Health care providers, former patients, and other opponents presented a wave of testimony Thursday against the state health department’s proposed rule change, which would add requirements for abortions covered by Medicaid.This includes submitting the patient’s medical information to demonstrate that the procedure is medically necessary
The administrative rule change notice was first announced in late December, the day before Christmas Eve. The proposal is the Department of Public Health and Human Services’ response to a survey requested by Republican lawmakers in 2021 about how Medicaid funds are being spent on abortions. Federal law prohibits the use of Medicaid for rape, incest, or most abortions other than medical risks to the mother’s life, but a state court in Montana ruled in 1995 that it was “medically necessary”. determined that the Montana Medicaid dollar must cover the abortion if it is deemed to be.
At Thursday’s virtual hearing, more than 20 people voted against the proposal, and at least 90 people attended the conference call. The sole proponent is Derek Ostreicher, lead attorney for the Montana Family Foundation, a conservative policy group, who believes taxpayer funds cover “selective non-therapeutic treatments.” He said the organization would support process changes to prevent it from happening.
Physicians, nurses and patients with personal abortion experience say the rule unfairly targets some of Montana’s most economically vulnerable patients, delays treatment and interferes with patient-provider relationships. He strongly urged the ministry to reject its own proposal on the grounds that it is unfair.
“Women’s health is compromised when medically necessary abortions are restricted,” said Leah Miller, a physician at the American College of Obstetrics and Gynecology in Missoula. “Restrictions disrupt the patient-provider relationship, disproportionately affecting low-income women and women who live far from their providers.”
Occasionally, doctors and former patients would openly cry during their testimony, explaining how personal and time-sensitive abortion is important. She talks about having an abortion as a college student when she was in college. Morgan said the baby died from complications during his prenatal medical procedure, something he didn’t realize until a doctor informed him during a follow-up appointment.
“It was a very, very sad and shocking time. And I think it’s unethical to put any barriers to women to stand between women and doctors during this time. It’s just a period,” Morgan said. Told. “These decisions should only be made by a woman and her doctor, and these decisions need to be made quickly.”
Providers currently submit forms stating that an abortion is medically necessary, but do not need to submit any additional information. If adopted, the Gianforte administration’s rule changes would require providers to obtain pre-approval for Medicaid coverage, verify patient age, medications, “how many times the patient has been pregnant, how many times the patient has given birth,” etc. You must provide valid medical records. Birth, last menstrual period, pregnancy test status and results, allergies, chronic conditions, surgery, behavioral health problems, smoking, substance abuse, and obstetric history.
Other providers, including maternal-fetal medicine experts and abortion clinic representatives, said the proposed process was unnecessary and could pose risks to patients in need of proper medical care. Missoula State physician Dr. Timothy Mitchell testified that terminating a pregnancy due to severe fetal abnormalities may not be considered medically necessary by the department’s standards.
“Instead, these patients are forced to continue these pregnancies to term, increasing their risk of complications and prolonging grief and healing,” Mitchell said. It is based on scientific evidence and best practices and must preserve the doctor-patient relationship.Unfortunately, these proposed changes to Medicaid threaten communication between doctors and patients and It undermines judgment.”
The rule change also prohibits nurse practitioners and physician assistants from billing Medicaid for abortions, even though there are professionals and doctors who can legally practice abortion services in Montana. State ACLU attorney Akilah Deernose said the provision was just part of a rule that civil rights groups considered unconstitutional and inconsistent with the 1995 state court ruling.
“That court ruled that the state created a general program to provide medical services to low-income Montanas through administrative regulation and then chose abortion care for discriminatory treatment by withholding benefits. “The choice to exercise the constitutional right to abortion should not be dependent on income. This violates the spirit and letter of Montana’s statutes and constitution. increase.”
The state health department did not offer a rebuttal to Thursday’s testimony, but said the written justification for the rule helps ensure the state is complying with court decisions about medical needs. .
Public comments may be submitted to the Department in written form by 5:00 pm on January 20th.
