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 commentSo I am assuming
that the next time climate change is the subject of discussion, we will see Grendel lauding science and how such amazing things are possible using quantifiable data.
@fromdustreturned
I dont have an opinion on climate change. I cant stop the rain, summon thunder, or lower the oceans.
Fine
When science confirms the existence of an immortal soul for zygotes (or anyone for that matter), we can reopen the discussion.
sure, fine
1. science cant do that - lost all credibility with celestial calculus in the wake of that Angels Dancing on the Head of Pin debacle.
2. Science, as you know, presents the facts. The human intellect does the interpretation.
3. It's a tough proposition, but when you divorce the politics from the facts there is no excuse for reckless behaviour.
4. I'm okay with closing here.
@ no road
"Will you agree that having an abortion due to convenience, fear, anger or pride…is a selfish act?
I would hope that a women that finds herself carrying an unwanted baby at least has the courage to deliver the baby and then give it to someone who does want it and will love it. Give it that much of a chance.
Adoption, is to me, the minimum due required for making a mistake with sex."
noroadfugitive, I'll agree it's selfish if you agree it's none of your business unless you're the one considering it. An abortion can be considered for a number of reasons. The same goes for adoption. Suggesting adoption is more courageous than abortion proves you don't know what "courage" is.
If we really want to look at courage and selfishness, look no further than those picketing outside planned parenthood. I can't think of a more selfish, cowardly bunch than the slugs who bring their lawn chairs and mispelled signs to the side of a highway. Power in numbers, right? I don't see of these pigs alone with a sign... I see them in crowds where they aren't scared to bully young women who are struggling with serious issues. The only issue the picketers struggle with appears to be heart disease.
for what its worth...
Wow, Sooooo many tangential comments on this news article!
how about this......
Back to the main point of the article:
"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." (from the above article)
It sounds like the issue stated above is that there is currently poor documentation standards to substantiate the necessity of abortions to ensure the health of a woman.
I'm sure nobody here would sacrifice their lovely-lady (wife/girlfriend/etc.) if having a child were to place her life in jeopardy.
So lets just get back to the main point of the article, eh?
-austino
expanded economics
Any fiscal conservatives out there who aren't interested in government funded contraception wonder how much a birth costs or who foots that bill when the mother can't?
If one can argue "my taxes shouldn't go towards your birth control" does this mean these people failed algebra? Quick, which is more: 650 apples or 10,000?
Now that we have that squared away, can we all just quit with the fake fiscal conservative arguments? There's no such thing as a fiscal conservative who doesn't support government funded birth control. It's the dilemma that so many social conservatives have found themselves in. How to argue reasonably while still introducing religious beliefs. Spoiler alert: It's impossible so don't bother trying anymore.
This issue comes down to personal beliefs regarding the life of a human fetus. Sadly, the article does not discuss any of this and yet all these comments regarding the philosophy of abortion. Get over it. Read the article and comment on it. Read the title if you need to. It's about ECONOMICS!! NOT RELIGION!
lvmykyk and noroad- asked and answered
You asked a while back about why states should pay for abortions. I pointed out that in this country basic rights are equal for all, even if you are poor, such as the right to a public defender. If you can't afford a lawyer, one will be provided for you.
you countered that abortion is not necessary and equal to a nose job.
According to the supreme court, a woman's right to choose falls under her right to privacy, protected by the 14th amendment. Therefore, a poor woman who cannot pay is entitled to equal access under the law.
Even if you don't like it, that's the law.
I hope that's clear enough.
Latitude - Kudos
Nicely carried over the weekend, sir. You are calm and direct and logical. Well done.
I'm here
I'm here to convince the other side that they're wrong. Think I'll have much luck?
SG
Seriously? Again you are equating unprotected sex with a criminal act. I thought last time you mis spoke. But now it is clear that somewhere your subconcious is tying the two together.
You think that because someone is entitled to an attorney when they are accused of a crime, they are also entitled to an abortion when they have unprotected sex.
You are not entitled to a court appointed attorney in civil proceedings only criminal. You certainly have a right to an attorney in a civil case, but no one is obligated to provide one for you.
I think having unprotected sex is selfish and irresponsible. But I do not think it is criminal. And as far as I know there is no law on the books making it such. So I would see an abortion more along the lines of an attorney in a civil case. You have a right to have one, but you must secure one yourself.
@lovemykayak, no one is suggesting medicaid cover
all abortions. It appears you are saying any abortion, no matter what, is elective, and should not be covered by medicaid. I must assume then that you are referring to rape victims as well when you say "I think having unprotected sex is selfish and irresponsible."
So the victim is selfish and irresponsible for getting raped by someone who doesn't wear protection. I can't take your post seriously when you make the assumptions that you do. Medicaid doesn't cover all abortions, and, most importantly, not all abortions are elective. Get your story straight before you make an ass out of you and mption.
