today.
LMAO
Why?
Laughable
None of us paid any taxes that paid for an abortion. The oil companies did. We have no state tax on individuals, and there were no federally funded abortions. I support planned parenthood. They provide many services besides abortion. By the way, birth control does fail, that's how I got my two.
Men paying/Feminization of Poverty
The man doesn't have any say if the procedure happens or not. Why would you suggest that a man pay for something that he has no control over(the abortion) if it happens or not? Individuals should control their own destiny and health procedures.
To require that a man pay for the abortion or a portion would mean that he should have some say in whether or not it occurs-this isn't going to happen. And how would you confirm who has to pay for the abortion-do expensive DNA testing? Freedom opens doors. You can't have the freedom to chose and require the man pay for the abortion.
I was reading something and found this statement interesting in how it relates to men, women and poverty:
Prior to the legalization of abortion in the United States, it was commonly understood that a man should offer a woman marriage in case of pregnancy, and many did so. But with the legalization of abortion, men started to feel that they were not responsible for the birth of children and consequently not under any obligation to marry. In gaining the option of abortion, many women have lost the option of marriage. Liberal abortion laws have thus considerably increased the number of families headed by a single mother, resulting in what some economists call the “feminization of poverty.”
@Rough Cut: to be fair, just
@Rough Cut: to be fair, just about everything you say IS garbage.
If you were a real man you
If you were a real man you would have stuck around to find out.
AKnut - -
The man did CHOOSE to have unprotected sex, did he not?
If the result is a pregnancy, is he not automatically responsible for half of the cost, whether an abortion or having a child is chosen?
Your response is classic. The man is not responsible.
Please ck out the services
available at public health. Really grasp what the state is providing free and low cost. Grab a condom and a bus token.
Not sure you meant to equate unprotected sex to committing a criminal act. So I will ignore it.
Obtuse? No just trying to get some kind of logical and thought out response. Still waiting.
As for my personal life, thank you for caring. I know more than one way to scratch that itch. Sorry you don't, missing out on a lot. Your reproduction statement is very dismissive of our homosexual neighbors. If your statement were true they would be compelled to have hetero sex. That is crap. I think really what you mean is human beings are selfish and very much into personal gratification. And we are. Just some chose to control that and act responsibly. The same reason not all of us do drugs, drink or eat too much. Choices vs urges.
You respond by being even
You respond by being even more obtuse. Unbelievable. It's a pity your compassion towards people in other, more criminal situations doesn't extend towards people who make mere mistakes.
Also, I did provide a "logical and thought out response." Your dismissal of it doesn't disprove it, but it does show a lack of respect and an unwillingness to consider other arguments on your part.
pp
If I accidently drive into your car, please be sure to bill the DMV.
It was an accident I shouldn't pay for it.
If I eat too many nachos at a football game do I bill the school district for my gastric bypass? Or does that bill go to Health and Social Services?
I mean by your logic I should have to pay for my mere mistakes or accidents.
For me it comes down to
For me it comes down to this.
Rationally:
If the MAJORITY of tax payers (Democracy) don’t want to pay for the selective surgery of someone else they should not have to. Elective Surgery is not a right.
Morally:
A woman should have absolute control over her body. YES
A baby should have absolute control over its body. YES
Females are unique and special in this world as they may choose (through consensual sex) to share their bodies with another human…a baby The baby has no choice in this matter.
Now the women’s body is two peoples body and the rights of both must be considered.
If the woman elects abortion/death for the baby then that is the most severe result for the baby.
If a women must have an abortion to live, or never had a CHOICE in the beginning (rape, incest, etc), then I say ok for the abortion.
BUT
If the woman chooses abortion for any other reason, then that is an act of selfishness….the ultimate selfishness.
2P: so we already have a solution...
what's most troubling about your notion that "we already have a real world solution" to whatever you want to label unwanted pregnancies is that it extends to the other end of the life span:
Suppose when you're old and no one's around that wants to take care of you -- does your real world solution apply then as well? What's to stop the next generation from thinking, "Why not? He's inconvenient, and I think his intellect is gone, anyway."
Careful, it's what you reap when you put a low value on human life.
Calypso, souls are little more than security blankets
And mine frayed and unraveled many years ago. I don't have a soul, never did. Souls are too theologically, simplistically, reductionist for me and, of course, there is no evidence for them. It's time we've all outgrown the idea of something outside, of what will be the rotting meat of our brains, having a butterfly-like existence of its own.
Vilayanur S. Ramachandran said something once about the brain: "here is this mass of jelly that I can hold in the palm of my hand, and it can contemplate the vastness of interstellar space."
Yes, now that is wonderful, true, and for me, serendipitously comforting but I'll grant you, probably not as comforting as believing dead children will be reunited with dead puppies and dead Grandmas in the afterlife. Though, if there is a Jesus afterlife, I'm going to have to ask why Yahweh always watches people going to the bathroom. What a creepy deity.
