Legislature(2013 - 2014)BELTZ 105 (TSBldg)

03/04/2013 01:30 PM JUDICIARY

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                    ALASKA STATE LEGISLATURE                                                                                  
              SENATE JUDICIARY STANDING COMMITTEE                                                                             
                         March 4, 2013                                                                                          
                           1:38 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Senator John Coghill, Chair                                                                                                     
Senator Lesil McGuire, Vice Chair                                                                                               
Senator Fred Dyson                                                                                                              
MEMBERS ABSENT                                                                                                                
Senator Donald Olson                                                                                                            
Senator Bill Wielechowski                                                                                                       
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 49                                                                                                              
"An Act  defining 'medically necessary abortion'  for purposes of                                                               
making payments under the state Medicaid program."                                                                              
     - HEARD AND HELD                                                                                                           
SENATE BILL NO. 56                                                                                                              
"An  Act   relating  to   certain  crimes   involving  controlled                                                               
substances; and providing for an effective date."                                                                               
     - HEARD AND HELD                                                                                                           
SENATE BILL NO. 22                                                                                                              
"An Act  relating to the  commencement of actions for  felony sex                                                               
trafficking and  felony human trafficking; relating  to the crime                                                               
of sexual  assault; relating  to the  crime of  unlawful contact;                                                               
relating   to    forfeiture   for   certain    crimes   involving                                                               
prostitution; relating to  the time in which  to commence certain                                                               
prosecutions; relating  to release  for violation of  a condition                                                               
of  release  in  connection  with   a  crime  involving  domestic                                                               
violence; relating to interception  of private communications for                                                               
certain sex  trafficking or human trafficking  offenses; relating                                                               
to  use  of evidence  of  sexual  conduct concerning  victims  of                                                               
certain crimes;  relating to procedures for  granting immunity to                                                               
a witness in a criminal  proceeding; relating to consideration at                                                               
sentencing of  the effect of a  crime on the victim;  relating to                                                               
the time  to make an  application for  credit for time  served in                                                               
detention  in a  treatment  program or  while  in other  custody;                                                               
relating   to  suspending   imposition   of   sentence  for   sex                                                               
trafficking;  relating to  consecutive sentences  for convictions                                                               
of  certain  crimes  involving   child  pornography  or  indecent                                                               
materials to minors; relating to  the referral of sexual felonies                                                               
to a  three-judge panel;  relating to  the definition  of 'sexual                                                               
felony' for  sentencing and probation  for conviction  of certain                                                               
crimes;  relating to  the definition  of "sex  offense" regarding                                                               
sex  offender registration;  relating  to  protective orders  for                                                               
stalking and  sexual assault and  for a crime  involving domestic                                                               
violence;  relating  to  the  definition  of  'victim  counseling                                                               
centers'  for  disclosure  of certain  communications  concerning                                                               
sexual assault  or domestic violence; relating  to violent crimes                                                               
compensation;  relating  to   certain  information  in  retention                                                               
election of judges concerning sentencing  of persons convicted of                                                               
felonies; relating  to remission of sentences  for certain sexual                                                               
felony offenders; relating to the  subpoena power of the attorney                                                               
general  in  cases  involving  the use  of  an  Internet  service                                                               
account; relating  to reasonable efforts  in child-in-need-of-aid                                                               
cases  involving  sexual  abuse  or  sex  offender  registration;                                                               
relating  to mandatory  reporting  by athletic  coaches of  child                                                               
abuse or  neglect; making  conforming amendments;  amending Rules                                                               
16, 32.1(b)(1), and 32.2(a), Alaska  Rules of Criminal Procedure,                                                               
Rule  404(b), Alaska  Rules  of Evidence,  and  Rule 216,  Alaska                                                               
Rules  of Appellate  Procedure;  and providing  for an  effective                                                               
     - SCHEDULED BUT NOT HEARD                                                                                                  
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: SB  49                                                                                                                  
SHORT TITLE: MEDICAID PAYMENT FOR ABORTIONS; TERMS                                                                              
SPONSOR(s): SENATOR(s) COGHILL                                                                                                  
02/11/13       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/11/13       (S)       JUD, FIN                                                                                               
02/15/13       (S)       SPONSOR SUBSTITUTE INTRODUCED-REFERRALS                                                                
02/15/13       (S)       JUD, FIN                                                                                               
02/27/13       (S)       JUD AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
02/27/13       (S)       Heard & Held                                                                                           
02/27/13       (S)       MINUTE(JUD)                                                                                            
03/04/13       (S)       JUD AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
BILL: SB  56                                                                                                                  
SHORT TITLE: RECLASSIFYING CERTAIN DRUG OFFENSES                                                                                
SPONSOR(s): SENATOR(s) DYSON                                                                                                    
02/15/13       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/15/13       (S)       JUD, FIN                                                                                               
03/04/13       (S)       JUD AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
WITNESS REGISTER                                                                                                              
JENNIFER ALLEN, Director of Public Policy                                                                                       
Planned Parenthood Votes Northwest                                                                                              
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
LAURA EINSTEIN, Chief Legal Counsel                                                                                             
Planned Parenthood of the Great Northwest                                                                                       
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
MYRTLE GOHRING, representing herself                                                                                            
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
JOANIE CLEARY, representing herself                                                                                             
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
ALAN SMITH, representing himself                                                                                                
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
DONNA STARK, representing herself                                                                                               
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
PAM CLEMENS representing herself                                                                                              
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
