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Arizona

Low-Income Women's Access to Abortion

According to state Medicaid policy, Arizona allows women eligible for state medical assistance for general health care to obtain funds for abortion where:  (1) the procedure is necessary to preserve the life of a woman endangered by a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself; (2) the pregnancy is the result of rape or incest; or (3) abortion is medically necessary because continuation poses a serious physical or mental-health problem for the woman by:  (a) creating a serious physical or mental-health problem; (b) seriously impairing a bodily function; (c) causing dysfunction of a bodily organ; (d) exacerbating a health problem; or (e) preventing the woman from obtaining treatment for a health problem.  Arizona Health Care Cost Containment System (AHCCCS), AHCCCS Medical Policy Manual, Policy 410:  Maternity Care Services, Pregnancy Termination, 410-414 (Rev. Feb. 14, 2003); AHCCCS, AHCCCS Medical Policy Manual, Exhibit 410-1:  Certificate of Necessity for Pregnancy Termination (Rev. Feb. 2003); AHCCCS, AHCCCS Medical Policy Manual, Exhibit 410-2:  Monthly Pregnancy Termination Report (Rev. Feb. 2003).

An unenforceable statute provides that no public funds may be used to pay for abortion care unless necessary to save the woman's life.  Ariz. Rev. Stat. Ann. § 35-196.02.  (Enacted 1980; Amended 2010)

In 2002, the Arizona Supreme Court held that this law violated the Arizona constitution, and because the state funds abortion in cases of life endangerment, rape, or incest, the state must also cover medically necessary abortion services.  The court stopped short of holding that the state must fund medically necessary abortion services to the same extent that it funds other pregnancy-related services.  Simat Corp. v. Arizona Health Care Cost Containment Sys., 56 P.3d 28 (Ariz. 2002).

In 2010, this law was amended to add an additional provision that prohibits the use of public funds to pay for a health contract that includes abortion care unless the procedure is necessary to save the life of the woman or to avert substantial and irreversible impairment of a major bodily function.  Ariz. Rev. Stat. Ann. § 35-196.02(B) (Enacted 2010)  The state Medicaid office's interpretation of circumstances in which coverage is required, as per the court's holding in Simat, is outlined in its policy manual, detailed above.

Certain documentation is required to receive public funding in some cases.  Cases requiring documentation include:  (1) a minor under 18 or an incapacitated adult may not obtain publicly funded abortion care without the written consent of a parent or guardian; and (2) if the pregnancy is the result of rape or incest, documentation must be obtained that the crime was reported to the proper authorities.  AHCCCS, AHCCCS Medical Policy Manual, Policy 410:  Maternity Care Services, Pregnancy Termination, 410-415 (Rev. Feb. 14, 2003); AHCCCS, AHCCCS Medical Policy Manual, Exhibit 410-1:  Certificate of Necessity for Pregnancy Termination (Rev. Feb. 2003); AHCCCS, AHCCCS Medical Policy Manual, Exhibit 410-2:  Monthly Pregnancy Termination Report (Rev. Feb. 2003).

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