Mike
FYI: The people commenting
FYI: The people commenting on this story were not aborted.
Another view of Planned Parenthood
But first, Swimmergirl gets an A+ for the best comment of the day: "No one is pro-abortion." This is so very true. Many of us are pro-choice. There is a difference. In a perfect world, all of us would wish that abortion didn't need to exist at all.
Now on to my praise of Planned Parenthood:
As a sexually active responsible bisexual (that means, yes, I've had sex with both genders), I was alive and "getting busy" during the height of the AIDS pandemic in the early 1990s.
As a responsible person, I educated myself on the dangers of HIV/AIDS and how to protect myself. I turned to places like Planned Parenthood which offered condoms, education and HIV tests at minimal cost.
As such:
- I've never gotten anyone pregnant (which reduced the abortion rate of the entire world);
- I've never contracted any sexually-transmitted disease (thereby reducing the STD rate worldwide);
- I've been HIV-negative my entire life (thereby reducing the rate of HIV transmission and AIDS related deaths worldwide).
And I have Planned Parenthood to thank for all of this.
I will always advocate for more funding for their services. They are a valuable and necessary part of our community.
another view of Jo
then without Planned Parenthood you would have singlehandedly increased the abortion rate, been a global STD-infectant, and spread death worldwide?
You, my friend, are a roughshod juggernaut.
Grendel
You sound rather jealous of Jo.
@jo - icky...
@jo - icky...
simple
To the fiscally conservative: What is cheaper?
$0.25 for a condom or $650?
$650 or 18 years of child support?
The contraception is intended to prevent unwanted pregnancies. The abortion is an emergancy back-up.
It all comes down to economics. Prevention of unwanted pregnancies becoming unwanted children.
To the social conservatives: Constitutional. Deal with it.
more simple
Cheesy,
If it all comes down to economics then…the cheapest is abstinence. Dont forget that one.
But if YOU decide to have sex YOU should buy a 25cent condom.
If YOU decide not to use a condom and it results in a pregnancy then YOU should pay the $650 for an abortion
If YOU decide not to pay for the abortion YOU can pay for 18 years of child support.
noroad
"If YOU decide not to use a condom and it results in a pregnancy then YOU should pay the $650 for an abortion"
Got it. You support the right to choose an abortion, as long as you're not paying for it. That wasn't clear from your other posts.
Regarding abstinence, obviously abstinence is not a successful strategy for birth control as exemplified by Bristol. Humans have biological drives that are not going to be denied. But the goal is to avoid pregnancy, right? Perhaps our schools should be teaching youth effective practices that satisfy the biological urgency but avoid pregnancy. You know, oral, manual,...lots of options. That wouldn't even require you to pay for a 25 cent condom, which should be music to a fiscal conservative's ears like yours.
"And I have Planned
"And I have Planned Parenthood to thank for all of this"
Jo,
I hope you could have achieved all of those things without Planned Parenthood.
A quick note about your sentence " I've never gotten anyone pregnant (which reduced the abortion rate of the entire world);"
This is a false dichotomy because another, and more likely answer is not considered...which is.. if you got someone pregnant they could also have had the baby.
Pregnancy doesn’t automatically equal abortion.
Lat, Apparently you didn’t
Lat,
Apparently you didn’t read my post below...it sums up my position.
Also…No… music to my ears would be that it is parents and not the government who are responsible for the sex education of their children…
Why do some people assume we need the government for everything?
Repost:
For me it comes down to this.
Rationally:
If the MAJORITY of tax payers (Democracy) don’t want to pay for the selective surgery of someone else they should not have to. Elective Surgery is not a right.
Morally:
A woman should have absolute control over her body. YES
A baby should have absolute control over its body. YES
Females are unique and special in this world as they may choose (through consensual sex) to share their bodies with another human…a baby The baby has no choice in this matter.
Now the women’s body is two peoples body and the rights of both must be considered.
If the woman elects abortion/death for the baby then that is the most severe result for the baby.
If a women must have an abortion to live, or never had a CHOICE in the beginning (rape, incest, etc), then I say ok for the abortion.
BUT
If the woman chooses abortion for any other reason, then that is an act of selfishness….the ultimate selfishness.
Repost end.
@ no road
You are wrong. I cannot give myself an HIV test.
And although pregnancy doesn't always equal abortion, unintended pregnancies are usually the #1 reason for abortion. Since I've never wanted to make a baby, had I gotten anyone pregnant, that would have increased the likelihood of an abortion.
Bottom line: I was a responsible adult. I empowered myself not to contract STDs and not to get anyone pregnant. And I succeeded.
And Planned Parenthood played a BIG role in that.