ELANN MOREN representing herself                                                                                              
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
ALBERT BOWLING representing himself                                                                                             
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
SUSAN PACILLO representing herself                                                                                              
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
MARIAM LANDAU representing herself                                                                                              
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
RHONDA WIDENER, representing herself                                                                                            
Fairbanks, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
CLOVER SIMON representing herself                                                                                               
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
KIME MCCLINTOCK representing herself                                                                                            
Anchorage, AK                                                                                                                 
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
LISA EGAN LAGERQUIST, representing herself                                                                                      
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
BETTYE DAVIS, representing herself                                                                                              
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Asked the sponsor to withdraw SB 49.                                                                      
PAMELA SAMASH representing herself                                                                                              
Nenana, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 49.                                                                          
JEAN JAMES representing herself                                                                                                 
Fairbanks, AK                                                                                                                   
POSITION STATEMENT: Testified in opposition to SB 49.                                                                       
HEATHER BRANDON representing herself                                                                                            
Juneau, AK                                                                                                                    
POSITION STATEMENT: Testified in opposition to SB 49.                                                                         
PHILIP STEWART representing himself                                                                                             
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in opposition to SB 49.                                                                       
ACTION NARRATIVE                                                                                                              
1:38:54 PM                                                                                                                    
CHAIR JOHN COGHILL called the Senate Judiciary Standing                                                                       
Committee meeting to order at 1:38 p.m. Present at the call to                                                                  
order were Senators Dyson, McGuire, and Chair Coghill.                                                                          
          SB  49-MEDICAID PAYMENT FOR ABORTIONS; TERMS                                                                      
1:40:24 PM                                                                                                                    
CHAIR COGHILL announced the consideration  of SB 49. [SSSB 49 was                                                               
before the committee.]                                                                                                          
1:41:48 PM                                                                                                                    
JENNIFER  ALLEN, Director  of Public  Policy, Planned  Parenthood                                                               
Votes  Northwest,  introduced  herself and  Laura  Einstein.  She                                                               
expressed  appreciation   for  the   opportunity  to   speak  and                                                               
respectfully asked the members to oppose  SB 49. She said this is                                                               
necessary  to  protect the  freedom  and  privacy of  all  Alaska                                                               
women, regardless  of their income,  and to ensure that  they are                                                               
able to make  their own pregnancy decisions  in consultation with                                                               
their doctors.                                                                                                                  
MS. ALLEN  stated that Planned  Parenthood is  uniquely qualified                                                               
to speak  to SB  49, because  it is  a healthcare  provider whose                                                               
mission  is   to  ensure  access  to   high-quality  reproductive                                                               
healthcare for all. She relayed  that Planned Parenthood operates                                                               
five health  centers in Alaska,  and the majority of  services it                                                               
provides  to more  than 7,000  Alaskans  are preventative.  These                                                               
include  cancer  screening,  birth  control,  and  screening  for                                                               
sexually transmitted infections, including  HIV. She said Planned                                                               
Parenthood  is committed  to providing  preventative services  to                                                               
ensure that women  and men are supported in  planning and spacing                                                               
the pregnancies  they have. When  a woman makes the  personal and                                                               
often complex decision to end  a pregnancy, Planned Parenthood is                                                               
proud to  be a place  that provides safe  and legal care  for the                                                               
MS.  ALLEN   explained  that  the   first  reason   that  Planned                                                               
Parenthood is asking the committee to  oppose SB 49 is because it                                                               
puts  women's health  at risk.  It may  cause women  to avoid  or                                                               
delay seeking  abortion services,  which may increase  the chance                                                               
of their continuing a health-threatening  pregnancy or push their                                                               
abortion into  the second  trimester. Pregnancy  decisions should                                                               
be made  by women and their  doctors, yet SB 49  puts politicians                                                               
directly  between women  and their  doctors. She  emphasized that                                                               
doctors, not  government, are  the right ones  to decide  what is                                                               
medically necessary. The Alaska  Supreme Court recognizes and the                                                               
constitution requires  that women's pregnancy  decisions (whether                                                               
to terminate  or carry to  term) be given equal  protection under                                                               
the law. Thus,  abortion services must be  provided to low-income                                                               
women  so that  their  pregnancy choices  are  not restricted  by                                                               
their economic status. In addition,  the definition of "medically                                                               
necessary"  may not  be  further  limited without  discriminating                                                               
against women who rely on the  government for healthcare. It is a                                                               
simple matter of fairness, she said.                                                                                            
1:45:24 PM                                                                                                                    
LAURA  EINSTEIN Chief  Legal Counsel,  Planned Parenthood  of the                                                               
Great Northwest,  said she  would talk about  why the  bill isn't                                                               
needed, why  it isn't  constitutional given  the holdings  in the                                                               
2001 decision in  State of Alaska v. Planned  Parenthood, and how                                                               
similar  efforts to  oppose a  more stringent  test for  Medicaid                                                               
coverage of abortions than for  other procedures have failed. She                                                               
noted that the sponsor statement  says the bill is needed because                                                               
the  term   "medically  necessary   abortion"  has   "acquired  a                                                               
constitutional  component of  unknown scope."  Planned Parenthood                                                               
respectfully disagrees, she said.                                                                                               
First,  the  Medicaid  rules  have  a  definition  of  "medically                                                               
necessary"  that  is used  for  nearly  all services  covered  by                                                               
Medicaid.  That  definition  focuses on  physician  standards  of                                                               
practice  and   trusts  Alaska   physicians  to   evaluate  their                                                               
