Abortion Providers: Restrictions
Minnesota 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 Where Abortion Services May Be Provided
Minnesota places medically unnecessary restrictions on where abortion services may be provided.
Among the most common TRAP regulations are those restricting the provision of abortion services 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 provide abortion services only in hospitals, an impossibility in many parts of the country.
Minnesota requires all abortion procedures after the first trimester to be provided in a hospital or an "abortion facility." Minn. Stat. Ann. §145.412 subd.1 (2) (Enacted 1974).
Restrictions on Who May Provide Abortion Services
Minnesota prohibits certain qualified health-care professionals from providing abortion services.
Only a physician licensed by the state to practice medicine, or a physician-in-training supervised by a licensed physician, may provide abortion. Minn. Stat. Ann. § 145.412(subd. 1)(1) (Enacted 1974).
Protections: State Consitutional Protection
The Minnesota Constitution protects the right to choose as a fundamental right and to a greater extent than the U.S. Constitution. The Minnesota Supreme Court held that a law limiting state medical assistance for abortion to cases of life endangerment and reported rape and incest was unconstitutional under the state constitutional right to privacy because it prohibited reimbursement for medically necessary abortion services while providing funding for health-care services necessary to carry a pregnancy to term. Women of Minn. v. Gomez, 542 N.W.2d 17 (Minn. 1995). 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).
Minnesota has an unconstitutional and unenforceable provision in its law that no abortion may be provided after the first half of the gestation period (20 weeks) unless necessary to preserve the woman’s life or health. Consistent with sound medical practice, the physician must provide such a procedure "under circumstances which will reasonably assure" fetal survival and a second physician must be "immediately accessible." Minn. Stat. Ann. §§ 145.411 (subd. 2) (Enacted 1974), 145.412 (subd. 3) (Enacted 1974), 145.423 (subd. 2) (Enacted 1976).
A court held that the provision restricting abortion after 20 weeks is unconstitutional because "whether or not a fetus is viable must be left to the medical judgment of the physicians because the point of viability will vary from case to case." Hodgson v. Lawson, 542 F.2d 1350, 1354 (8th Cir. 1976).
NARAL Pro-Choice America supports the legal framework established in Roe v. Wade and does not oppose restrictions on post-viability abortion so long as they contain adequate exceptions to protect the woman’s life and health. NARAL Pro-Choice America opposes Minnesota’s law because it is unconstitutional to the extent that it prohibits pre-viability abortion by defining viability at 20 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).
A woman may not obtain an abortion until at least 24 hours after the attending or referring physician orally, in person or by telephone, (1) informs her of the probable gestational age of the "unborn child"; (2) describes the medical risks associated with the proposed procedure, including, when medically accurate, infection, hemorrhage, breast cancer, danger to subsequent pregnancies, and infertility; (3) describes the risks of carrying the pregnancy to term; and (4) for abortion services provided after the fetus has reached a gestational age of 20 weeks, the physician must tell the woman that anesthesia is available to alleviate possible fetal pain.
In addition, at least 24 hours prior to an abortion, the woman must receive a state-mandated lecture by the physician or physician’s agent, by telephone or in person, that must include: (1) that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care; (2) that the "father" is liable for child support even if he has offered to pay for the abortion; and (3) that she has a right to review state-prepared materials that describe the "unborn child," list agencies that offer alternatives to abortion, and contain information on "fetal pain."
The state-prepared materials must: (1) describe the anatomical and physiological characteristics of the fetus at two-week gestational increments, including the possibility of survival; (2) describe the medical risks associated with the proposed procedure and with carrying a pregnancy to term; (3) state that medical assistance benefits may be available for prenatal care, childbirth, and neonatal care and that the "father" is liable for child support even if he has offered to pay for an abortion; (4) provide a comprehensive list of public and private agencies and services, including adoption agencies, available to assist the woman through pregnancy, upon childbirth, and while the child is dependent or provide a toll-free 24-hour hotline that can be called to obtain such a list; and (5) describe for a fetus of 20 weeks gestation or more, the development of the fetal nervous system and the capacity of the fetus to feel pain, in an objective, nonjudgmental, and scientifically accurate way.
