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State Laws

Massachusetts


Political Information

Executive (Governor)

Mixed-choice

Senate

Pro-choice

House

Pro-choice

Abortion-Care Policies

Abortion Providers

Abortion Providers: Restrictions

Massachusetts imposes extra restrictions on abortion providers, despite the fact that all health-care providers already must comply with a variety of federal and state regulations governing health, safety, building and fire codes, and zoning requirements.  

Restrictions on Who May Provide Abortion Services

Massachusetts prohibits certain qualified health-care professionals from providing abortion services.

Only a physician authorized to practice medicine in the state may provide abortion.  Mass. Gen. Laws Ann. ch. 112, § 12K (Enacted 1974; Last Renumbered 1977; Last Amended 2005), Mass. Gen. Laws Ann. ch. 112, § 12L (Enacted 1974; Last Renumbered 1977).


Abortion Rights

Protections: State Consitutional Protection

The Massachusetts Declaration of Rights protects the right to choose as a fundamental right and to a greater extent than the U.S. Constitution.  The Massachusetts Supreme Judicial Court held that a law limiting state medical assistance for abortion to cases of life endangerment was unconstitutional under the Declaration of Rights because it prohibited reimbursement for medically necessary abortion services.  Moe v. Sec’y of Admin. & Fin., 417 N.E.2d 387 (Mass. 1981).  A similar restriction has been upheld by the U.S. Supreme Court under the U.S. Constitution.  Williams v. Zbaraz, 448 U.S. 358 (1980).

The Massachusetts Supreme Judicial Court held that imposing a two-parent consent requirement upon a minor seeking abortion care, even with a judicial bypass, is unconstitutional under the Declaration of Rights.  Planned Parenthood League of Massachusetts, Inc. v. Attorney General, 677 N.E.2d 101 (Mass. 1997).  The U.S. Supreme Court has held that a two-parent notice requirement with a judicial bypass is constitutional.  Hodgson v. Minnesota, 497 U.S. 417 (1990).


Post-Viability Ban

Massachusetts’ post-viability abortion restriction states that, after 24 weeks, no abortion may be provided unless necessary to preserve the woman’s life or to prevent a "substantial risk of grave impairment of her physical or mental health."  The physician must take all reasonable steps, consistent with the procedure used and good medical practice, to preserve the life and health of the fetus.  Mass. Gen. Laws Ann. ch. 112, § 12M (Enacted 1974; Last Renumbered 1977), 12P (Enacted 1974; Last Renumbered 1977).

NARAL Pro-Choice America supports the legal framework established in Roe v. Wade. Regarding the right to abortion in the third trimester, Roe allows for restrictions on post-viability abortion so long as they contain adequate exceptions to protect the woman’s life and health. However, many states have bans with inadequate exceptions, no exceptions at all, or define viability as occurring at a particular point in pregnancy. A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside 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. NARAL Pro-Choice America opposes Massachusetts’ post-viability restriction because the health exception is dangerously narrow.  NARAL Pro-Choice America further opposes this law because it is unconstitutional to the extent that it prohibits pre-viability abortion by defining viability at 24 weeks.  A state may not prohibit abortion prior to viability, which is that point at which a fetus is capable of "meaningful life" outside 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).


Biased Counseling

Biased Counseling

Massachusetts has a partially unconstitutional and unenforceable law that provides that a woman may not obtain an abortion until at least 24 hours after she signs a consent form that must include:  (1) a description of the stage of development of the "unborn child"; (2) the type of abortion procedure to be used and the possible complications of the abortion; (3) the availability of alternatives to abortion; and (4) a statement that a woman’s choice not to terminate a pregnancy shall not constitute grounds for the denial of public assistance.  Mass. Gen. Laws Ann. ch. 112, § 12S (Enacted 1974; Last Amended 1980).

A court held that the mandatory delay and the requirement that the consent form include a description of fetal development are unconstitutional.  Planned Parenthood League of Mass., Inc. v. Bellotti, No. 80-1166-MA (D. Mass. Nov. 4, 1987).


