SB 49-MEDICAID PAYMENT FOR ABORTIONS; TERMS  2:13:28 PM CHAIR COGHILL reconvened the meeting and announced the consideration of SB 49 and opened public testimony. [SSSB 49 was the working document.] 2:14:09 PM NANCY BIENVENUE, representing herself, said she is a registered nurse and the former CEO of Care Net. This is a pregnancy center that offers life affirming assistance for women facing an unplanned pregnancy and post-abortion assistance. She related that she made some poor choices in 1975 and had an elective abortion. She shared her personal story and described being stunned to learn that the state would pay for her foolish choices. She emphasized that SB 49 is not about freedom and privacy and the right for a woman and her doctor to make a choice about abortion. Rather, the bill is about funding an elective abortion. She pointed out that the statute says [a Medicaid paid] abortion is for medical necessity, and urged the legislature to consider that when making a choice for what is good, sensible and moral. 2:19:15 PM GRADY PENNELL, Pastor, Eagle River Grace Church, said he supports SB 49 because it gives the unborn child a fighting chance for life. Furthermore, it is consistent with the teachings of the majority of the world religions. He noted that this can be fact-checked on-line. He shared stories of African American men who probably would not have been born if today's abortions laws had been on the books when their mothers were pregnant. 2:21:44 PM PATRICIA STEEN, representing herself, stated that legal abortion is the law of the land and there can be no discrimination between which women can choose and which cannot. It is a matter of access and the civil rights of citizens under the 14th Amendment. She pointed out that abortions, including those that are publicly funded, have been declining in Alaska. She cited federal statistics on the cost of raising a child and pointed out that the total amount paid for all the publicly funded abortions in Alaska would pay for just one child who needed to be on public assistance throughout his or her life. She said the number of abortions decline proportionally with access to affordable birth control, adequate sex education, adequate health care, and the ability to adequately support the children. The wording proposed in SB 49 is in direct conflict with what is available to two-thirds of the women in the world, and is completely unconstitutional considering the U.S. Supreme Court decision and the 14th Amendment. She concluded that abortion rights need to be safeguarded and supported for all women regardless of their economic status. SENATOR DYSON asked if her point is that abortion should be allowed because raising a child is too expensive and the kid may be poor. MS.STEEN said her point is that the proposed language limits abortions for women who cannot afford to pay for them. 2:25:56 PM JOSHUA DECKER, staff attorney, ACLU of Alaska, thanked the committee for allowing him to supplement the written testimony that was submitted on February 27, 2013. He stated that SB 49 has serious constitutional problems. First, it violates the separation of powers in Alaska. The Supreme Court decision in State of Alaska v. Planned Parenthood was a decision of constitutional dimension that the legislature lacks the power to alter through legislation. Because SB 49 seeks to limit the rights articulated by the Supreme Court, it is unconstitutional from a separation of powers view. The bill is also unconstitutional from an equal protection view. It animates from a desire to limit abortions, which is not a neutral criterion for the state allocating money to Medicaid recipients, and the narrow definition of what is medically necessary does not treat women who receive Medicaid assistance equally. For these reasons the ACLU of Alaska is asking the committee not to pass SB 49, he said. CHAIR COGHILL said the committee received the well-written testimony and he disagrees with it completely. SENATOR DYSON asked, aside from the Supreme Court decision, if the ACLU has ever held an opinion that an unborn child has value or worth on its own. MR. DECKER said the ACLU holds the position that everyone has value, but SB 49 doesn't speak to that. Rather, the bill speaks to an unconstitutional discrimination of publicly funding a constitutional right. SENATOR DYSON restated the question asking whether the ACLU believes that an unborn child has intrinsic value or worth on its own. MR. DECKER said certainly, but that isn't the end of the inquiry. Because of the conclusive Supreme Court statement, SB 49 would offend a longstanding constitutional requirement and, if passed, lead to expensive and unnecessary litigation. SENATOR DYSON observed that his question was not answered. 2:30:44 PM SHERRY WRIGHT, representing herself, testified in support of SB 49. She shared her personal story of how an abortion at age 17 negatively affected her life. She only got peace from the horrible choice she made through the grace of God, much prayer, and finally telling her secret. She related that she volunteers as a post-abortion counselor, and most of the women in the group say that they aborted their child as a matter of convenience. She expressed hope that this common-sense bill passes. CHAIR COGHILL observed that her testimony was that there could be psychological and emotional cost to a woman who has an abortion. MS. WRIGHT agreed and suggested he search on-line for websites featuring post-abortion trauma. 2:35:14 PM REGINA CHENAULT, M.D., representing herself, said she is a surgeon testifying in support of SB 49. She offered her medical opinion that very few medical conditions make an abortion medically necessary. Mental conditions do not qualify as medical necessity for a woman to get an abortion. In fact, many mental health patients have children, raise them, and contribute to society. She emphasized that state Medicaid dollars do not need to be spent killing babies. They are valuable gifts from God that have intrinsic worth. She related her experience that women who have had an abortion never get away from having made that bad decision. By contrast, many women with life-threatening diseases risk their own lives to continue a pregnancy. She shared two patient stories where the women chose to have abortions that would be paid for by Medicaid and stated that she disagrees that Medicaid should pay for these types of abortions. CHAIR COGHILL asked her opinion about including some psychological component to prove a medical need for an abortion. DR. CHENAULT said she agrees only in cases of incest. CHAIR COGHILL noted that the bill already includes exceptions for rape and incest. 