Low-Income Women's Access to Abortion
Alaska allows women eligible for state medical assistance for general health care to obtain public funds for medically necessary abortion care. An abortion is considered medically necessary if the woman's health is endangered by the pregnancy. State v. Planned Parenthood of Alaska, Inc., 28 P.3d 904 (Alaska 2001); Alaska Medical Assistance Program, Physician Provider Billing Manual, § 1-2, (Rev. June 2012) at http://manuals.medicaidalaska.com/physician/physician.htm.
In 2000, the Alaska legislature enacted an unconstitutional and unenforceable statute eliminating funding for "therapeutic abortions," a category which included abortion services provided to ameliorate a condition harmful to the woman's health. Alaska Admin. Code tit. 7, §§ 47.200(a)(4) (E)-(F) (includes therapeutic abortion amongst funded services), 47.290(8) (defines therapeutic abortion). The statute denies Medicaid assistance for medically necessary abortion services, unless a woman is at risk of dying or her pregnancy resulted from rape or incest. Alaska Admin. Code tit. 7, § 43.140.
A court found that the 2000 statute violated the Alaska constitution because it prohibited funding for some medically necessary abortion care. The court issued a permanent injunction prohibiting its enforcement. State v. Planned Parenthood of Alaska, Inc., 28 P.3d 904 (Alaska 2001).
In 2002, the Alaska legislature enacted a 2003 budget bill providing that no state funds appropriated for medical assistance may be used to pay for an abortion that is not a mandatory service under federal law. Such a budget restriction fails to fund all medically necessary abortion services. H.B. 403, 22d Leg., 2d Sess. (Alaska 2002).
However, the Alaska attorney general found that this budget restriction was unenforceable in light of the court-issued permanent injunction and advised the state to continue to fund medically necessary abortion care. Alaska Op. Att'y Gen. No. 883-02-0028 (June 28, 2002).
A court agreed that the budget restriction was without effect and ordered the state to continue to fund medically necessary abortion services. Planned Parenthood of Alaska, Inc. v. Livey, No. 3-AN-98-07004 CI (Alaska Super. Ct. Aug. 19, 2002).
The legislature has continued to enact similar budget restrictions. H.B. 310 & 312, 25th Leg., 2d Sess. (Alaska 2008). However, in reviewing such restrictions, the state attorney general continues to advise the state to fund medically necessary abortion services in accordance with the decisions of both courts. Alaska Op. Att'y Gen. No. 883-03-0044 (Nov. 18, 2003); Alaska Op. Att'y Gen. No 883-07-0070 (June 6, 2007); Alaska Op. Att'y Gen. No 883-08-0074 (May 9, 2008).
In 2014, the legislature again attempted to restrict Medicaid funding for abortion services by enacting S.B.49, which severely narrows the definition of "medically necessary" to deny Medicaid assistance for abortion services unless a woman is at risk of dying or her pregnancy resulted from rape or incest. S.B.49, 28th Leg., 2d Sess. (Alaska 2014). The law was challenged immediately, and in July 2014, before it would have gone into effect, a court issued a preliminary injunction, blocking enforcement of the law while the legal challenge is pending. Planned Parenthood of the Great Northwest v. Streur, 3AN-14-04711 CI (Alaska Super. Ct. July 17, 2014).