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 commentGrendel - what point are you making?
OK, I'm with you on the pig thing, seemed like an odd tangent to me as well.
As for #3 though -
whether you call it pregnancy, human life, or as the law states "gestational age" - the result is the same. AZ considers a woman pregnant or the gestational age of the fetus to begin prior to intercourse.
Under Arizona’s H.B. 2036, the state would recognize the start of the unborn child’s life to be the first day of its mother’s last menstrual period. The legislation is being proposed so that lawmakers can outlaw abortions on fetuses past the age of 20-weeks, but the verbiage its authors use to construct a time cycle for the baby would mean that the start of the child's life could very well occur up to two weeks before the mother and father even ponder procreating.
On page eight of amendment to H.B. 2036, lines 1-3.
the "gestational age" is “calculated from the first day of the last menstrual period of the pregnant woman,”
http://www.azleg.gov/legtext/50leg/2r/adopted/s.2036jud.pdf
what what?
Language means something specific in legalese. There is a reason the legislature chose the terminology -- gives it durability to weather motions for amendment or repeal.
At heart, it was a tactical move to get the 20 wks based on widely accepted calculations of a baby's due date 40 wks from last menstrual cycle.
without the procreative event, your 2 wk issue is moot. You cant abort what's not there.
True..
..you cannot abort what isn't there. However, the "morning after" pill is an extremely high dose of standard oral contraceptives. Although multiple studies have shown that the pill functions by preventing ovulation and is ineffective for women who have already ovulated, many conservatives view it, in essence, as an abortifact.
I see very little distance between the current "legalese" and the eventual legislation:
"...as pregnancy is calculated from the first day of the last menstrual period, use of oral contraceptives constitutes prevention of pregnancy through potential abortion following established methodology of the "morning after" pill, and as such shall be illegal. "
incendiary? need a kleenex?
Your first argument is that I'm incendiary? Cool. Maybe you shouldn't post 10,000 comments on boards you don't belong on if your skin is too thin to receive feedback.
As far as genetics go, Scientists have inserted human DNA into pig cells, creating pig-human embryos which then could be inserted into a human mother or pig mother. So, my point is, for the third time, is that the first two months of development in a mammal fetus is so similar that they are interchangeable.
Still don't understand my point? Yes, human DNA has the schematics for creating humans, but for the first two months of development, the human fetus is as human as a pig.
so, out of 4 talkig points that you consider an argument, only one is relevant. Arizona created the pregnant (human life) loop hole so women seeking abortions had a shorter window to do so legally. As SG mentioned, it doesn't matter what words you use. It's your faith, and science disagrees.
@cp
1. I understand your point: women should be cautioned that there is the possibility they may be carrying any sort of mammal in their uterus, most likely a pig. And that at least within the first 2 months of pregnancy, no doctor can tell these women conclusively that they are NOT carrying a pig;
2. you might be a genius, cheeesypoof, but that doesnt give you license to be an idiot;
3. you were behaving like an indolent putz. Your argument is irrelevant to the discussion, yet you insisted on singling me out to engage in a bizarro topic that has nothing to do with the thread.
4. people say stupid things when they get upset. Lose the misplaced passion.
grendel, more good deflecting. Considering not one comment out
of how many you've made is on topic with the article, I take your latest comment as a compliment. I obviously got under your skin, as you wouldn't have singled me out and continued to make increasingly immature comments towards me. Now I'm an idiot? Remember, hombre?
As far as being a genius goes, it doesn't take a rocket scientist to have critical thoughts. Your inability to defend your argument that "human life" begins at conception is proof enough that your critical thinking skills are lacking.
A group of cells, where the cells themselves are living, most definitely do not constitute a "human life". Your faith that is does is simply that: faith. We need more than just your faith before we can take the lives of a clump of cells and put them above the life of a mother. And the term "human life" is as general as it gets. Are you referring to a "soul"? Not a valid argument, but that hasn't stopped people in the past. The human body naturally self-preserves. A mother can naturally abort the fetus at any stage in the pregnancy. Natural herbs can be used to induce a miscarriage even. Whether unconsciously or not, a woman has the right to self-preserve.
