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Montana politics, elections and legislative news

Abortion bill would require Medicaid patients to prove medical necessity

 Rep. Jane Gillette
Montana Legislature
Rep. Jane Gillette

Lawmakers are considering two proposals aimed at possible gaps in court orders that protect abortion. Restricting access to abortion has been a top priority for Montana Republicans for years, but a pair of rulings from the state Supreme Court have protected the right to terminate a pregnancy.

A 1995 state Supreme Court decision found that the state must cover abortions for Medicaid patients when “medically necessary.” Republican Rep. Jane Gillette from Bozeman is bringing House Bill 544 to require those patients and doctors to submit extensive paperwork to show an abortion is medically necessary in order to get prior authorization.

“Prior authorization in health care and within our Medicaid program right now is very common,” Gillette said.

An administrative rule with the same requirements is currently under consideration by the state health department.

Leah Miller with the American Academy of Obstetrics and Gynecology says the decision to have an abortion should remain between a doctor and patient.

“Delaying care for prior authorization is dangerous for women’s health.”

If an abortion is performed during a health emergency, a doctor would be required to submit the same paperwork for review before reimbursement.

The bill advanced out of committee on a party-line vote and is now headed to the House floor.

Republican Rep. Lola Sheldon-Galloway of Great Falls is carrying a separate bill to ban abortion after a fetus is viable at 24 weeks. Sheldon-Galloway carried a 20-week abortion ban during the 2021 legislative session that’s currently blocked while a lawsuit plays out in court.

Sheldon-Galloway’s bill mirrors language found in the Montana Supreme Court Armstrong decision, which says the state’s right to privacy protects access to pre-viable abortions. The bill includes exceptions to the ban when abortion is necessary to save the life of the pregnant person.

Opponents to the bill say it would interfere with individuals’ right to privacy, and that abortion after 20 weeks occurs only in extreme circumstances.

According to the U.S. Centers for Disease Control and Prevention, less than 1% of abortions occurred after 21 weeks gestation nationwide in 2021.

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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