ANTI-CHOICE LAWS
Abortion Ban
AFTER 12 WEEKS
Rhode Island's unconstitutional and unenforceable ban outlaws abortions performed as early as twelve weeks. R.I. Gen. Laws Ann. §§ 23-4.12-1 (Enacted 1997; Last Amended 1998), 23-4.12-2 (Enacted 1997), 23-4.12-3 (Enacted 1997), 23-4.12-4 (Enacted 1997), 23-4.12-5 (Enacted 1997; Last Amended 1998), 23-4.12-6 (Enacted 1997).
A court held that Rhode Island's ban is unconstitutionally vague and has issued a permanent injunction prohibiting its enforcement. Rhode Island Med. Soc'y v. Whitehouse, 239 F.3d 104 (1st Cir. 2001). The U.S. Supreme Court previously held that a similar ban that lacks an exception to protect a woman's health and that bans more than one procedure places an undue burden on a woman's right to choose and is unconstitutional. Stenberg v. Carhart, 530 U.S. 914 (2000).
Rhode Island's unconstitutional and unenforceable law makes the performance of any abortion procedure that falls within a broad definition a felony, unless the procedure is necessary to preserve the life of a woman endangered by a physical disorder, physical illness, or physical injury, including a life-endangering condition caused by or arising from the pregnancy itself, and no other medical procedure will suffice. R.I. Gen. Laws Ann. §§ 23-4.12-1 (Enacted 1997; Last Amended 1998), 23-4.12-2 (Enacted 1997), 23-4.12-3 (Enacted 1997), 23-4.12-4 (Enacted 1997), 23-4.12-5 (Enacted 1997; Last Amended 1998), 23-4.12-6 (Enacted 1997).
There is also a Federal Abortion Ban, which applies nationwide regardless of state law. The federal ban prohibits the performance of certain second trimester abortions and does not contain an exception for a woman's health. In April 2007, the U.S. Supreme Court upheld the ban, making it the first time since Roe v. Wade that the Court has upheld a ban on a previability abortion procedure. Click here to read more about the Federal Abortion Ban.
Biased Counseling
A woman may not have an abortion until after a physician or physician's agent informs her of the gestational age of the fetus and the nature of the proposed procedure and its material medical risks, and she signs a form that includes the statement: "If you decide to carry your pregnancy to term but not to keep the child, you may be able to place the child with either a relative, or with another family through foster care or adoption." R.I. Gen. Laws Ann. §§ 23-4.7-2 to -4.7-5 (Enacted 1982).
With respect to a previous version of this law, a court held that the requirements that a woman be informed of the nature of an abortion and the gestational age of the fetus are constitutional. Women's Med. Ctr. of Providence, Inc. v. Roberts, 530 F. Supp. 1136 (D.R.I. 1982).
Insurance Prohibition for Abortion
Rhode Island has an unconstitutional and unenforceable law which provides that no health insurance contract, plan, or policy delivered or issued for delivery in the state may provide coverage for abortion unless the procedure is necessary to preserve the woman's life or the pregnancy resulted from rape or incest. Coverage for abortion may be obtained only through an optional rider for which an additional premium must be paid. R.I. Gen. Laws Ann. § 27-18-28 (Enacted 1983).
Rhode Island has a partially unconstitutional and unenforceable law which provides that the state or any city or town must not include coverage for abortion in any employees' health insurance contract, plan, or policy unless the procedure is necessary to preserve the woman's life or the pregnancy resulted from rape or incest. R.I. Gen. Laws Ann. § 36-12-2.1 (Enacted 1981).
A court has permanently enjoined §27-18-28 as unconstitutional and held that §36-12-2.1 is unconstitutional and unenforceable as applied to municipal employees. Nat'l Educ. Ass'n of R.I. v. Garrahy, 598 F. Supp. 1374 (D.R.I. 1984), aff'd, 779 F.2d 790 (1st Cir. 1986).
Refusal to Provide Medical Services
ABORTION REFUSAL CLAUSE
Rhode Island allows certain individuals or entities to refuse to provide abortion services.
To whom does the refusal clause apply? Physicians or other persons associated with, employed by, or on the staff of a health care facility.