patients' needs  and provide appropriate  care. Second,  the U.S.                                                               
Supreme Court  has articulated a  definition that is  helpful for                                                               
physicians  in determining  medical necessity.  The U.S.  Supreme                                                               
Court  stated  that  whether  an   abortion  is  necessary  is  a                                                               
professional  judgment  that  takes   into  account  all  factors                                                               
relevant  to the  wellbeing of  the  patient including  physical,                                                               
emotional,  psychological, familial,  and  age.  This allows  the                                                               
attending physician the latitude needed  to make the best medical                                                               
judgment.  Third,  the  Alaska  courts  have  defined  "medically                                                               
necessary" for abortions. In the  2001 Medicaid funding case, the                                                               
Alaska Superior Court defined "medically  necessary" in its order                                                               
compelling  the state  to start  paying  for medically  necessary                                                               
abortions. The court stated that  an abortion is deemed medically                                                               
necessary if  it prevents the death  or disability of a  woman or                                                               
to  ameliorate a  condition harmful  to the  woman's physical  or                                                               
psychological  health.  The  Alaska Supreme  Court  affirmed  the                                                               
trial court decision, effectively affirming that definition.                                                                    
MS. EINSTEIN stated that SB  49 is unnecessary because the Alaska                                                               
courts and the Medicaid rules  already provide the parameters for                                                               
determining what a medically necessary  abortion is. In addition,                                                               
the court  made several findings that  are relevant to SB  49 and                                                               
prove that the  bill is not constitutional. The  court framed the                                                               
issue  as  the protection  of  either  continuing or  terminating                                                               
pregnancy  from  discriminatory  governmental  treatment.  SB  49                                                               
requires a  higher bar for  abortion than any other  service paid                                                               
for  by Medicaid.  It is  therefore  discriminatory treatment  of                                                               
abortion, which is a fundamental right in Alaska.                                                                               
The Alaska Supreme  Court in the Medicaid funding  case also made                                                               
it clear  that any rule involving  a fundamental right, as  SB 49                                                               
does, must  be neutral. That  means a definition cannot  be based                                                               
on  the fact  that some  people oppose  abortion. The  court held                                                               
that when the state government  seeks to provide medical care for                                                               
the poor, it  is obliged to do  so in a neutral manner  so as not                                                               
to infringe on the constitutional  rights of Alaska citizens. The                                                               
state  is   prohibited  from  using   criteria  that   imposes  a                                                               
discriminatory burden on the exercise of a fundamental right.                                                                   
MS. EINSTEIN maintained that SB 49  is not a neutral bill because                                                               
it  contains  a  definition  for "medically  necessary"  that  is                                                               
beyond  the  standards  applied   for  other  Medicaid  services.                                                               
Because it favors continuing a  pregnancy over termination, it is                                                               
not a neutral bill.                                                                                                             
She said  the court  also framed  the equal  protection violation                                                               
that occurs when a woman  who terminates her pregnancy is treated                                                               
differently compared to a woman  who continues her pregnancy. The                                                               
court stated that  a woman who carries her pregnancy  to term and                                                               
a  woman   who  terminates  her   pregnancy  exercise   the  same                                                               
fundamental right  to reproductive  choice. The  equal protection                                                               
clause in the Alaska Constitution  does not permit the government                                                               
to  discriminate  against  either  woman. They  must  be  granted                                                               
access  to  state  health  care  under  the  same  terms  as  any                                                               
similarly  situated  person.  She  pointed  out  that  the  equal                                                               
protection analysis in the 2001  decision is applicable to SB 49.                                                               
The bill  has the effect  of governmental  discrimination because                                                               
it  imposes  a  more  onerous  definition  on  abortion  than  is                                                               
required for the treatment of pregnancy.                                                                                        
MS.  EINSTEIN  explained  that   if  there  is  a  constitutional                                                               
challenge of  this legislation,  it will  be up  to the  state to                                                               
prove  that there  is a  compelling need  for this  definition of                                                               
"medically  necessary."  She  noted that  the  sponsor  statement                                                               
justifies the bill  as filling a gap, but it  doesn't explain why                                                               
this  particular definition  is  necessary. It  appears that  the                                                               
only  possible  justification  is  to  limit  women's  access  to                                                               
abortions, but the Alaska Constitution does not permit that.                                                                    
1:51:34 PM                                                                                                                    
MS.  EINSTEIN  stated  that  since  2001  there  have  been  four                                                               
attempts to  limit Medicaid paid  abortions. In  2002 legislation                                                               
was  introduced  that  sought  to  define  "medically  necessary"                                                               
almost exactly  the same  as SB 49  does. The  attorney general's                                                               
office  evaluated that  bill and  determined it  would likely  be                                                               
found unconstitutional  and result in costly  litigation. In both                                                               
2010  and 2012  Legislative Legal  Services was  asked about  the                                                               
power of  the legislature to  limit the definition  of "medically                                                               
necessary." In both instances legislative  counsel stated that if                                                               
the  Alaska Supreme  Court adheres  to its  findings in  State of                                                               
Alaska v.  Planned Parenthood of  Alaska, the state would  not be                                                               
able to  burden the  right of abortion  services unless  the same                                                               
burden is placed on medical  services to continue a pregnancy. If                                                               
there  is  no   comparable  burden  on  the   continuation  of  a                                                               
pregnancy,  the  state  cannot   burden  the  right  to  abortion                                                               
services. She  emphasized that that  opinion fully applies  to SB                                                               
MS.  EINSTEIN said  that in  2012, the  Department of  Health and                                                               
Social  Services   (DHSS)  added  a  certification   process  for                                                               
physicians, but left the determination  of whether an abortion is                                                               
medically necessary in  the purview of the physician.  This is as                                                               
it should  be. She  urged the committee  to maintain  the current                                                               
status and rule.                                                                                                                
1:54:37 PM                                                                                                                    
SENATOR  DYSON asked  if Planned  Parenthood finds  it acceptable                                                               
