ANTI-CHOICE LAWS
Refusal to Provide Medical Services
ABORTION REFUSAL CLAUSE
Nevada allows certain individuals or entities to refuse to provide abortion services.
To whom does the refusal clause apply? Nurses, nursing assistants, other employees hired to provide direct personal health services, or private hospitals, or licensed medical facilities.
What does the refusal clause allow? Except in a medical emergency, an employer may not require a nurse, nursing assistant, or other employee hired to provide direct personal health service to participate directly in the induction or performance of an abortion if the employee has provided a written statement indicating a moral, ethical, or religious basis for refusal to participate. The refusal to participate may not be a basis for penalty or discipline by the employer.
A private hospital or licensed medical facility is not required to permit the use of its facilities for the induction or performance of an abortion except in a medical emergency. The refusal to permit an abortion may not be a basis for a cause of action.
Must the refusal be in writing? Yes, an employee must provide a written statement indicating a moral, ethical, or religious basis for refusal to participate.
Does the law require the refusing entity to notify the persons affected? No.
Are there circumstances under which a refusal clause may not be exercised? Yes, during medical emergencies.
Does the law require the refusing individual or entity to provide medically and factually accurate information or provide a referral for abortion services? No.
Does the law provide a mechanism for women to otherwise obtain specific reproductive health services, information, or referrals if an individual and/or entity exercises a refusal clause? No.
Nev. Rev. Stat. Ann. § 632.475 (Enacted 1973; Last Amended 1985); Nev. Rev. Stat. Ann. § 449.191 (Enacted 1973; Last Amended 1989).
INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE
Although Nevada law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception, certain employers and/or insurers may require that their plans exclude coverage for contraception.
To whom does the refusal clause apply? Insurers that are affiliated with a religious organization and that object to contraceptive coverage on religious grounds.
What does the refusal clause allow? An insurer that is affiliated with a religious organization and that objects to contraceptive coverage on religious grounds may refuse to provide coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? Yes. The law permits insurers affiliated with religious organizations to refuse to provide contraceptive coverage. This broad refusal clause inappropriately includes insurers that operate in the public sphere.
Does the law require the refusing entity to notify the persons affected? Yes. An insurer exercising the religious exemption must provide written notice of the excluded services to the prospective insured.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause? No.
Nev. Rev. Stat. Ann. §§ 689A.0415, .0417; §§ 689B.0376, .0377; §§ 695B.1916, .1918; §§ 695C.1694, .1695. (Enacted 1999).
Restrictions on Low-Income Women's Access to Abortion
Nevada prohibits public funding of abortion for women eligible for state medical assistance for general health care unless the procedure is necessary to save the life of a pregnant woman, or the pregnancy is the result of rape or incest and the woman signs a notarized affidavit or witnessed declaration attesting to the rape or incest. Div. of Health Care Financing & Policy, Nev. Dep't of Human Resources, Medicaid Services Manual, ch. 600, § 603.4(2)(c) (Sept. 9, 2003), at http://dhcfp.state.nv.us/MSM/Ch%20600%2007-20-04.pdf.
Restrictions on Young Women's Access to Abortion
Nevada law restricts young women's access to abortion.
Is the law enforceable? No. A federal court held that this law is unconstitutional and unenforceable because the judicial bypass procedure does not sufficiently protect a pregnant young woman's constitutional right to an abortion. Glick v. McKay, 937 F.2d 434 (9th Cir. 1991) (preliminary injunction upheld), No. CV-N-85-331-ECR (D. Nev. Oct. 10, 1991) (permanent injunction issued).
Who is considered a minor? A young woman under the age of 18 who is not married and not emancipated.
What is required - parental consent or parental notice? Notice.
Who must be notified? One parent.
Are there other trusted adults who may be notified instead? No.
What is the process for providing notification? A young woman may not obtain an abortion unless the attending physician personally gives notice to one parent. If the parent cannot be so notified after a reasonable effort, notice must be made by certified mail.