Mandatory Delays

Mandatory Delay

Massachusetts has a partially unconstitutional and unenforceable law that provides that a woman may not obtain an abortion until at least 24 hours after she signs a consent form that includes biased-counseling information. Mass. Gen. Laws Ann. ch. 112, § 12S (Enacted 1974; Last Amended 1980).

A court held that the mandatory delay and the requirement that the consent form include a description of fetal development are unconstitutional.  Planned Parenthood League of Mass., Inc. v. Bellotti, No. 80-1166-MA (D. Mass. Nov. 4, 1987).


Insurance Coverage for Abortion

No state measure.

Abortion Coverage for Low-Income People

Restricts Low-Income Women’s Access to Abortion

Massachusetts allows women eligible for state medical assistance for general health care to obtain public funds to pay for medically necessary abortion services, or for abortion care if the woman is a victim of rape or incest reported to a law-enforcement agency or public-health authority within 60 days of the incident.  A medically necessary abortion is one which is necessary in light of all factors affecting the woman’s health.  Mass. Regs. Code tit. 130, § 484.001, 433.455 at http://www.mass.gov/Eeohhs2/docs/masshealth/regs_provider/regs_physician.pdf.

A court held that a previous statute that prohibited state funds from paying for abortion services except to preserve the woman’s life was unconstitutional under the Massachusetts Declaration of Rights because it prohibited reimbursement for medically necessary abortion services.  Moe v. Sec’y of Admin. & Fin., 417 N.E.2d 387 (Mass. 1981).


Young People & Abortion

Parental Consent

Massachusetts law restricts young women’s access to abortion.

Is the law enforceable?  Yes, although a state court held that the two-parent requirement is unconstitutional and unenforceable under the due-process provisions of the Massachusetts Declaration of Rights as an unjustified burden on a young woman’s right to choose.  The court issued an order that the law be construed to require the consent of only one parent.  Planned Parenthood League of Mass., Inc. v. Attorney General, 677 N.E.2d 101 (Mass. 1997).

Who is considered a minor?  A young woman under the age of 18 and not married.

What is required – parental consent or parental notice?  Consent.

Who must provide consent?  Pursuant to a court’s decision, one parent.  (As written, two parents).

Are there other trusted adults who may provide consent instead?  No.

What is the process for obtaining consent?  As written, a young woman may not obtain an abortion unless the attending physician secures the written consent of both parents.  However, consent of one parent is sufficient if one of the young woman’s parents has died or is unavailable.  Consent of the custodial parent is sufficient if her parents are divorced.

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.  A doctor may provide an abortion without the young woman’s parents’ consent "in 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 giving 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?  Yes.  A court has ruled that the two-parent requirement is unconstitutional under the State Declaration of Rights and issued an order that the law be construed to require the consent of only one parent.  Planned Parenthood League of Mass., Inc. v. Attorney General, 677 N.E.2d 101 (Mass. 1997).

Other information about the law:  None.

Mass. Gen. Laws Ann. ch. 112, § 12S (Enacted 1974; Last Amended 1980).


Family-Planning Policies

Insurance Coverage & Contraception

Supports Insurance Coverage of Contraception

Massachusetts law requires health-insurance plans that cover prescription medication to provide equitable coverage for contraception.

What is required?  If a health-insurance plan provides coverage for outpatient prescription medication and devices or outpatient services, it must provide coverage for any Food and Drug Administration-approved outpatient prescription contraception or outpatient contraceptive services.

To which insurance plans does the law apply?  Individual and group insurance policies, individual or group medical or hospital service agreements, and health maintenance organization (HMO) policies issued or renewed on or after January 1, 2003 that provide coverage for prescription medication and devices or outpatient services.

Does the law provide additional protections for women?  Yes.  Coverage for prescription contraception and outpatient contraceptive services must be provided under the same terms and conditions as those for other prescription medication and devices and other outpatient services.

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?  Employers that are churches or qualified church-controlled organizations.