for abortion to be used as birth control.                                                                                       
MS. EINSTEIN  said she believes  that a woman's decision  to have                                                               
an abortion  is a  very complex decision  with many  factors, and                                                               
the idea that a woman uses abortion as birth control is....                                                                     
SENATOR DYSON interjected that it is repulsive.                                                                                 
MS. EINSTEIN  continued to  say that  as a  matter of  policy and                                                               
belief, those at  Planned Parenthood do not judge  any woman. Her                                                               
life  may be  very complicated  and she  may have  any number  of                                                               
reasons for her decision.                                                                                                       
MS. ALLEN  added that  she and  Ms. Einstein do  not work  in the                                                               
health centers,  but the health  center staff would  probably say                                                               
that is not the reality of  what they see. It's a deeply personal                                                               
decision that women make and a lot  of factors go into it that no                                                               
one else knows about.                                                                                                           
1:56:48 PM                                                                                                                    
SENATOR DYSON asked  if a woman would be turned  away if she said                                                               
she  had changed  her  mind  and did  not  want  to continue  her                                                               
MS. ALLEN  said Planned Parenthood  supports women  in exercising                                                               
their safe  and legal right  to make whatever  pregnancy decision                                                               
is  right  for the  woman,  including  abortion. She  added  that                                                               
Planned Parenthood doesn't walk in  the woman's shoes and doesn't                                                               
know why she may have changed her mind.                                                                                         
SENATOR  DYSON asked  if  she said  that  all medical  procedures                                                               
should have comparable medical screening processes                                                                              
MS.  EINSTEIN clarified  that she  was talking  about the  Alaska                                                               
Supreme Court decision  that said that a  different, more adverse                                                               
burden cannot  be placed on  a woman  who decides to  terminate a                                                               
pregnancy  compared  to  a  woman   who  decides  to  continue  a                                                               
pregnancy. She noted that she  also cited legislative counsel who                                                               
said  the  standards  for   defining  "medically  necessary"  for                                                               
coverage of  abortion would have to  be the same for  coverage of                                                               
SENATOR  DYSON  asked  how Planned  Parenthood  would  define  an                                                               
elective  abortion  as opposed  to  one  for  which there  was  a                                                               
medical necessity.                                                                                                              
MS.  EINSTEIN  said she  understands  there  is this  concept  of                                                               
elective  abortion,  but she  doesn't  know  what it  means.  She                                                               
continued that  a woman can  get in a  situation where she  has a                                                               
medical condition  of pregnancy and  for many reasons  related to                                                               
health  she may  decide  that the  best decision  is  to have  an                                                               
abortion. In  addition, the determination of  medically necessary                                                               
will be made by a physician.  He or she will sign the certificate                                                               
attesting that  the woman's  health was  an important  factor and                                                               
therefore justified  the state paying  for that service,  just as                                                               
the physician could ask the state to pay for other services.                                                                    
2:00:32 PM                                                                                                                    
SENATOR DYSON asked  at what point a right  conveys an obligation                                                               
on others  to pay  for a  service that  some people  find morally                                                               
repugnant.  He noted  that the  Runaway Slave  Act was  a similar                                                               
issue.  People were  forced to  pay for  law enforcement  and the                                                               
courts to send escaped slaves  back, even those who found slavery                                                               
morally repugnant.                                                                                                              
MS.  EINSTEIN  said  the  Alaska   Supreme  Court  answered  that                                                               
question in State  of Alaska v. Planned Parenthood  of Alaska. It                                                               
said the  state doesn't  have to  pay for  anything, but  once it                                                               
commits to paying  for a program like health care  for low income                                                               
persons, it must do so in a neutral and nondiscriminatory way.                                                                  
2:03:17 PM                                                                                                                    
SENATOR MCGUIRE  asked if she  was aware of instances  at Planned                                                               
Parenthood where a woman was  denied coverage for a Medicaid paid                                                               
abortion  because she  was  unable to  qualify  based on  medical                                                               
MS. ALLEN replied  that she wasn't aware of that,  but she wasn't                                                               
involved in the billing process.                                                                                                
MS.  EINSTEIN added  that  if the  physician  certified that  the                                                               
abortion  was medically  necessary,  Medicaid would  pay for  it.                                                               
Whether there have  been situations where a  physician decided an                                                               
abortion wasn't  medically necessary  isn't something she  or Ms.                                                               
Allen would  know about, but  a claim  would not be  submitted to                                                               
Medicaid in that circumstance.                                                                                                  
SENATOR MCGUIRE  said she  was trying  to understand  what advice                                                               
Planned Parenthood gives  a woman and what other  safety nets are                                                               
available  in   Alaska  both  for   carrying  to  term   and  for                                                               
MS. EINSTEIN  explained that  an abortion  is never  performed at                                                               
Planned Parenthood  without the woman going  through an education                                                               
process   so  that   she  understands   all   her  options.   She                                                               
acknowledged  that  many  women call  Planned  Parenthood  having                                                               
already  made up  their  minds,  but they  still  go through  the                                                               
education process.  Every woman  is asked questions  to determine                                                               
how confident  she is in her  decision, and to make  sure that it                                                               
truly is her decision.                                                                                                          
She addressed the effect of SB  49. If it passes with the current                                                               
language,  very  few  women  would  qualify  for  coverage  under                                                               
Medicaid. Some of  those women may be able to  raise the money to                                                               
pay for an  abortion, but it might take longer.  Right now, there                                                               
are  no  physicians  in  Alaska   who  perform  second  trimester                                                               
abortions,  so any  woman  past  14 weeks  will  have  to fly  to                                                               
Washington  state. That  means  she'll have  to  raise even  more                                                               
money to have the procedure.  The majority of women who otherwise                                                               
qualify for Medicaid services would not meet the standard.                                                                      
2:07:41 PM                                                                                                                    
