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New Definition of 'Medically Necessary' Abortion Prompts Lawsuit in Alaska

January 30, 2014 — Planned Parenthood of the Great Northwest on Wednesday filed a lawsuit challenging regulations that restrict what qualifies as a "medically necessary" abortion in Alaska's Medicaid program, the AP/Atlanta-Journal Constitution reports (Bohrer, AP/Atlanta Journal-Constitution, 1/29).

The rules are scheduled to take effect on Feb. 2.

Rules for Physicians

The regulations would require a physician to select one of two options when filling out a certificate to request Medicaid coverage for an abortion. Under the first option, the physician would have to certify that a pregnancy resulted from rape or incest or was needed to save a woman's life. In such cases, federal funding for abortions is permitted under the federal Hyde Amendment.

The other option would be for the physician to indicate that an abortion was needed to avoid a serious risk to the woman's physical health, meaning that "impairment of a major bodily function" would have occurred if the pregnancy continued. The physician would have to specify the woman's condition from the state's list of 23 impairments that could put a woman in "imminent danger" of such impairment. The list includes an option stating that the abortion was needed because of "another physical disorder" (Women's Health Policy Report, 1/9).

Last summer, the state's Legislative Affairs Agency reviewed the proposed regulations at the request of a Democratic state senator and concluded in a legal memo that the rules would "likely be found unconstitutional" (Francescani, Reuters, 1/30).

Lawsuit Details

PPGNW filed the suit against Alaska Health Commissioner Bill Streur in Anchorage Superior Court, arguing that they violate constitutional rights to equal protection and privacy. The suit cites a 2001 Alaska Supreme Court decision that ruled the state is required to fund medically necessary abortions if it funds other medically necessary medical treatments for low-income residents.

The suit also argues that the regulations violate the administrative procedure act because the state Department of Health and Social Services failed to hold a hearing on the regulations when they were initially proposed.

PPGNW also asked the court for a restraining order and a preliminary injunction against the rules so that they cannot take effect while the case proceeds (AP/Atlanta Journal-Constitution, 1/29).

Comments

PPGNW spokesperson Joshua Decker said that the state's Medicaid program "can't single out abortions and treat them differently from other Medicaid services." He added, "With every other service, Alaska trusts its medical doctors to adhere to the best interests of their patients" (Reuters, 1/30).

A DHSS spokesperson said Streur would not comment on the lawsuit until he had reviewed it with the state's Department of Law (AP/Atlanta Journal-Constitution, 1/29).