What does the refusal clause allow? No physician or other person associated with, employed by, or on the staff of a health care facility, who objects in writing on moral or religious grounds to a scheduled abortion, may be required to participate in medical procedures that result in an abortion. The refusal to participate may not be a basis for civil liability, disciplinary action, or recriminatory action.
No physician or other licensed health care practitioner acting within the scope of his or her practice may be compelled to perform, and no person shall be compelled to assist at, an abortion.
Must the refusal be in writing? Yes.
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? No.
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.
R.I. Gen. Laws Ann. § 23-17-11 (Enacted 1978; Last Amended 1979); R.I. Code R. § 14 000 009 (Enacted 1973; Last Amended 2002).
INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE
Although Rhode Island 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? Religious employers for whom prescription contraceptive methods are contrary to their bona fide religious tenets.
What does the refusal clause allow? An insurer may issue a religious employer a health insurance contract, plan, or policy that excludes coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? Yes. The law defines the term "religious employer" as a "church or a qualified church-controlled organization" as defined by federal law. This exemption allows a broad range of organizations engaged in secular activities, some of which may receive government funding, to deny women necessary services based on religious doctrine.
Does the law require the refusing entity to notify the persons affected? Yes. An employer exercising a refusal clause must provide written notice to prospective enrollees listing the contraceptive health care services the employer refuses to cover.
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.
R.I. Gen. Laws §§ 27-18-57, -19-48, -20-43, -41-59 (Enacted 2000; Last Amended 2002).
STERILIZATION REFUSAL CLAUSE
Rhode Island allows certain individuals or entities to refuse to perform or participate in sterilizing procedures.
To whom does the refusal clause apply? Physicians or other persons associated with, employed by, or on the staff of a health care facility.
What does the refusal clause allow? No physician or other person associated with, employed by, or on the staff of a health care facility, who objects in writing on moral or religious grounds to a scheduled sterilization, may be required to participate in medical procedures that result in a sterilization. The refusal to participate may not be a basis for civil liability, disciplinary action, or recriminatory action.
Must the refusal be in writing? Yes.
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? No.
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.
R.I. Gen. Laws Ann. § 23-17-11 (Enacted 1978; Last Amended 1979).
Restrictions on Low-Income Women's Access to Abortion
Rhode Island prohibits public funding of abortion for women eligible for state medical assistance for general health care unless the procedure is necessary to preserve the woman's life or the pregnancy is the result of rape or incest. R.I. Dep't of Human Servs. Code of Rules, Medical Assistance, §§ 0300.20.05.15 (Rev. June 1994), 0300.20.05.20 (Rev. May 1995), at http://www.ridhscode.org/0300.htm.
Rhode Island's constitution has an invalid and unenforceable provision banning the use of public funds for abortion. R.I. Const. art. I, § 2 (Enacted 1986). This provision is in conflict with federal law. Participating state medical assistance programs must meet the federal requirements for abortion coverage. Federal law currently requires states participating in the Medicaid program to fund abortion in cases of life endangerment, rape, or incest.
Restrictions on Young Women's Access to Abortion
Rhode Island law restricts young women's access to abortion.
Is the law enforceable? Yes.
Who is considered a minor? A young woman under the age of 18 who is not married or emancipated.
What is required - parental consent or parental notice? Consent.
Who must provide consent? One parent.
Are there other trusted adults who may provide consent instead? No.
What is the process for obtaining consent? A young woman may not obtain an abortion unless one parent consents.
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, in the case of "an emergency requiring immediate action."
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 either that she is mature and capable of informed consent or that an abortion is in her best interests.
Are there other significant requirements under the law? No.
Has a court considered the constitutionality of this law? No.
Other information about the law: None.
R.I. Gen. Laws Ann. §§ 23- 4.7-4, -6 (Enacted 1982).
Spousal Notice
A court held that Rhode Island's husband notification requirement for abortion is unconstitutional. Planned Parenthood of R.I. v. Bd. of Med. Review, 598 F. Supp. 625 (D.R.I. 1984).
This law provides that a married woman may not obtain an abortion unless her husband has been notified, except if: she is living apart from her husband; she provides a written statement that "the fetus was not fathered by her husband"; either spouse has filed for divorce; or "there is an emergency requiring immediate action." R.I. Gen. Laws Ann. §§ 23-4.8-1 to -4.8-5 (Enacted 1982).