SENATOR  MCGUIRE  asked  under   what  aspect  of  the  medically                                                               
necessary  standard  are most  poor  women  able to  qualify  for                                                               
Medicaid abortions today.                                                                                                       
MS. EINSTEIN  explained that  Planned Parenthood  physicians have                                                               
been provided with  the language from the  court decisions, which                                                               
is to  ameliorate a  condition harmful to  a woman's  physical or                                                               
psychological health.  That is the  standard of  harmful, whereas                                                               
SB 49  talks about a  serious risk to the  life or health  of the                                                               
woman, which means  either death or impairment of  a major bodily                                                               
function. That  is an extremely  high bar, and most  people don't                                                               
get that sick in a pregnancy.                                                                                                   
MS. ALLEN said it isn't possible  to create an exhaustive list of                                                               
all the  conditions that might result  in harm to a  woman's life                                                               
or health,  and that  speaks to  why Planned  Parenthood believes                                                               
that a more  general medical necessity certification  by a doctor                                                               
is the appropriate standard.                                                                                                    
2:10:41 PM                                                                                                                    
SENATOR MCGUIRE asked how often  women come to Planned Parenthood                                                               
seeking treatment after attempting to self-abort.                                                                               
MS. EINSTEIN said  she has been with Planned  Parenthood for five                                                               
years and was not aware of that happening.                                                                                      
SENATOR  MCGUIRE  asked the  sponsor  to  consider the  potential                                                               
unintended  consequences of  narrowing the  definition too  much.                                                               
She  questioned whether  some women  may  attempt a  self-induced                                                               
abortion and  whether that might  ironically result in  a medical                                                               
situation that would allow her to qualify.                                                                                      
2:12:33 PM                                                                                                                    
CHAIR COGHILL  acknowledged that his  view of the  equality issue                                                               
was different  than Planned Parenthood,  and the fact  that there                                                               
isn't  unlimited health  care for  Alaskans generally  shows that                                                               
there will  be limitations. He  also offered his belief  that the                                                               
Alaska  Supreme  Court gave  good  criteria,  but left  open  the                                                               
difference  between elective  and medically  necessary. The  bill                                                               
seeks  to follow  those  guidelines closely,  but  there will  be                                                               
debate about the emotional side, he said.                                                                                       
CHAIR COGHILL noted  that former Senators Davis  and Lincoln were                                                               
2:14:47 PM                                                                                                                    
MYRTLE  GOHRING, representing  herself, Anchorage,  AK, testified                                                               
in opposition to  SB 49. She said  that in nine days  she will be                                                               
90 years  old and her  experience of  bridging a time  of illegal                                                               
back-alley  abortions and  life after  Roe v.  Wade will  perhaps                                                               
clarify  her  position.  She   relayed  that  illegal  abortions,                                                               
despite the risk,  were often the only  family planning available                                                               
for her generation. The consequences  were often serious but only                                                               
then  could the  family  doctor  be called  in  to  clean up  the                                                               
damage. She questioned why anyone would  want to go back to that.                                                               
She  highlighted that  the Alaska  Supreme Court  has ruled  that                                                               
women's pregnancy  decisions, whether  to terminate or  carry the                                                               
pregnancy to  term, are  to be given  equal protection  under the                                                               
MS. GOHRING stated support for  the court's decision not only for                                                               
the health  and wellbeing of the  mothers, but also for  the sake                                                               
of the  children involved.  She explained that  for more  than 30                                                               
years  she worked  as a  teacher  and guidance  counselor and  it                                                               
wasn't difficult  to identify the children  with low self-esteem,                                                               
and overall  feelings of being unwanted.  Unfortunately, her work                                                               
with many  of their  mothers or care  takers confirmed  this. She                                                               
said that  the human and  social cost of denying  abortion rights                                                               
is  too  high for  everyone,  and  emphasized the  importance  of                                                               
continuing to  give women and  their doctors the freedom  to plan                                                               
their families without governmental interference.                                                                               
2:17:42 PM                                                                                                                    
JOANIE CLEARY, representing herself,  Anchorage, AK, testified in                                                               
opposition to  SB 49.  She said  she is a  social worker  who has                                                               
worked in the  field of child abuse and neglect  for more than 10                                                               
years, and  she believes  that every  child has  the right  to be                                                               
born wanted  and cared  for. She characterized  SB 49  as another                                                               
attempt to chip away at a  woman's right to choose abortion, even                                                               
though  the  procedure  is  still  legal  in  this  country.  She                                                               
emphasized that  the legislature should  not get involved  in the                                                               
personal and  medical decisions  that should  be between  a woman                                                               
and  her doctor.  At a  time when  services for  poor people  are                                                               
being eroded,  passage of SB  49 would further harm  poor women's                                                               
ability to  make appropriate decision  about care  for themselves                                                               
and  their  families. Referring  to  the  question about  whether                                                               
taxpayers  should  be  forced  to  pay  for  services  they  find                                                               
repugnant, she pointed  out that in a society ruled  by law, many                                                               
people  end up  paying for  services they  don't agree  with. She                                                               
cited examples and urged the committee to oppose SB 49.                                                                         
2:19:44 PM                                                                                                                    
ALAN  SMITH, representing  himself, Anchorage,  AK, testified  in                                                               
opposition  to  SB 49.  He  stated  agreement with  the  previous                                                               
comments and offered his belief  that the bill second-guesses the                                                               
professional judgment  of medical  providers in  determining what                                                               
is medically necessary. SB 49 is not needed.                                                                                    
DONNA STARK,  representing herself,  Anchorage, AK,  testified in                                                               
opposition to  SB 49 and  stated agreement with all  the previous                                                               
testimony today.  She pointed  out that  in 2005  the legislature                                                               
passed  AS 18.05.032  that created  the informed  consent website                                                               
