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Montana politics, elections and legislative news

Groups push back on proposal to restrict Medicaid coverage for abortions

Hospital monitor.
Josh Burnham
Montana Public Radio

More than two dozen health care providers, mental health advocates and Medicaid patients are arguing against a proposed state rule that would further restrict state coverage of abortion. One organization spoke in support of the rule during a public hearing on Thursday.

Several residents gave emotional testimony to the state health department recounting their stories accessing abortion.

Linda Schmitt talked about a life-threatening hemorrhage she experienced while pregnant, was rushed to the hospital and abortion was her only option.

“When was I going to call for Medicaid coverage? When in that story was I going to be at a computer to deal with paperwork? Thank god there was no nurse saying, ‘doctor, we have no approval.’”  

Schmitt is referring to a part of the proposed rule that would require pre-authorization from the state health department for Medicaid coverage to terminate a pregnancy. The draft rule allows for emergency procedures, but some providers are concerned that the language is vague and may not cover all situations.

The proposed rule would add new requirements for proving that an abortion is medically necessary, like documentation showing a patient has a physical illness that would be “significantly aggravated” by pregnancy. State health department director Charlie Brereton has said the definition of medically necessary needs clearer parameters to prevent taxpayer dollars from going to elective abortions.

A legal precedent from 1995 requires that the state cover abortions for Medicaid patients when “medically necessary” – a broader umbrella of circumstances that aren’t necessarily covered through federal Medicaid dollars due to the Hyde Amendment.

The rule would also prevent nurse practitioners and physician assistants from billing Medicaid for abortion services – allowing only medical doctors to provide care.

Marjorie Albers, a physician from Miles City, says accessing abortion is already arduous in rural places and for low-income people.

“The bill does not improve safety, but decreases the ability for patients to receive the care that they need,” she said.

Akilah Deernose, with ACLU of Montana, said she believes the proposed rule could violate two state Supreme Court precedents, which found the state’s right to privacy protects access to abortion and that the state must cover abortion for Medicaid recipients when medically necessary.

Derek Oestricher, an attorney for the Montana Family Foundation, was the sole proponent and said the rule would put Montana in line with the 1995 precedent that stipulates patients only receive coverage when medically necessary.

“We support the amendment's purpose to ensure there is sufficient documentation to support that taxpayer funded abortions meet the criteria for payment by Montana’s Medicaid program,” he said.

The health department will continue taking public comment until Jan. 20.

Shaylee covers state government and politics for Montana Public Radio. Please share tips, questions and concerns at 406-539-1677 or  
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