2:42:16 PM PATTI PRICE, representing herself, stated support for SB 49. 2:42:50 PM CONNIE BELL, representing herself, testified in support of SB 49. She said the testimony by Planned Parenthood makes it clear that there is a need to define "medically necessary." She offered her belief that the unborn child has intrinsic value whose rights are originally from God. Good law upholds those rights and for Alaska to have a good law the term "medically necessary" needs a definition. 2:44:02 PM JEAN BRAMER, M.D., representing herself, said she is an OB/GYN physician who strongly supports SB 49. She stated that this is not a prolife and prochoice debate; this is about funding. Defining "medically necessary" is very important to keep from spending thousands of dollars on elective abortions. She described an elective abortion as an inconvenient pregnancy that wants to be terminated for no medical reason. In fact, very few medical reasons would make an abortion reasonable. The list of medical conditions in the bill is very broad and will cover the women who should be covered, but it will not allow the state to pay for an elective abortion. Private insurance does not cover elective abortion so there is no reason that Medicaid should cover them, she said. The bill brings clarity to what is important, but it does not try to change the legality of elective abortions. It's a matter of funding. 2:47:46 PM WILLIAM RESINGER, M.D., representing himself, said he took the original Hippocratic Oath which forbade both abortion and euthanasia. As a radiologist he said he is in the unique position of being able to testify on behalf of the unborn; they are human beings. He described things he has witnessed during ultrasounds, and pointed out that abortion is the only surgical procedure that has 100 percent mortality. Because abortion destroys a human being, it's important to clearly and carefully define what constitutes "medical necessity." 2:50:55 PM IIONA FARR M.D., representing herself, testified in support of SB 49. She said that as a physician she does her best to promote life and she doesn't want her tax dollars going to pay for abortions that are not medically necessary as it results in the death of unborn Alaska children. Noting that eighteen states have passed legislation prohibiting abortions in the new health exchanges, she stressed the importance for Alaska to set a clear standard for what is medically necessary before the federal government imposes a definition. DR. FARR suggested the committee remove kidney infections from the list of medical conditions that qualify for medical necessity. This condition is fairly common during pregnancy and is not a reason for abortion. At the least, specify kidney infection with sepsis. She also suggested adding congenital fetal abnormalities incompatible with life to the list, because these often result in complications with the pregnancy. Mental health issues or economic conditions are not reasons to have an abortion. She related several patient stories and stated that most abortions in Alaska are elective and should not be paid for by taxpayers. CHAIR COGHILL asked her to submit her suggestions in writing. DR. FARR agreed and noted that she biopsies the uterus before doing an ultrasound. CHAIR COGHILL asked if she was aware of complaints that vaginal ultrasounds were repugnant. DR. FARR answered no; either an abdominal or trans-vaginal ultrasound should be done before any type of intrauterine procedure is performed. 2:56:50 PM SID HEIDERSDORF, Vice President, Alaskans for Life, stated that Alaskans for Life supports all efforts to remove the state from the abortion business, and opposes the Medicaid program paying for elective procedures, especially abortion. That is not what the program is for. Alaskans for Life holds the view that nothing qualifies as a medically necessary abortion, but acknowledges that SB 49 is a step in the right direction. However, the list of conditions to qualify for a medically necessary abortion is so broad it would be easy for an abortionist to circumvent the intention of the statute. Thus, the committee should consider requiring a second physician to certify the medically necessary conditions. 3:00:51 PM GEORGE BROWN M.D., representing himself, said he is a pediatric physician who has practiced in Alaska for many years. He began by pointing out that current research shows that physical and mental illness cannot be separated. By definition there is an emotional need if someone who is terribly distraught comes in seeking help. What should happen is to help that person make the most sensible decision for them. However, if families receive the help they need to raise their children, there will be less demand for abortion. DR. BROWN thanked the committee for listening respectfully to each side of this very complicated issue. He expressed hope that both sides do everything possible to prevent unwanted pregnancies. He concluded reading the following from his prepared comments: Our Alaska and United States Constitution[s] expressly promise freedom of speech, of the press, of public assembly to petition, and freedom of and from religion. These are solemn and challenging promises. They are not all yet kept for many of us, sadly for too many of us. If I had somehow been able to add another constitutional promise, I would have added "freedom to practice tolerance everywhere and as often as anyone possible could." It is important for you to understand that the health of body and mind cannot be divided. I ask you to carefully consider the negative impact that passage of SB 49 will have on the emotional and physical health of many Alaskan women. 3:05:58 PM CHAIR COGHILL held SB 49 in committee.