regarding pregnancy  and pregnancy alternatives. It  requires any                                                               
woman seeking  an abortion  to sign  an affidavit  verifying that                                                               
she has  had access  to the information.  She continued  that the                                                               
statute  provides that  the website  contain objective,  unbiased                                                               
information  that describes  abortion  procedures, medical  risks                                                               
and   possible   complications,   and   possible   physical   and                                                               
psychological effects  that have  been associated  with pregnancy                                                               
and having an abortion.                                                                                                         
The website further  states that risks increase  as the pregnancy                                                               
advances. Ms. Stark  said that in Alaska, the risk  of dying from                                                               
pregnancy is 7.4  per 100,000 live births. Between  1990 and 1999                                                               
there  were  8  pregnancy-related deaths.  High  blood  pressure,                                                               
blood  clots,  and  heavy bleeding  were  responsible  for  those                                                               
deaths. Under  the heading "high  blood pressure risk"  it states                                                               
that  a woman  with  high blood  pressure has  a  higher risk  of                                                               
complications. More importantly,  it states that a  woman who has                                                               
never had  high blood pressure  can develop it  during pregnancy.                                                               
Under the section  on abortion risks, it states  that the overall                                                               
risk of a  woman dying as a direct result  of illegal abortion is                                                               
less than 1  per 100,000. It also states that  the earlier in the                                                               
pregnancy that the abortion is performed  the safer it is for the                                                               
woman. A review of the  stages of embryonic and fetal development                                                               
would also  indicate that if  a woman does  not want to  face the                                                               
higher  risk  of  death  associated  with  the  complications  of                                                               
pregnancy, it  is necessary  for her safety  to have  an abortion                                                               
early and not wait for further fetal development.                                                                               
MS. STARK  said that SB  49 contradicts the  information provided                                                               
on the informed consent website.  It takes a medical decision out                                                               
of the individual woman's and  her doctor's control and places it                                                               
in the hands of legislators, which  is in direct violation of the                                                               
constitution. She asked  which legislator who votes  for the bill                                                               
is  prescient  enough  to  know  which  pregnancy  will  lead  to                                                               
complications. She reiterated her opposition to SB 49.                                                                          
PAM  CLEMENS representing  herself, Anchorage,  AK, testified  in                                                               
opposition  to  SB  49.  She said  she  opposes  the  legislation                                                               
because  similar legislation  has  been deemed  unconstitutional,                                                               
and  because she  believes that  all Alaskans  should have  equal                                                               
access to health care, including  abortion. She urged the members                                                               
to listen to their constituents and oppose the legislation.                                                                     
2:24:45 PM                                                                                                                    
ELANN  MOREN representing  herself, Anchorage,  AK, testified  in                                                               
opposition  to SB  49. She  stated agreement  with the  foregoing                                                               
testimony and  added that  the bill  is blatantly  biased against                                                               
poor women.  It will open  the door  to the return  of back-alley                                                               
abortionists that Alaska put out  of business in 1970, four years                                                               
before Roe  v. Wade  passed. She shared  her experience  while in                                                               
high  school of  being raped  and finding  herself pregnant.  She                                                               
described  the  horror  of  undergoing  old  wives  remedies  for                                                               
miscarriage,  an  illegal  abortion  that didn't  work,  and  her                                                               
attempted  suicide.  She  said  she  is  sharing  this  story  to                                                               
illustrate the many  ways that an unplanned  pregnancy can occur.                                                               
SB 49  would take  away a  poor woman's ability  to seek  a safe,                                                               
legal  abortion from  a properly  trained professional.  She said                                                               
she  is thankful  for  the  lawmakers in  1970  that put  illegal                                                               
abortionists out of business, and  believes that there is no more                                                               
need for government involvement on  the issue. Alaska has trusted                                                               
doctors to  work with  their patients to  determine what  is best                                                               
for  the patient.  Pregnancy decisions  should  be left  up to  a                                                               
woman  in  consultation with  her  doctor,  her family,  and  her                                                               
2:29:12 PM                                                                                                                    
ALBERT BOWLING  representing himself, Anchorage, AK,  stated that                                                               
he was  speaking in opposition  to SB  49, which would  limit the                                                               
definition  of what  is medically  necessary  by prohibiting  any                                                               
mental health  evaluations of women seeking  abortions covered by                                                               
Medicaid funds.  He relayed  that he has  suffered from  a mental                                                               
illness in the  past and can clearly state that  when a person is                                                               
confronted  with an  extreme crisis  in  their social  situation,                                                               
their mental  health is  of significant  consequence. He  said he                                                               
can  imagine that  the mental  health issues  of a  woman finding                                                               
herself  with  an  unintended and  unwanted  pregnancy  could  be                                                               
momentous.  He observed  that  the state  seems  thinks that  the                                                               
mental health  issues of poor  woman to be  markedly inconsistent                                                               
with those of  other women. It's an argument he  doesn't buy into                                                               
and believes  it is an  attack on  poor women. He  concluded that                                                               
access  to abortion  in the  U.S. is  legal and  constitutionally                                                               
protected, and  he finds this  attempt to deny poor  women access                                                               
to  the same  level of  health care  available to  other citizens                                                               
very objectionable.                                                                                                             
2:31:24 PM                                                                                                                    
SUSAN PACILLO  representing herself,  Anchorage, AK,  stated that                                                               
she absolutely opposes  SB 49 and was appealing  to the committee                                                               
to do  what is  right based  on the  Alaska Constitution.  If the                                                               
bill were to pass, the state would  spend a lot of money in court                                                               
when  it  could instead  spend  the  money  on birth  control  or                                                               
education or  to feed poor children.  It will be a  waste of both                                                               
time and  money, because the  constitution says that  funding for                                                               
poor women for abortion services is required.                                                                                   
2:32:32 PM                                                                                                                    
