JUNEAU — Proposed new state regulations would further define what constitutes a “medically necessary” abortion for purposes of receiving Medicaid funding.
The proposed change comes months after new regulations took effect for abortion payment conditions. Alaska’s health department last year backed off language that critics said would have restricted the definition of a “medically necessary” abortion for purpose of payment under the Medicaid program.
The proposed new certificate to request Medicaid funds features two boxes. A provider would have to certify the pregnancy was the result of rape or incest or the abortion was performed to save the life of the woman. The so-called Hyde Amendment, which is attached to congressional spending bills, allows for federal funds to be used for this option.
Under the other option, a provider would have to indicate that an abortion was medically necessary to avoid a threat of serious risk to the physical health of a woman from continuation of her pregnancy due to “impairment of a major bodily function,” such as renal disease that requires dialysis, epilepsy, congestive heart failure, a pregnancy not implanted in the uterine cavity and a coma.
Comments are being taken on the new proposal until Sept. 27.
State health commissioner William Streur told The Associated Press on Monday he decided to take another look at the regulations when the department did not see any change. He said the state received about 260 certificates requesting state funds for abortions as of the end of May, a “considerably faster pace” compared with the same time frame a year earlier when officials had instead hoped to see reductions, he said.
None of the certificates had the box indicating rape, incest or risk of death checked, he said, though he had told the Anchorage Daily News some abortions surely were due to those factors.
“I need to start getting some explanation,” he told the AP. With the Legislature moving in this direction and his department facing “severe” budget cuts, “I have to take a look at everything that’s out there, and this is one that bothered me,” he said. “I thought we made excessive considerations last time to accommodate some of the special interest groups and want to take another run at it.”
He said the proposal would not deny an abortion but would deny payment for those that do not fit the criteria.
Treasure Mackley, political and organizing director for Planned Parenthood Votes Northwest, said her group was still analyzing the proposal, but “we continue to object to unconstitutional restrictions on low-income women’s access to abortion in Alaska.” She said pregnancy decisions should be left to a woman and her doctor and not to politicians or people making regulations.
Sen. Hollis French, D-Anchorage, who last year called on the department to withdraw proposed regulations seen as seeking to further define “medically necessary,” said the department should rethink this latest effort, too. He sent a letter spelling out his concerns to Streur on Monday.
“It’s a slightly different twist on the same exact efforts of theirs to shut down publicly funded abortions in the state of Alaska,” he said in an interview. “It is not constitutional.”
The Alaska Supreme Court has held that the state must fund medically necessary abortions if it funds medically necessary services for others with financial needs. French said as soon as the state starts defining qualifying conditions, it begins creating different eligibility standards.
The new proposal contains language similar to a bill proposed during the last legislative session, which sought to define “medically necessary,” though the proposed regulation includes in its definition of medically necessary a “psychiatric disorder that places the woman in imminent danger of medical impairment of a major bodily function” if an abortion isn’t performed. The issue of whether to include mental illnesses came up during discussion of the bill in the state Senate but wasn’t included in the version that passed the Senate.
The bill was held over for further consideration in the House.
The bill’s sponsor, Sen. John Coghill, has said the high court left legislators to decide what “medically necessary” means and that his bill was an effort to provide clarity to that. Bill supporters argued that public money should not be used to pay for so-called “elective” abortions but critics called the measure unconstitutional.
Online: Public notice of proposed new regulations for abortion funding: http://bit.ly/1eXOXvY