@cheesypoof
not so fast with the self-righteous indignation, hombre. [page 3]:
lvmykyk 07/13/12 - 03:32 pm
Speaking of selfish and lazy
Co-opting the pain and tragedy of another for your political agenda is not ok. It disgusts me when victims of violent crimes are exploited and used as political pawns. Don't presume to know the heart of all victims. If a victim chooses to speak to their personal journey, that is their choice. But do not act as if you have the right to speak for them, you continue the usary.
lvmykyk - no, you are
I'm merely saying that in this country, we hold many things to be available to all people regardless of their ability to pay, including the vote, basic education, emergency care (ambulance, ER can't turn someone away) food, which is provided if one can't afford it, and criminal council, even though most crimes are 'elective'.
I'm not equating one with the other - you are the one with the need to judge others, not me.
I'm merely saying that if abortion is a legal right under the 14th amendment, right to privacy, as determined by the Supreme Court, then doesn't every US citizen deserve equal access to that right? Making sure poor women do not have access to an abortion is by definition an inequity.
lvmykyk - pot kettle
and yet, you would speak for all fetuses, and all women, apparently.
If you can determine the values and feelings of all women who've ever had unprotected sex, why can't someone else speculate on the feelings of someone who's been raped?
It must be really lonely up in Ivory Tower perfectionville.......
and I'd guess that you are not qualified to cast the first stone......
if abortion is a legal right,
then where do I get my voucher? If you want to split hairs, I have just as much right to an abortion as the next American, or compensation for my right being infringed.
Abortion is not a right. Privacy is the issue, and the sooner you straighten that one out the sooner you'll understand the difference between what's permissive and what's entitled.
That's not a sexist interpretation. Sexist would be whining about us XYs having to register with Selective Service in order to be eligible for federal loans, fed & state employment, and a host of other programs you Double Xs get.
Ever notice how men often
Ever notice how men often hijack debates about women's issues into discussions about their own issues? Not just this one, but in every domestic violence discussion there's always the guy who says, "but women assault men, too!" And in contraception debates, there's always, "but I don't get condoms for free!" And in rape discussions, there's always, "but why don't people acknowledge that men get raped, too?" And so on!
It's pretty pathetic.
Oh, and Grendel, stop whining. You and every one of us knows that men have many cultural advantages over women in our society.
@grendel et al.
Let's see what the Alaska Constitution says about it...
"§ 22. Right of Privacy
The right of the people to privacy is recognized and shall not be infringed. The legislature shall implement this section."
There is NOTHING more private than personal healthcare decisions. Birth control is healthcare. Decisions about birth control are private and that right shall not be infringed.
Gov Parnell's proposal injects government into the most private decisions a person can make. If this is allowed what's to stop the State from saying you cannot have a heart bypass operation?
SG - transference much?
You are exceptionally judgemental. Did I speak to every person's experience? no. Did I suggest making abortion illegal? no. I think you have typed yourself into a corner and are reaching.
I am not against anyone getting an abortion. Knock yourself out. But you pay for it. I am witholding nothing from you. If you feel everyone should have one free, great start a 501c3. Apply for grants, fundraise, bake sale anyone?
Because I am sick of survivors of violent crimes being used, I am in an ivory tower? I am not the one cashing in on their experience. I would never presume what someone else feels, or how they experience it. Rape, Assault, Incest, Molestation are heinous crimes, violations beyond measure. Using them as a rally cry for abortion negates the seriousness of the crime and degrades it to a political talking point. I will speak out against the use of those crimes to further any agenda not directly connected to increase prosecution and increased sentencing.
El_Boorba
Good stuff! You realize that under Obamacare everyone's med records hit the (secure) public domain for the apparatchiki to access so they can evaluate your healthcare requests and claims. But don't worry about leaks or compromises of these private records - it'll be just between you and the govt -- every GS-5 and above working in HHS.
You're absolutely right,
You're absolutely right, Grendel. I'd feel much more secure if selfless corporations like Wells Fargo or Premera maintained my medical records rather than the evil, selfish federal government, which is always out to make a quick buck.
@grendel
My medical records are already in the hands of corporations... and thanks to laws like HIPPA there are rules for what can and cannot be shared.
and grendel, it's the Affordable Care Act. Almost entirely written by Republicans of the 1994 variety. You should really call it HeritageCare after the right wing think tank the Heritage Foundation which crafted it.
I actually miss the Contract With America Republicans-you know the ones who actually worked with the Democrats to make laws that helped the country.
What happened to you all? Where did the crazy come from?
@Grendel, lovemykayak,
so we can't have a reasonable discussion on this matter because you two choose not to include cases where abortion in your mind IS necessary? Self-righteous? How stupid do you think the rest of us are? For some reason you think you can hijack the discussion, picking and choosing what aspects of it we are allowed to discuss and in what context.
Speaking of selfish and lazy
"Co-opting the pain and tragedy of another for your political agenda is not ok. It disgusts me when victims of violent crimes are exploited and used as political pawns. Don't presume to know the heart of all victims. If a victim chooses to speak to their personal journey, that is their choice. But do not act as if you have the right to speak for them, you continue the usary."