MARIAM  LANDAU representing  herself,  Anchorage,  AK, urged  the                                                               
committee to oppose SB 49.  She said the definition of "medically                                                               
necessary"  has  already been  decided  by  the constitution  and                                                               
subsequent  court  decisions.  From   her  perspective  it  is  a                                                               
question  of  equal  access,  which  is  a  basic  right  in  the                                                               
constitution. Abortion should not be  singled out and treated any                                                               
different than  any other medical procedure.  The discussion last                                                               
week  about what  should  be  included in  the  list [of  medical                                                               
conditions] illustrates that politicians  are not the best people                                                               
to make  these decisions. In cases  where a woman's health  is at                                                               
risk,  the woman  and her  doctor should  be the  ones to  decide                                                               
[whether to continue the pregnancy or not.]                                                                                     
2:34:03 PM                                                                                                                    
RHONDA WIDENER, representing herself,  Fairbanks, AK, stated that                                                               
for  a variety  of  reasons  she absolutely  opposes  SB 49.  She                                                               
stated that  she is a  married, working  mother and if  she found                                                               
herself unexpectedly pregnant tomorrow  she would have difficulty                                                               
paying for  both child care  and her astronomical fuel  bill. She                                                               
suggested that  the legislature should spend  time addressing her                                                               
energy expenses rather than her  reproductive decisions. She said                                                               
she doesn't  come close to  qualifying for Medicaid, but  she has                                                               
difficulty obtaining  family planning  resources with  the health                                                               
insurance she pays for. Being a  low income woman in the state of                                                               
Alaska and relying on Medicaid  has to be unimaginably difficult.                                                               
Abortion is never  an easy decision for a woman,  but it's not an                                                               
area  that elected  officials should  interfere  in. She  further                                                               
asserted that passing the bill won't save a dime.                                                                               
2:37:05 PM                                                                                                                    
CLOVER SIMON  representing herself, Anchorage,  AK, characterized                                                               
SB  49 as  yet another  attempt  to narrow  the circumstances  in                                                               
which  a poor  woman can  access abortion  services. To  actually                                                               
reduce abortion  rates in  Alaska, she  suggested looking  at the                                                               
options  for providing  family planning  services for  low-income                                                               
citizens. She  noted that for  citizens under the 250  percent of                                                               
the federal poverty level there  is a 90/10 match program through                                                               
Medicaid that Alaska could be  taking advantage of but isn't. She                                                               
urged the committee  to look at putting something  like that into                                                               
effect and  to begin  looking at  what can be  done to  make sure                                                               
that the  children born in  Alaska are  wanted and coming  into a                                                               
family  that is  prepared to  raise them  as best  they can.  She                                                               
offered her opinion that SB  49 is unconstitutional and expressed                                                               
hope that instead  of wasting money on lawsuits,  the state would                                                               
spend money  on birth control  services and education  for people                                                               
across Alaska to try and reduce the number of abortions.                                                                        
2:40:09 PM                                                                                                                    
KIME  MCCLINTOCK representing  herself, Anchorage,  AK, testified                                                               
in  opposition to  SB 49.  She said  she was  born and  raised in                                                               
Alaska, and  plans to bring  the skills  she is learning  back to                                                               
Alaska once she  completes her master's degree  in public health.                                                               
She  offered her  belief that  doctors,  not politicians,  should                                                               
determine what  is medically necessary.  From her  perspective SB                                                               
49 essentially tries to create two  classes of women, and that is                                                               
wrong. As  stated earlier, limiting access  won't actually reduce                                                               
the number of abortions in  Alaska. She suggested the legislature                                                               
instead ensure  that all women  have access to  affordable family                                                               
2:42:03 PM                                                                                                                    
LISA EGAN  LAGERQUIST, representing  herself, Juneau,  AK, stated                                                               
that she, too, was testifying to  urge the committee to oppose SB                                                               
49.  Noting that  testimony  during the  first  hearing was  that                                                               
having an abortion  could be harmful to a  woman's mental health,                                                               
she said  it's important  to understand that  having a  child and                                                               
being pregnant isn't  easy either. She characterized SB  49 as an                                                               
attempt  to  take  decision-making  power away  from  women,  and                                                               
offered her belief  that this medical decision  should be between                                                               
only a woman  and her doctor. She urged the  committee to vote no                                                               
on SB 49 and spend time on more important issues.                                                                               
BETTYE  DAVIS,  representing  herself, Anchorage,  AK,  said  she                                                               
appreciates the need  to define medically necessary  but from her                                                               
perspective the discussion  should not take place in  the form of                                                               
a bill.  She reviewed her efforts  as former chair of  the Health                                                               
and  Social Services  Committee to  initiate the  discussion with                                                               
the Department  of Health and  Social Services (DHSS),  and asked                                                               
if the committee  had solicited input from  either the department                                                               
or physicians. She asked the  sponsor to consider withdrawing the                                                               
bill  and holding  the  discussion in  another  venue, because  a                                                               
court  challenge  would ensue  if  it  were  to pass.  She  urged                                                               
bringing  the right  people  to  the table  to  come  to a  clear                                                               
understanding of  what "medically  necessary" means in  order for                                                               
the state to pay.                                                                                                               
CHAIR COGHILL said he would take  her words to heart and continue                                                               
the conversation, but he would not withdraw the bill.                                                                           
2:47:11 PM                                                                                                                    
PAMELA  SAMASH representing  herself,  Nenana,  AK, testified  in                                                               
support  of  SB  49.  She  stated that  the  government  has  the                                                               
important job of  keeping the public safe at all  stages of life.                                                               
She asked  the committee to  remember that when a  pregnant woman                                                               
is harmed  or murdered,  the criminal  is prosecuted  for harming                                                               
two people, not  just one. A video called silent  scream shows an                                                               
abortion of the very people that  are being decided on today, she                                                               