The U.S. Supreme Court held that requiring a woman to notify her husband prior to an abortion is unconstitutional. Planned Parenthood of S.E. Pa. v. Casey, 505 U.S. 833 (1992).
Targeted Regulation of Abortion Providers (TRAP)
Rhode Island imposes a variety of burdensome requirements on abortion providers that are not imposed on other health care providers, including:
Restrictions on Where Abortions May Be Performed
Rhode Island places medically unnecessary restrictions on where abortions may be performed.
Providers of any abortion services - including private physicians - must comply with administrative and patient testing requirements, and providers of first trimester surgical abortions must comply with additional physical plant requirements. R.I. Code R. 14 000 009.
Rhode Island requires that surgical abortions after the 14th week through the end of the 18th week of gestation must be performed in a hospital, a licensed freestanding ambulatory surgical center, a licensed physician office, or a freestanding surgical facility, and that after the 18th week of gestation, abortions must be performed in a hospital or ambulatory surgical center. R.I. Code R. 14 000 009, §§ 2.3 to 2.4.
Restrictions on Who May Perform Abortions
Rhode Island prohibits certain qualified health care professionals from performing abortions.
Only a physician licensed by the state to practice medicine or osteopathy or other licensed health care practitioner acting within the scope of his or her practice may perform abortions; however, surgical abortions may be performed only by a physician. R.I. Code R. 14 000 009, § 1.4, 1.5, 5.1 (Enacted 1973; Last Amended 2000).
PRO-CHOICE LAWS
Contraceptive Equity
Rhode Island 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, it must provide coverage for Food and Drug Administration-approved prescription contraceptive drugs and devices.
To which insurance plans does the law apply? Individual or group health insurance contracts, plans, or policies issued or renewed in the state, except certain limited benefit policies, that provide coverage for prescription drugs.
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? Religious employers for whom prescription contraceptive methods are contrary to their bona fide religious tenets.
What does the refusal clause allow? An insurer may issue a religious employer a health insurance contract, plan, or policy that excludes coverage for contraception.
Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women? No. The law appropriately defines the term "religious employer" as a tax-exempt church or association of churches or an elementary or secondary school controlled, operated, or principally supported by a church or an association of churches. This definition is appropriately limited in scope, applying to religious entities but not broad-based entities that operate in the public sphere.
Does the law require the refusing entity to notify the persons affected? Yes. An employer exercising a refusal clause must provide written notice to prospective enrollees listing the contraceptive health care services the employer refuses to cover.
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.
R.I. Gen. Laws §§ 27-18-57, -19-48, -20-43, -41-59 (Enacted 2000).
Low-Income Women's Access to Family Planning
Rhode Island provides increased access to reproductive health care services through a Section 1115 waiver. As part of this waiver, the state is allowed to cover family planning services for 24 months for women with incomes at or below 250% of the federal poverty level who would lose Medicaid eligibility postpartum.
Beneficiaries of family planning coverage available through the waiver are not required to pay premiums, but must pay co-payments for covered services.
The waiver will expire on Sept. 30, 2011.
R.I. Rite Care Section 1115 Health Demonstration Fact Sheet, Ctrs. for Medicare and Medicaid Servs., Aug. 1, 2008 at http://www.cms.hhs.gov/MedicaidStWaivProgDemoPGI/downloads/Rhode%20Island%20RIteCare%20Fact%20Sheet.pdf (last visited Oct. 28, 2008); NARAL Pro-Choice America Survey of State Medicaid Offices
OTHER LAWS
Post-Viability Abortion Restriction
Rhode Island's post-viability abortion restriction provides that no abortion may be performed on a "quick child," defined as "an unborn child whose heart is beating, who is experiencing electronically-measurable brainwaves, who is discernibly moving, and who is so far developed and matured as to be capable of surviving the trauma of birth with the aid of usual medical care and facilities," unless necessary to preserve the woman's life. R.I. Gen. Laws Ann. § 11-23-5 (Enacted 1975).
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 Rhode Island's post-viability abortion restriction because it does not contain an exception to protect the health of the woman.