Minn. Stat. Ann. §§ 145.4241, .4242 (Enacted 2003; Last amended 2006), .4243 (Enacted 2003).
In addition, an earlier law provides that no abortion may be provided unless the woman consents after a full explanation of the procedure and its effect. Minn. Stat. Ann. §§ 145.412(subd.1)(4) (Enacted 1974). A court held that this law is constitutional. Hodgson v. Lawson, 542 F.2d 1350 (8th Cir. 1976).
Minnesota requires a woman seeking an abortion to wait at least 24 hours between the time she receives biased-counseling materials and when she can get the procedure.
Insurance Coverage & Abortion
No state measure.
Low-Income Women & Abortion
Restricts Low-Income Women’s Access to Abortion
Minnesota allows women eligible for state medical assistance for general health care to obtain public funds for abortion: (1) to preserve the life of a woman endangered by a physical disorder, physical injury, or a physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself; (2) if the pregnancy resulted from rape or incest; (3) for health/therapeutic reasons. Minn. Dep’t of Human Servs., Minnesota Health Care Programs Provider Manual, ch. 10, p. 27 (Sept. 26, 2013).
Unconstitutional and unenforceable statutes and an administrative rule prohibit public funds for abortion unless: (1) two physicians certify that the procedure is medically necessary to preserve her life; (2) the pregnancy is the result of criminal conduct and the incident is reported within 48 hours after the victim becomes physically able to report the crime; or (3) the pregnancy is the result of incest and the incident and relative are reported to a valid law-enforcement agency for investigation. Minn. Stat. Ann. § 256B.0625 (subd. 16) (Original Statute Enacted 1967; Relevant Provision Enacted 1978; Last Amended 1987); Minn. R. § 9505.0235(subp. 2).
A court held that the provisions limiting abortion coverage to life endangerment, rape, and incest, while permitting the use of funds for childbirth medical services, violate the Minnesota constitution and issued a permanent injunction prohibiting their enforcement. Women of Minn. v. Gomez, 542 N.W.2d 17 (Minn. 1995).
Young Women & Abortion
Minnesota law restricts young women’s access to abortion.
Is the law enforceable? Yes. The United States Supreme Court held that this law is constitutional. Hodgson v. Minnesota, 497 U.S. 417 (1990).
Who is considered a minor? A young woman under the age of 18.
What is required – parental consent or parental notice? Notice.
Who must be notified? Both parents.
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 until at least 48 hours after written notice has been personally delivered by the physician to both parents, unless only one parent is living, the second parent cannot be located through "resonably diligent effort," or the abortion is authorized in writing by the persons entitled to notice. If notice is given by certified mail, the 48-hour period begins to run at noon on the next day on which regular mail delivery takes place.
May the parental mandate be waived if a young woman is a victim of rape or incest? Yes, by declaring that she is a victim of sexual abuse, which must then be reported to the proper authorities.
May the parental mandate be waived if a young woman is a victim of child abuse? Yes, by declaring that she is a victim of physical abuse or neglect, which must then be reported to the proper authorities.
May the parental mandate be waived if a young woman’s health is threatened? No.
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 without parental consent is in her best interests.
Are there other significant requirements under the law? No.
Has a court considered the constitutionality of this law? Yes. The U.S. Supreme Court has ruled that this law is constitutional. Hodgson v. Minnesota, 497 U.S. 417 (1990).
Other information about the law: None.
Minn. Stat. Ann. §§ 144.343 (Enacted 1971; Last Amended 1986), 645.451(subd.2) (Enacted 2004).
Insurance Coverage & Contraception
No state measure.
Low-Income Women & Contraception
Supports Low-Income Women’s Access to Contraception
Minnesota provides increased access to reproductive-health-care services through a Section 1115 family-planning waiver. The waiver allows the state to cover family-planning services for men and women between the ages of 15 and 50 with incomes at or below 200 percent of the federal poverty level who are not enrolled in other Minnesota health plans. Additionally, enrollees must be (1) U.S. citizens or persons who meet the state’s defined immigration requirements and (2) Minnesota residents.
Beneficiaries of family-planning coverage available through the waiver are not required to pay premiums or co-payments for covered services. Covered services include: contraceptive counseling and information; contraceptive supplies, devices, implants and prescriptions; office visits, consultation, examination and medical treatment provided in conjunction with family-planning services; voluntary sterilization; diagnosis, testing and treatment of STIs found during a family-planning visit; HIV testing and counseling.