Judging by your comments I can tell you aren't really interested in discussing your "human life" question, though. You aren't witty or thoughtful to inject your faith in the public arena. It's selfish and immature. You can make your talking points about my character, as though it some how supports your argument, but most of us can see it for what it is: deflection
grendel, more good deflecting. Considering not one comment out
of how many you've made is on topic with the article, I take your latest comment as a compliment. I obviously got under your skin, as you wouldn't have singled me out and continued to make increasingly immature comments towards me. Now I'm an idiot? Remember, hombre?
As far as being a genius goes, it doesn't take a rocket scientist to have critical thoughts. Your inability to defend your argument that "human life" begins at conception is proof enough that your critical thinking skills are lacking.
A group of cells, where the cells themselves are living, most definitely do not constitute a "human life". Your faith that is does is simply that: faith. We need more than just your faith before we can take the lives of a clump of cells and put them above the life of a mother. And the term "human life" is as general as it gets. Are you referring to a "soul"? Not a valid argument, but that hasn't stopped people in the past. The human body naturally self-preserves. A mother can naturally abort the fetus at any stage in the pregnancy. Natural herbs can be used to induce a miscarriage even. Whether unconsciously or not, a woman has the right to self-preserve.
Judging by your comments I can tell you aren't really interested in discussing your "human life" question, though. You aren't witty or thoughtful to inject your faith in the public arena. It's selfish and immature. You can make your talking points about my character, as though it some how supports your argument, but most of us can see it for what it is: deflection
grendel, more good deflecting. Considering not one comment out
of how many you've made is on topic with the article, I take your latest comment as a compliment. I obviously got under your skin, as you wouldn't have singled me out and continued to make increasingly immature comments towards me. Now I'm an idiot? Remember, hombre?
As far as being a genius goes, it doesn't take a rocket scientist to have critical thoughts. Your inability to defend your argument that "human life" begins at conception is proof enough that your critical thinking skills are lacking.
A group of cells, where the cells themselves are living, most definitely do not constitute a "human life". Your faith that is does is simply that: faith. We need more than just your faith before we can take the lives of a clump of cells and put them above the life of a mother. And the term "human life" is as general as it gets. Are you referring to a "soul"? Not a valid argument, but that hasn't stopped people in the past. The human body naturally self-preserves. A mother can naturally abort the fetus at any stage in the pregnancy. Natural herbs can be used to induce a miscarriage even. Whether unconsciously or not, a woman has the right to self-preserve.
Judging by your comments I can tell you aren't really interested in discussing your "human life" question, though. You aren't witty or thoughtful to inject your faith in the public arena. It's selfish and immature. You can make your talking points about my character, as though it some how supports your argument, but most of us can see it for what it is: deflection
grendel, more good deflecting. Considering not one comment out
of how many you've made is on topic with the article, I take your latest comment as a compliment. I obviously got under your skin, as you wouldn't have singled me out and continued to make increasingly immature comments towards me. Now I'm an idiot? Remember, hombre?
As far as being a genius goes, it doesn't take a rocket scientist to have critical thoughts. Your inability to defend your argument that "human life" begins at conception is proof enough that your critical thinking skills are lacking.
A group of cells, where the cells themselves are living, most definitely do not constitute a "human life". Your faith that is does is simply that: faith. We need more than just your faith before we can take the lives of a clump of cells and put them above the life of a mother. And the term "human life" is as general as it gets. Are you referring to a "soul"? Not a valid argument, but that hasn't stopped people in the past. The human body naturally self-preserves. A mother can naturally abort the fetus at any stage in the pregnancy. Natural herbs can be used to induce a miscarriage even. Whether unconsciously or not, a woman has the right to self-preserve.
Judging by your comments I can tell you aren't really interested in discussing your "human life" question, though. You aren't witty or thoughtful to inject your faith in the public arena. It's selfish and immature. You can make your talking points about my character, as though it some how supports your argument, but most of us can see it for what it is: deflection
@Grendel
I'm curious, how do you define 'human life'?
Is it simply human DNA inside some viable cells, as in a human zygote? Or is there a soul involved?