So for me to include ALL cases of abortion is to extort the victims? But for you to exclude certain cases is what exactly? Couldn't be for political gain because that's what I was doing BY INCLUDING ALL CASES. Seriously? Why do you bother posting on here? You admittedly disregard the facts and still pretend like you make a valid point. There's no valid point. You can't even refute mine. Lazy and selfish... so true.
By the way, I am not providing any specific cases of sexual victims. I am simply including ALL cases. By rejecting certain cases means you have a reason for doing so. There is funding for victims of sex crimes outside of medicaid, but the victims must seek that help beyond a doctor's visit. The state funding as it sits now is less invasive and less demeaning for women who are victims. And you would like to speak for them as though they aren't part of this discussion? Can you say hypocrite?
to cheeesypoof
I have not brought religion, absolutism, or my political ideology into this forum. I've ignored baiting attempts to engage in these topics, and I've refrained from calling anyone a twit, pillow-biter, witless crawdad, etc.
What I find shallow and unacceptable is the swift dismissal of pro-life's basic premise: all human life should be protected. You can what-if the circumstantials till you are blue in the face -- doesn't mean a thing to me unless you are willing to entertain the most basic question: what if life should begin at conception? Come to terms with that one and then the ethics of every choice forward are not so complicated.
grendel, you're premise that life begins at conception is your
faith and based on absolutely nothing other than a book that was written by men 2000 years. The fact that a human embryo during the first two months of development is almost identical to that of a pig suggests that it is no more human than a pig is. Unless your faith assumes human life begins in a pig embryo at conception, than I can tell I have entertained the question more than you have.
Faith is not wanting to know what's true. Your faith prevents you from acknowledging the content of my posts. You're a hypocrite. You don't bother to refute anything I have introduced, and yet you say I haven't entertained a theory that the tooth fairy exists, therefore my argument is debunked. Do you understand how silly you sound? I provide a logical explanation for why I believe what I do. You disregard it all, and bring up your faith.
Your faith does not agree with the facts. You can't introduce a theory, then say "prove me wrong." If I came to you and said the tooth fairy exists and she told me that life in a human begins at age 18 I would be no less wrong than you. Faith prevents you from carrying on a reasonable discussion. This is your problem. Not the rest of ours. So why don't you keep it to yourself.
@cheeesypoof
are you suggesting that it's a lottery? Luck of the draw? You or yours could give birth to a pig? You might have some explaining to do.
I said nothing about faith in this argument. You did.
I acknowledge the content of your posts -- they're slanted and offer no ethical foundation. Band-aids fix boo-boos, and that's all you're addressing -- what to do after the fact. But, like you accuse me, you see the facts as they suit you.
Regards to when life begins: "I dont know" is an unacceptable answer because it allows a process to go forward that is deliberate without the deliberation.
lvmykyk - you have been
Very clear in your comments that you've deemed anyone having unprotected sex as thoughtless, selfish, irresponsible and lazy, and that you are 'more evolved or more informed'.
(6 quotes on this particular thread)
Certainly every circumstance is different, just like all women are different. I listed 6 different scenarios off the top of my head (page 2 of comments) that wouldn't fall into your personal ideal of how everyone else should behave.
I guess my basic question is: Who are you to judge whether a poor woman needing an abortion has been "irresponsible and lazy"? You going to head a panel to critique every circumstance according to your personal ideals?
And what of other things the government provides assistance for that could be deemed by someone as 'evolved' as you as being 'irresponsible'? No type II diabetes treatment for the poor?
@grendel, I refer you to my comment regarding pigs:
"The fact that a human embryo during the first two months of development is almost identical to that of a pig suggests that it is no more human than a pig is. Unless your faith assumes human life begins in a pig embryo at conception, than I can tell I have entertained the question more than you have. "
Now, if you can come up with the following from what I wrote:
"are you suggesting that it's a lottery? Luck of the draw? You or yours could give birth to a pig? You might have some explaining to do."
All I can say is, you fail... miserably. If you struggle to comprehend the fact that human embryos and most mammal embryos are almost identical during the first two monthcs of development, then I don't know what to tell you. Maybe you should take your computer over to the nearest window and toss it out. Computers are incredible tools for us all. You can research important issues that you don't understand and get a better understanding of them.
You can argue this reasonably, or you can continue to deflect with immature tactics. It's what anyone with overpowering faith does. When your faith is confronted with the truth, the natural tendency is to react immaturely and deflect. How's that going by the way?
By the way, people in Arizona believe human life begins up to two weeks prior to conception. I struggle to take you people seriously, and every chance you have, you make it worse.
@cp
1. you're incendiary;
2. I have no idea what you're getting at about pig embryos, when chromosomal coding is much more effective than the untrained eye;
3. you got that AZ factoid wrong -- it's pregnancy, not human life;
4. I think we're done here. No response, pls