What does the refusal clause allow?  A church or qualified church-controlled organization is not required to provide equitable coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?  No.

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 provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  No.

Mass. Gen. Laws Ann. ch. 175, § 47W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176A, § 8W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176B, § 4W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176G, § 4O (Enacted 2002).


Improves Insurance Coverage of Contraception

Massachusetts law builds upon federal law by requiring that insurers cover all unique therapeutic products for contraception without cost-sharing. Insurers must also cover patient education and counseling on contraception, and related services, such as device insertion and removal. Mass. Gen. Laws Ann. ch. 175, § 47W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176A, § 8W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176B, § 4W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176G, § 4O (Enacted 2002, Last Amended 2017).


Improves Insurance Coverage of Contraception

Massachusetts law requires health-insurance plans to cover dispensing of a 12-month supply of prescription contraceptives after an initial dispensing of 3 months. Mass. Gen. Laws Ann. ch. 175, § 47W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176A, § 8W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176B, § 4W (Enacted 2002, Last Amended 2017); Mass. Gen. Laws Ann. ch. 176G, § 4O (Enacted 2002, Last Amended 2017).


Contraception Coverage for Low-Income People

Improves Insurance Coverage of Contraception

Massachusetts law requires health-insurance coverage through Medicaid to provide benefits that allow for dispensing a 12-month supply of prescription contraceptive drugs at one time. Mass. Gen. Laws Ann. ch. 118E, § 10K (Enacted 2017).


Supports Low-Income Women’s Access to Contraception

Massachusetts provides Medicaid coverage of over-the-counter emergency contraception without a prescription. Mass. Gen. Laws Ann. ch. 118E, § 10K (Enacted 2017).


Emergency Contraception

EC in the ER

Massachusetts law ensures that sexual-assault survivors receive access to emergency contraception (EC) in hospital emergency rooms.  As part of the minimum standards for the examination and treatment of a sexual-assault survivor, a physician or other health-care provider must provide a woman with medically and factually accurate written information about EC, offer her EC, and provide EC to her upon request.

Mass. Gen. Laws Ann. ch. 41, § 97B (Original Statute Enacted 1974; last amended 2005); Mass. Gen. Laws Ann. ch. 111, § 70E (Original Statute Enacted 1979; last amended 2005).


Other Important Issues

Clinic Protections

Clinic Protections

A law-enforcement official may order the immediate dispersal of a gathering of two or more people that substantially impedes access to (defined as to block, detain, render access unsafe or difficult, or departure from) an entrance or a driveway to a reproductive-health-care facility (defined as a place where abortion services are provided, other than a hospital).  Following such order, protesters must immediately disperse at least 25 feet from an entrance or a driveway to the reproductive-health-care facility for eight hours, or until the close of clinic business hours.  The 25-foot boundary must be clearly delineated and the law posted outside a reproductive-health-care facility.  Failure to comply with such order shall be punishable by fine, jail, or both.  

If a person intentionally injures or attempts to injure a person attempting to enter a reproductive-health-care facility shall be punishable by fine or jail, or both.  If a person impedes or interferes with the operation of a vehicle attempting to enter or depart from a reproductive-health-care facility shall be punished by a fine or jail.  

If a person fails to comply with a dispersal order or fails to comply with other sections of the law, civil action can be pursued.  A court may award as remedies: (1) temporary, preliminary, and permanent injunctive relief; (2) compensatory and punitive damages; and (3) costs, attorneys’ fees, and expert witness fees.  In an action brought by the attorney general the court may also award civil penalties.  Any violation of an injunction is considered a criminal offense.  Mass. Gen. Law Ann. ch. 266, §120E½  a-i (Enacted 2014).  


Refusals & Guarantees

Refusals of Medical Care

ABORTION REFUSAL CLAUSE

Massachusetts allows certain individuals or entities to refuse to provide abortion services.

To whom does the refusal clause apply?  Physicians, persons associated with, employed by, or on the medical staff of a hospital or health facility, private hospitals, or health facilities.