May the parental mandate be waived if a young woman is a victim of rape or incest? No.
May the parental mandate be waived if a young woman is a victim of child abuse? No.
May the parental mandate be waived if a young woman's health is threatened? Yes, but only if the attending physician determines that "an abortion is immediately necessary to preserve the patient's life or health."
May the parental mandate be waived under any other circumstances? Yes, the young woman may try to obtain permission from a judge.
If a young woman must obtain permission from a judge, what is the process? She must secure a court order stating that she is mature enough to make an intelligent and informed decision, that she is financially independent or emancipated, or that parental notice is detrimental to her best interests.
Are there other significant requirements under the law? No.
Has a court considered the constitutionality of this law? Yes. A court held that the statute is unconstitutional because the judicial bypass procedure is constitutionally inadequate and issued a permanent injunction prohibiting enforcement of the law. Glick v. McKay, 937 F.2d 434 (9th Cir. 1991) (preliminary injunction upheld), No. CV-N-85-331-ECR (D. Nev. Oct. 10, 1991) (permanent injunction issued).
Other information about the law: None.
Nev. Rev. Stat. Ann. §§ 442.255 (Enacted 1981; Last Amended 1985), .2555 (Enacted 1985).
Targeted Regulation of Abortion Providers (TRAP)
Nevada law subjects abortion providers to burdensome restrictions not applied to other medical professionals.
Restrictions on Where Abortions May Be Performed
Nevada places medically unnecessary restrictions on where abortions may be performed.
Among the most common TRAP regulations are those restricting the performance of abortions to hospitals or other specialized facilities, which require doctors to obtain medically unnecessary additional licenses, needlessly convert their practices to mini-hospitals at great expense, or perform abortions only in hospitals, an impossibility in many parts of the country.
Nevada requires that an abortion performed either after the 24th week of pregnancy, or if there is a reasonable likelihood of the fetus surviving outside the womb by natural or artificial support systems, must be performed in a licensed hospital. Nev. Rev. Stat. Ann. § 442.250.2 (Enacted 1973; Last Amended 1985).
Restrictions on Who May Perform Abortions
Nevada prohibits certain qualified health care professionals from performing abortions
Only a physician licensed to practice in the state or employed by the U.S. government using accepted medical practices and procedures may perform an abortion. Nev. Rev. Stat. Ann. § 442.250 (Enacted 1973; Last Amended 1985).
PRO-CHOICE LAWS
Contraceptive Equity
Nevada law requires health insurance plans that cover prescription drugs to provide equitable coverage for contraception.
What is required? If a health insurance plan provides coverage for prescription drugs or devices or outpatient care, it must provide coverage for any Food and Drug Administration-approved contraceptive drugs or devices or any health care service related to contraception.
To which insurance plans does the law apply? Individual and group insurance policies, hospital or medical service contracts, and health maintenance organization (HMO) policies issued or renewed on or after October 1, 1999 that provide coverage for prescription drugs or devices or outpatient care.
Does the law provide additional protections for women? Yes. Insurers may not: (1) impose a greater copayment, coinsurance, deductible, or waiting period than that imposed on other prescription drugs or outpatient care; (2) refuse to issue or cancel a health insurance policy because the prospective insured uses or may use contraception; (3) offer incentives to an insured or health care provider to discourage the use of covered contraceptives; or (4) penalize a health care provider for providing contraceptives.
Does the law contain a refusal clause, allowing certain employers and/or insurers to refuse to provide or pay for contraceptive coverage? Yes.
To whom does the refusal clause apply? Insurers that are affiliated with a religious organization and that object to contraceptive coverage on religious grounds.
What does the refusal clause allow? An insurer that is affiliated with a religious organization and that objects to contraceptive coverage on religious grounds may refuse to provide coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? Yes. The law permits insurers affiliated with religious organizations to refuse to provide contraceptive coverage. This broad refusal clause inappropriately includes insurers that operate in the public sphere.
