New regulations on Medicaid coverage of abortions in Alaska take effect next month, requiring doctors to identify specific medical issues that qualify the abortion as “medically necessary.”
Doctors performing abortions and seeking Medicaid funds to pay for it must file paperwork with the state Department of Health and Social Services providing the woman’s name and Medicaid identification number.
The old form required doctors to check one of two boxes: one asserting the abortion was carried out because the pregnancy was “the result of an act of rape or incest,” or that the procedure was necessary “due to physical disorder, physical injury, or physical illness.”
The other box gave doctors the option to perform the abortion because the deemed it “medically necessary.”
The new form, required by the state starting Feb. 2, requires doctors opting for the “medically necessary” option to specify the woman’s specific medical necessity from a list of more than 20 conditions. The list ranges from “pregnancy not implanted in the uterine cavity,” also known as ectopic pregnancies, to diabetes and epilepsy.
The new form also allows doctors to choose other physical or psychiatric disorders not on the list, essentially a “none of the above” option.
“It isn’t changing access (to abortion),” said DHSS Commissioner William Streur. “It’s asking for more detail.”
Streur said the new form, and the information it discloses, is necessary to help the state understand the medical necessity of abortions.
“All it does is ask for more detail than we previously asked for,” he said. “It’s much less invasive than us going in and doing a medical chart review at the clinic where the abortion is performed.”
Joshua Decker, interim exe director at American Civil Liberties Union of Alaska, said forcing women to disclose sensitive medical information is unconstitutional.
“This regulation treats abortion unlike any other medical procedure,” Decker said in a phone interview Tuesday.
“The Alaska Supreme Court clearly said that the state cannot single out abortion, or treat abortion differently, than other medical services,” Decker added. “Nowhere else in the Medicaid system where the state uses ‘medically necessary’ does it require patients to jump through these hoops.”
Treasure Mackley, the political and organizing director for Planned Parenthood Votes Northwest, wrote in a release that the new rules are “essentially a nearly complete ban on Medicaid funding of abortion.”
Mackley wrote that the “misguided restriction (will) interfere with women's personal medical decisions and end up costing taxpayers more,” if the rule is challenged in court.
“We’re not denying a person from receiving the abortion,” Streur said. “We’re merely denying payment for it if the document is not submitted. The physician is still making the decision on whether or not to perform the abortion.”
Decker said the ACLU is “considering all of its options” with regard to a challenge of the new rule.