A bill tightening the definition of "medically necessary abortions" under the Medicaid program was approved by the House Judiciary Committee on Friday, and was under consideration by the House Finance Committee on Saturday evening.
The bill is another attempt by primarily Republican legislators to stop payments for what they contend are elective abortions. A Supreme Court ruling last year struck down a 1998 law intended to restrict Medicaid funding to cases of rape or incest, or when the mother's physical health is at stake.
Now legislators are going after the definition of "therapeutic" abortions, which are government-funded because they address the "psychological health" of poor women.
Sen. Pete Kelly, a Fairbanks Republican, contends the existing law allows women to get abortions merely because they are "stressed out" by being pregnant.
There were nearly 600 "medically necessary" abortions funded in the last fiscal year, while in Michigan - a state with 9 million people, to Alaska's 630,000 - there were only 33, Kelly said. Only six of the Alaska abortions were for cases of rape or incest.
"I am not sure why the Centers for Disease Control is not up here with gas masks and rubber suits trying to figure out why women in this state can't be pregnant here without having some horrible medical problems," Kelly said.
Under the bill, a woman with "psychological illness" would be eligible for a Medicaid-funded abortion only if medication for that illness would be "highly dangerous to the fetus" and would endanger the woman's health if she didn't take it.
The bill also establishes that a woman is Medicaid-eligible if she has "a serious adverse physical condition" that would "seriously endanger" her health if the pregnancy continues.
Those changes would "cover only those abortions that are medically necessary instead of using abortion as a form of birth control," said Karen Vosburgh, executive director of Alaska Right to Life.
Juneau Democratic Sen. Kim Elton objected that the bill is "substituting political judgment for medical judgment," and expressed concern that some women's lives might be put at risk.
The bill passed the Senate by 12-8, short of the two-thirds majority that would be required to overturn a veto by Democratic Gov. Tony Knowles, who is pro-choice.
A doctor who is also a rare pro-life Democratic legislator testified in favor of the bill at Friday's House Judiciary Committee hearing.
"We're not looking at the Roe v. Wade issue," said Sen. Donny Olson of Nome, referring to the landmark U.S. Supreme Court ruling on abortion in 1973. "I wouldn't want my tax dollars to be used, that I earned, to be used in a manner that I feel is inappropriate."
But House Minority Leader Ethan Berkowitz, an Anchorage Democrat, suggested that it then would be logical to exempt pacifists and atheists from federal income taxes because of defense expenditures and faith-based initiatives, respectively.
Berkowitz said childbirth could be considered a serious danger to women's health. Therefore, the proposed definition of medical necessity is "not at all instructive or helpful," and the vagueness probably makes it unconstitutional, he said.
The unusual debate included a number of personal anecdotes, most triggered by a failed amendment that would have included among eligible abortions cases in which fetuses would not survive until live birth.
Olson recounted a midnight flight to Gambell on St. Lawrence Island in the Bering Sea, when it was 30 degrees below zero.
"I ended up delivering a breach delivery out there at 32 weeks," he said. "I'd never even seen a breach done before, let alone done one. ... Fortunately, we had a good outcome.
"I don't decide whether people live or die. It's very difficult for a physician to decide whether a fetus is going to survive a live birth. I am not God. ... I've seen people I thought were going to live until the next morning die on me, and I've told myself that I would never forgive them for dying on me, as well as I've seen people that I thought for sure were going to die on me that night that were alive and well the next morning."
Rep. Scott Ogan, recently back at the Capitol after nearly dying of a heart attack in March, smiled and nodded in agreement.
"The best medical opinions would suggest that I wouldn't even be here right now," said Ogan, a Palmer Republican. "Having been dead and revived. And then all the fatalistic things that they said were going to happen to me after I was on the respirator and all the other stuff, and it's all pretty much proved to be wrong. All due respect to the medical profession ... God sticks his nose in it and intervenes."
And Rep. Jeannette James, a North Pole Republican, recounted her own mixed experiences with pregnancy.
"I've had a stillborn at full term, and I've had three live births that are just fine, and I've also had one where the fetus died in the process," James said. She concluded: "None of us would be here today if a mom hadn't given us life."
Bill McAllister can be reached at firstname.lastname@example.org.
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