@Lat58
1. Good morning; new day.
2. My faith is irrelevant to this discussion. Here's why:
It’s like this: facts support a decision; faith compels action in accordance with a higher authority. They are not mutually exclusive: interpretation of the facts provides options, while one’s faith injects conviction that may be compelling toward one option and at same time reject another.
My faith compels the existence of a human soul. The facts present that at conception all the ingredients are there for ready assembly of a human being. If the ingredients are there, then completeness is necessarily the presence of a human soul. That’s where faith ends.
Action: that I should act in such a way that I will my action to be in accord with a universal principle (hat-tip to I. Kant's Law of Universalizability). I believe one should regard human life as beginning at conception. SHOULD is the operative word, the categorical imperative that exists outside of time, and is not dependent on one’s faith because a secularist may draw the same conclusion. When you accept the “should” (ie. I should not speed, I should brush my teeth, I should police my dog’s lawn biscuits) as a universal, then your options refine, rejecting what you should not do.
@Grendel: you can believe
@Grendel: you can believe what you want, but when those beliefs manifest into public policy, we have a serious problem. The issues put forth by the anti-abortion crowd are entirely faith-based: the existence of a soul (which is immortal and shouldn't really be affected by abortion anyway), the beginning of personhood at conception (personhood without a brain--there's a dangerous slippery slope!), and the idea that women can't be trusted to take charge of their own bodies (because, you know, they're all selfish welfare-queens or something).
You don't have a fact-based argument. A blastocyst, zygote, and fetus are not persons. Propping them up as more important than the mother's life is not only fallacious, but also sexist, demeaning, insensitive, and completely inappropriate.
As to your "completeness" argument, if I have carrots, chicken stock, noodles, and celery on the kitchen counter, I do not have soup until I cut everything up, throw it in a pot, and cook it through.
@2P
1.You need to be careful about sweeping statements such as “entirely faith-based”. Try your favorite search-engine with “atheist pro-life” and standby.
2. I’m not proposing we legislate what we "should" or "should not" do. What I am proposing is that when a moral question (personal choice) impacts the public domain (as in “Who’s going to pay for this?”) it likewise enters the ethical domain and deserves more than a squishy address. AZ’s HB 2036, for example, takes a bold stance. But it will take a court ruling to really draw the line.
I think I was clear where I draw the line in terms of faith and fact. If I said Leprechauns watch over pre-conceived souls waiting for a vacancy – that’s my business and has no bearing on the topic. Lat58 asked and I posted. You are welcome to rip away, but don’t hurt yourself.
Fact, Grendel?
Fact: I have all of the ingredients to assemble a cake in my pantry - flour, sugar, butter... I even have a recipe for cake in the Betty Crocker cookbook.
Also Fact: I do not have a cake in my pantry.
But you're free to believe I have a cake in my pantry if your faith so dictates. Just don't try to make me eat it.
@Lat58
what do you call this creation you've made when you put it in the oven?
dont get hung up on my use of "ingredients"; perhaps it was poor word choice on my part.
Ah! Now we get to the nub of it!
"what do you call this creation you've made when you put it in the oven?"
That is the correct question. And you're asking the correct person; the cook.
Maybe I consider it a cake as soon as I pour the ingredients together in the cake pan. Maybe as soon as it goes in the oven. Maybe when it's a third done and still a gooey mess. Or maybe not until it comes out when the timer buzzes.
Point being, I'm the cook, so it's my call. Your cake may vary.
bakatcha
RIGHT on. What should you call it, being a reasonable and well-qualified cook?
(let's not beat this into the ground. I get your point)
Ever worked in a restaurant?
Cooks are generally borderline psychotic. Not many "reasonable and well-qualified" ones out there, in my opinion. But it's not my place to judge their mental competence.
If it's my ingredients and my kitchen, I get to define when it's a 'cake'.
So the question boils down to: Is a woman's uterus and the human batter contained within it 'hers'? Or do those belong to the government?
the problem with an imperfect metaphor
is that it doesnt address all the relevant questions. The cake scenario answers what to call it after it's been assembled, and that's it.
Incorrect
It also addresses who gets to define it, and at what point.
it's just a cake
no one's going to fight over the last slice.
Not so sure
You and your government agents might.