What does the refusal clause allow?  Allows physicians or persons associated with, employed by, or on the medical staff of a hospital or health facility, who object in writing on moral or religious grounds, to refuse to participate in medical procedures that result in an abortion.  The refusal to participate may not be a basis for a claim for damages or other recriminatory action.  The refusal of an applicant to a medical, nursing, social work, or psychology program to agree to counsel, suggest, recommend, assist, or in any way participate in abortion due to moral or religious objection may not be a basis for discrimination.

Conscientious objection to abortion may not be a basis for discrimination in employment, refusal to grant financial assistance by a state-aided program, or detrimental action by a program or institution supported at least in part by the state.  Allows private hospitals and health facilities to refuse to admit a woman for the purpose of providing abortion services.  The refusal to admit may not be a basis for discrimination by any person or entity.

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.

Mass. Gen. Laws Ann. ch. 112, § 12I (Enacted 1973; Last Amended 1981); Mass. Gen. Laws Ann. ch. 272, § 21B (Enacted 1973).

FAMILY-PLANNING REFUSAL CLAUSE

Massachusetts allows certain entities to refuse to provide family-planning services.

To whom does the refusal clause apply?  Private hospitals or other health facilities.

What does the refusal clause allow?  Allows private hospitals and health facilities to refuse to admit a woman for the purpose of receiving contraception if such services are referrals are contrary to the religious or moral principles of the hospital or facility.  In addition, allows private hospitals and health facilities to refuse to furnish or provide referrals for contraception or family-planning services if such services are contrary to the religious or moral principles of the hospital or facility.

Does the law require the refusing individual or 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 contraception or family-planning 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.

Mass. Gen. Laws Ann. ch. 272, § 21B (Enacted 1973).

INSURANCE COVERAGE FOR CONTRACEPTION REFUSAL CLAUSE

Although Massachusetts law requires health insurance plans that cover prescription medication to provide equitable coverage for contraception, certain employers may require that their plans exclude coverage for contraception.

To whom does the refusal clause apply?  Employers that are churches or qualified church-controlled organizations.

What does the refusal clause allow?  A church or qualified church-controlled organization is not required to provide equitable coverage for contraception.

Is this refusal clause overbroad, jeopardizing insurance coverage for contraception for women?  Yes.  The law applies to churches or qualified church-controlled organizations as defined by federal law.

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 provide a mechanism for women to obtain contraceptive coverage if their employer exercises a refusal clause?  No.

Mass. Gen. Laws Ann. ch. 175, § 47W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176A, § 8W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176B, § 4W (Enacted 2002); Mass. Gen. Laws Ann. ch. 176G, § 4O (Enacted 2002).

STERILIZATION REFUSAL CLAUSE

Massachusetts allows certain individuals or entities to refuse to perform or participate in sterilization procedures.

To whom does the refusal clause apply?  Physicians, persons associated with, employed by, or on the medical staff of a hospital or health facility, private hospitals, or health facilities.

What does the refusal clause allow?  Allows physicians and persons associated with, employed by, or on the medical staff of a hospital or health facility, who object in writing on moral or religious grounds, to refuse to participate in medical procedures that result in sterilization.  The refusal to participate may not be a basis for a claim for damages or other recriminatory action.  The refusal of an applicant to a medical, nursing, social work, or psychology program to agree to counsel, suggest, recommend, assist, or in any way participate in a sterilization due to moral or religious objection may not be a basis for discrimination.  Allows private hospitals and health facilities to refuse to admit a woman for the purpose of performing a sterilization.  The refusal to admit may not be a basis for discrimination by any person or entity.

Must the refusal be in writing?  Yes.

Does the law require the refusing individual or 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 sterilizing procedures?  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.

Mass. Gen. Laws Ann. ch. 112, § 12I (Enacted 1973; Last Amended 1981); Mass. Gen. Laws Ann. ch. 272, § 21B (Enacted 1973).


Counseling & Referral Bans

No state measure.

Everyone should be able to decide if, when, how, and with whom they start or grow a family.

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