Does the law require the refusing entity to notify the persons affected? Yes. An insurer exercising the religious exemption must provide written notice of the excluded services to the prospective insureds.
Are there circumstances under which a refusal clause may not be exercised? No.
Does the law provide a mechanism for women to obtain contraceptive coverage if their insurer exercises a refusal clause? No.
Nev. Rev. Stat. Ann. §§ 689A.0415, .0417; §§ 689B.0376, .0377; §§ 695B.1916, .1918; §§ 695C.1694, .1695. (Enacted 1999)
Freedom of Choice Act
Nevada has created additional protections for reproductive rights by adding an affirmative right to choose into its state law. In 1973, Nevada enacted a law affirming a woman's right to choose. This law was amended several times and in its current form is consistent with the framework established in Roe v. Wade. This law ensures women's access to pre-viability abortions and would remain in effect even if Roe v. Wade were overturned.
Abortions may be performed within 24 weeks after the commencement of a pregnancy. Nev. Rev. Stat. Ann. § 442.250 (Enacted 1973; Last Amended 1985). In November of 1990, Nevada voters passed a ballot initiative approving this law, and as a result the statute will remain in effect and cannot be amended, repealed, or otherwise changed except by a direct vote of the people. Nev. Question No. 7 (Enacted by Ballot Initiative 1990); Nev. Const. art.19, § 1(3).
Guaranteed Access to Prescriptions
Nevada law guarantees that women's birth control prescriptions will be filled. A pharmacist may refuse to fill a prescription for professional reasons only. Professional reasons for refusing include questions concerning the legitimacy or medical appropriateness of any prescription presented, or reasonable belief that the filling of the prescription would be unlawful. Regulations specify that a pharmacist may not refuse to fill a prescription based on ethical, moral, or religious reasons.
Nev. Admin. Code § 639.753 (2006); Nev. State Board of Pharmacy News (Nev. St. Bd. of Pharmacy & Nat'l Ass'n of Bds. of Pharmacy Found., Inc., Mount Prospect, IL), NV Vol. 17, No. 3, July 2006, at 4.
Protection Against Clinic Violence
A person who intentionally prevents another person from entering or exiting a medical or health facility or the office of a physician by physical detention or obstruction is guilty of a misdemeanor and will be fined up to $1000, imprisoned for up to three months, or both. Nev. Rev. Stat. Ann. § 449.760 (Enacted 1991).
OTHER LAWS
Informed Consent
Nevada has an abortion-specific informed consent law.
A woman may not obtain an abortion until after the physician or another qualified person informs her of the number of weeks that have elapsed from the probable time of conception, describes the procedure to be used and its consequences, and explains the physical and emotional implications of having an abortion. Nev. Rev. Stat. Ann. §§ 442.252, .253 (Enacted 1981; Last Amended 1985).
A court held that the provision requiring explanation of the physical and emotional implications of having an abortion was constitutional. Glick v. McKay, 616 F. Supp. 322 (D. Nev. 1985).
Post-Viability Abortion Restriction
Nevada's post-viability abortion restriction provides that no abortion may be performed after the 24th week of pregnancy unless there is a "substantial risk" that continuance of the pregnancy would endanger the woman's life or "gravely impair" her physical or mental health. Nev. Rev. Stat. Ann. § 442.250 (Enacted 1973; Last Amended 1985).
NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortions so long as they contain adequate exceptions to protect the life and health of the woman. NARAL Pro-Choice America opposes Nevada's post-viability restriction because it contains a dangerously narrow health exception. NARAL Pro-Choice America also opposes this law because it is unconstitutional to the extent that it prohibits pre-viability abortions by defining viability at 24 weeks. A state may not prohibit abotion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside of a woman's body. Roe v. Wade, 410 U.S. 113, 163 (1973). Because viability is a point that varies with each pregnancy, states may not declare that it occurs at a particular gestational age. Colautti v. Franklin, 439 U.S. 379, 388-89 (1979).