The waiver is temporarily extended through Dec. 31, 2016.
Minn. Family Planning Program, Project No. 11-W-00183/5, at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/mn/mn-family-planning-ca.pdf.
EC in the ER
Minnesota 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 and oral information about EC, offer her EC, and provide EC to her upon request. Hospitals are allowed to administer pregnancy tests and if the test is positive, the hospital does not have to provide the woman with EC. Minn. Stat. Ann. §§ 145.4711 to .4712 (Enaced 2007).
Other Important Issues
A person who intentionally and physically obstructs an individual’s access to or egress from a hospital or medical facility is guilty of a gross misdemeanor. A person whose access is obstructed may bring an action for damages, injunctive relief, attorneys’ fees, costs, and an additional civil penalty of up to $1000 for each violation. Minn. Stat. Ann. § 609.7495 (Enacted 1993; Last Amended 2002).
Crisis Pregnancy Centers
State Funds Crisis Pregnancy Centers
Minnesota funds crisis pregnancy centers (CPCs) directly through taxpayer funds. The funding stream is established through a "Positive Abortion Alternatives" program, administered by the Department of Health. In FY’16 and FY’17, CPCs are eligible to receive $1 million each fiscal year through this funding stream. Minn. Stat. Ann. § 145.4235 (Enacted, 2005; Last Amended, 2015).
State Refers to Crisis Pregnancy Centers
Minnesota law refers women to crisis pregnancy centers (CPCs). In connection with the state’s biased-counseling and mandatory-delay law, when a woman tells a health-care provider she is considering abortion, the provider must give her a state-maintained list of facilities that will satisfy the law’s mandate. CPCs are included on the list without disclaimer of their biased nature and are not distinguished from legitimate health centers. Minn. Stat. Ann. § 145.4243 (Enacted, 2003).
Refusals & Guarantees
Refusals of Medical Care
ABORTION REFUSAL CLAUSE
Minnesota allows certain individuals or entities to refuse to provide abortion services.
To whom does the refusal clause apply? Individuals, hospitals, or institutions.
What does the refusal clause allow? No person, hospital, or institution may be coerced, held liable, or discriminated against in any way because of a refusal to provide, accommodate, or assist in abortion services for any reason. No physician, nurse, or other person who refuses to provide or assist in abortion care may be dismissed, suspended, demoted, or otherwise prejudiced by a hospital with which the person is affiliated or employed. No health-plan company or health-care cooperative may be required to provide abortion services or coverage.
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.
Has a court considered the constitutionality of this law? A court held that the provision regarding hospitals and institutions is unconstitutional as applied to public hospitals and institutions. Hodgson v. Lawson, 542 F.2d 1350 (8th Cir. 1976).
Minn. Stat. Ann. §§ 145.414 (Enacted 1974; Last Amended 1995), .42 (Enacted 1971; Last Amended 1986).
FAMILY-PLANNING REFUSAL CLAUSE
Minnesota allows certain individuals to refuse to provide family-planning services.
To whom does the refusal clause apply? State employees.
What does the refusal clause allow? Allows state employees to refuse to provide family-planning services if such duty is contrary to personal beliefs. The refusal to provide such services may not be the basis for employment discrimination. When an employee refuses to provide family-planning services, the director or supervisor of the state agency must reassign that employee’s duties.
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 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. However, the director or supervisor of the state agency is authorized to reassign the duties of the employee in order to provide family-planning services effectively.
Minn. Stat. Ann. § 145.925 (Enacted 1978).
Counseling & Referral Bans
Counseling & Referral Ban
Family-planning grants made available by the Minnesota health commissioner may not pay for abortion services or referrals. Minn. Stat. Ann. § 145.925 (Enacted 1978; Last Amended 1997).
The Minnesota health commissioner also cannot make available grants under the Positive Abortion Alternatives program to an organization that provides, counsels, or refers for abortion. A grant recipient cannot have the same or similar name as an organization that provides such services. Minn. Stat. Ann. § 145.4235 (Enacted 2005; Last Amended 2012).