said.  Referring to  the concern  about  emotional distress,  she                                                               
recounted her terror  when she faced an  unplanned pregnancy. The                                                               
experience  at   Planned  Parenthood   was  different   than  was                                                               
testified to earlier,  she said. There was  no education process,                                                               
not  even an  ultrasound. She  asked  the committee  to pass  the                                                               
bill,  because taxes  should not  pay for  the death  of children                                                               
unless it is a medical emergency to the mother.                                                                                 
2:49:47 PM                                                                                                                    
JEAN  JAMES representing  herself,  Fairbanks,  AK, testified  in                                                               
opposition to  SB 49. She said  she grew up during  the time that                                                               
abortions were illegal, and it did  nothing to stop them. It made                                                               
it worse  for everyone  because a  lot of  women were  maimed. By                                                               
contrast, countries  with liberal  abortion laws, easy  access to                                                               
birth control,  and excellent sex  education have  abortion rates                                                               
that are  lower than the  U.S. She said  it is her  strong belief                                                               
that the  decision of  a medically  necessary abortion  should be                                                               
made by a medical doctor and  not by legislative mandate. In fact                                                               
it's  ironic that  people who  do  not want  government in  their                                                               
lives can support  this bill. She urged the committee  to vote no                                                               
on SB  49 and instead focus  on options that reduce  the need for                                                               
abortions  and other  more pressing  issues such  as energy,  air                                                               
pollution, the economy, and education.                                                                                          
2:52:17 PM                                                                                                                    
HEATHER BRANDON  representing herself,  Juneau, AK,  testified in                                                               
opposition to SB  49. She said that last year  in Ireland a woman                                                               
died because the physicians were  afraid to give her an abortion.                                                               
She asked if a  woman in Alaska would have to  die like the woman                                                               
in Ireland for  people to understand that this is  not a decision                                                               
for politicians to make.                                                                                                        
2:54:17 PM                                                                                                                    
PHILIP  STEWART representing  himself,  Juneau, AK,  said he  was                                                               
appalled  that   SB  49  was   being  considered   because  equal                                                               
opportunity under both  state and federal law is  mandated to all                                                               
women  to  make  their  own   health  and  reproductive  choices.                                                               
However, that  opportunity does not  exist without  the resources                                                               
necessary  to pursue  that opportunity.  SB 49  would deny  those                                                               
resources and the  opportunity to poor women. Passing  SB 49 will                                                               
force poor  women to bear  and raise children they  can't afford,                                                               
he said.  This may  condemn those  children and  their children's                                                               
children  to  continuing  poverty. He  maintained  that  everyone                                                               
knows that  if SB 49  is enacted it will  be in violation  of the                                                               
Alaska Constitution  and will  end up  before the  Alaska Supreme                                                               
Court.  He  characterized the  bill  as  cruel  and wrong  and  a                                                               
grandstanding ploy to appeal to a small but vocal voting bloc.                                                                  
2:55:45 PM                                                                                                                    
SENATOR DYSON  stated that he  takes great offense at  being told                                                               
that he is grandstanding, because his opinions are deeply held.                                                                 
MR. STEWART apologized.                                                                                                         
2:56:50 PM                                                                                                                    
CHAIR COGHILL  observed that it's  easy to impugn the  motives of                                                               
people standing on either side of this issue.                                                                                   
MR. STEWART reiterated his apology.                                                                                             
2:57:13 PM                                                                                                                    
CHAIR COGHILL held  SB 49 in committee and  kept public testimony                                                               
           SB  56-RECLASSIFYING CERTAIN DRUG OFFENSES                                                                       
2:58:40 PM                                                                                                                    
CHAIR COGHILL announced the consideration of SB 56.                                                                             
2:58:45 PM                                                                                                                    
SENATOR  FRED  DYSON,  sponsor  of SB  56,  explained  that  this                                                               
legislation  reduces the  penalty for  possession of  Schedule IA                                                               
and Schedule  IIA drugs  from an  automatic class  C felony  to a                                                               
class A  misdemeanor. The  bill makes it  clear that  the reduced                                                               
penalty  is only  available if  the evidence  shows no  intent to                                                               
distribute and nobody  is harmed. Using these  addictive drugs is                                                               
a bad behavior, but  in his view that does not  rise to the level                                                               
of a  felony. The  intention is to  stop overloading  the prisons                                                               
with  people  whose  crimes  are  nonviolent.  According  to  the                                                               
commissioner  of corrections,  another $250  million Goose  Creek                                                               
prison  will  be  needed  all  too  soon  if  prison  populations                                                               
continue to  rise at  the current rates.  The state  can't afford                                                               
CHAIR COGHILL  mentioned the talk  about gateway drug  issues and                                                               
expressed concern that these substances  would enter the realm of                                                               
SENATOR  DYSON  characterized  the  concern  as  unwarranted.  He                                                               
relayed that the  penalty for a class A misdemeanor  can be up to                                                               
one year  in jail and a  $10,000 fine, which sends  a signal that                                                               
it's a  dangerous activity.  The bill  also clarifies  that three                                                               
arrests for the same crime is  a felony. He said the intention is                                                               
to gain more efficient use of public resources.                                                                                 
CHAIR COGHILL held SB 56 in committee.                                                                                          
3:02:33 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Coghill  adjourned the Senate Judiciary  Standing Committee                                                               
meeting at 3:02 p.m.                                                                                                            

Document Name Date/Time Subjects
SB0049B Sponsor Substitute.pdf SJUD 2/27/2013 1:30:00 PM
SJUD 3/4/2013 1:30:00 PM
SJUD 3/5/2013 1:30:00 PM
SJUD 3/11/2013 5:00:00 PM
SB 49
Sectional SB 49.doc SJUD 2/27/2013 1:30:00 PM
SJUD 3/4/2013 1:30:00 PM
SJUD 3/5/2013 1:30:00 PM
SJUD 3/11/2013 5:00:00 PM
SB 49
Sponsor Statement - Medically Necessary.docx SJUD 3/4/2013 1:30:00 PM
SB 49 Sponsor Statement
SB0056A.pdf SJUD 3/4/2013 1:30:00 PM
SB 56
Sectional.pdf SJUD 3/4/2013 1:30:00 PM
SB 56
Sponsor Statement.pdf SJUD 3/4/2013 1:30:00 PM
SB 56
Factors Driving AK Prison Pop Growth.docx SJUD 3/4/2013 1:30:00 PM
SB 56 Factors Driving AK Prison Population Growth
Reclassification Presentation_Edited_02_15_13.pptx SJUD 3/4/2013 1:30:00 PM
SB 56 Reclassification Prsentation
LRS Fiscal Impact of Reclassifying Misconduct Involving a Controlled Substance IV.pdf SJUD 3/4/2013 1:30:00 PM
SB 56