00                            SENATE BILL NO. 49                                                                          
01 "An Act defining 'medically necessary abortion' for purposes of making payments                                         
02 under the state Medicaid program."                                                                                      
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. AS 47.07 is amended by adding a new section to read:                                                  
05            Sec. 47.07.068. Payment for abortions. (a) The department may not pay for                                  
06       abortion services under this chapter unless the abortion services are for a medically                             
07       necessary abortion or the pregnancy was the result of rape or incest and the rape or                              
08       incest was promptly reported to law enforcement or public health authorities. Payment                             
09       may not be made for an elective abortion.                                                                         
10            (b)  In this section,                                                                                        
11                 (1)  "abortion" has the meaning given in AS 18.16.090;                                                  
12                 (2)  "elective abortion" means an abortion that is not a medically                                      
13       necessary abortion;                                                                                               
14                 (3)  "medically necessary abortion" means that, in a physician's                                        

01       objective and reasonable professional judgment after considering medically relevant                               
02       factors, an abortion must be performed to avoid a threat of serious risk to the life or                           
03       physical health of a woman from continuation of the woman's pregnancy;                                            
04                 (4)  "serious risk to the life or physical health" includes, but is not                                 
05       limited to, a serious risk to the pregnant woman of                                                               
06                      (A)  death; or                                                                                     
07                      (B)  impairment of a major bodily function because of                                              
08                           (i)  diabetes with acute metabolic derangement or severe                                      
09                 end organ damage;                                                                                       
10                           (ii)  renal disease that requires dialysis treatment;                                         
11                           (iii)  severe pre-eclampsia;                                                                  
12                           (iv)  eclampsia;                                                                              
13                           (v)  convulsions;                                                                             
14                           (vi)  status epilepticus;                                                                     
15                           (vii)  sickle cell anemia;                                                                    
16                           (viii)  severe congenital or acquired heart disease, class                                    
17                 IV;                                                                                                     
18                           (ix)  pulmonary hypertension;                                                                 
19                           (x)  malignancy if pregnancy would prevent or limit                                           
20                 treatment;                                                                                              
21                           (xi)  kidney infection;                                                                       
22                           (xii)  congestive heart failure;                                                              
23                           (xiii)  epilepsy;                                                                             
24                           (xiv)  seizures;                                                                              
25                           (xv)  coma;                                                                                   
26                           (xvi)  severe infection exacerbated by pregnancy;                                             
27                           (xvii)  rupture of amniotic membranes;                                                        
28                           (xviii)  advanced cervical dilation of more than six                                          
29                 centimeters at less than 22 weeks gestation;                                                            
30                           (xix)  cervical or cesarean section scar ectopic                                              
31                 implantation;                                                                                           

01                           (xx)  any pregnancy not implanted in the uterine cavity;                                      
02                           (xxi)  amniotic fluid embolus; or                                                             
03                           (xxii)  another debilitating physical condition.