Bill aims to prohibit Montana Medicaid abortion funding in most instances

Sponsor calls measure Montana’s Hyde Amendment

By: - March 27, 2023 6:22 pm

The Montana state Capitol in Helena on Jan. 2, 2023. (Photo by Blair Miller, Daily Montanan)

The House Judiciary Committee heard testimony on a bill Monday that would prohibit public funds from being used to pay for abortions unless they were the result of rape or incest, or if the mother’s life is at risk.

House Bill 862 sponsor Rep. Mike Hopkins, R-Missoula, said committee members, regardless of party, should agree that state tax dollars should not be used to fund abortions no matter where they stand on the issue of abortion.

“It’s not unreasonable. It hasn’t been unreasonable for the last 40 years. And it’s not going to be unreasonable when it’s the law in the state of Montana,” Hopkins said.

Opponents, who had the majority of testimony on the bill, said it would functionally act as a ban on abortions for low-income Montanans who could not afford them and would end up costing the state more in the long-term when those children have to be supported by taxpayer money.

“Forcing someone to give birth against their will is unconscionable, and Montanans will not stand for this government intrusion into our private lives and our personal decisions,” said Aileen Gleizer, with Missoula’s Blue Mountain Clinic. “If you pass this law, you’ll be responsible for harming low-income Montana families and burdening Montanans with costs of paying for forced child bearing.”

Hopkins told the committee the bill was simple — that it would create a Montana Hyde Amendment, which bans the use of taxpayer dollars for abortions for people on Medicaid and Medicare in most cases. Montana is currently one of 16 states that uses its own state funds to cover certain abortions under Medicaid, according to the Kaiser Family Foundation.

In the 1995 decision in Jeannette R. vs. Ellery, a Montana court found the state had a statutory obligation to pay for medically necessary abortions under the Montana Medicaid program through the general fund.

Physicians performing a Medicaid-covered abortion have to certify they are doing so under one of three reasons: The procedure is necessary to save the life of the mother; the pregnancy was due to rape or incest; or it is medically necessary, “but the member’s life is not endangered, with space to provide an optional explanation.”

Hopkins’ proposal would limit public funds from being used for an abortion except under two circumstances: if the pregnancy is the result of rape or incest; or if a physician certified that the mother was in danger of dying unless an abortion is performed.

That differs from the administrative rule proposed by the Department of Public Health and Human Services, which says Montana Medicaid could also cover abortions when, “although it does not place the woman in danger of death unless an abortion is performed, a woman suffers from a physical or psychological condition that would, as certified by a physician, be significantly aggravated by the pregnancy.”

That proposed rule, which would require physicians performing abortions under Medicaid to require patients provide personal information about why an abortion is “medically necessary” and should be eligible for reimbursement, underwent a public hearing in January and is still awaiting full implementation.

Representatives for the Montana Family Foundation and the Montana Catholic Conference spoke as proponents of HB862 Monday. Montana Family Foundation President Jeff Laszloffy said the idea was not new and did not prohibit abortion.

“Taxpayer money should not be used to support a procedure that many people find objectionable,” he said. “This is especially true when that same taxpayer money could be used to provide preventative care or treatment for chronic diseases.”

Another bill that has already passed the House and been referred to a Senate committee, Bozeman Republican Rep. Jane Gillette’s House Bill 544, would limit Medicaid-covered abortions so they could only be performed by a physician. The bill would also allow for reimbursements with physician certification if the mother’s life was in danger; if the pregnancy was caused by rape or incest; or if the mother’s life was not in danger, if she had physical or mental illnesses that would be aggravated by a pregnancy.

The fiscal note for Hopkins’ bill from the Governor’s Office of Budget and Program Planning says its language conflicts with HB544. It says there were 648 Medicaid-covered abortion in Montana in FY2022, a number which is estimated to grow by about 20 during each of the next four years. Each abortion costs an estimated $400.

Opponents of the bill, including Montana abortion providers, civil rights groups, and citizens, said they believed that in addition to harming low-income people, the measure infringed on the right to privacy under the Montana Constitution.

In the 1999 Armstrong vs. State decision, the Montana Supreme Court held that the right to privacy means a woman can choose to have an abortion “unless the state can demonstrate a compelling interest for infringing the right.”

Danielle Vazquez, speaking on behalf of Montana Women Vote, said the bill would make low-income families suffer even more financially.

“Politicians shouldn’t be able to deny anyone access to health care services, including abortions, just because of their income or who their insurance provider is,” she said.

Jennifer Hensley, representing Missoula County at the hearing, also wondered how the bill might affect the county’s employee-funded insurance plan, which does not take any Medicaid funding.

Repeatedly asked by Rep. Laurie Bishop, D-Livingston, if he intended for the bill to apply to such plans as well, Hopkins said he did not have a current answer and would like time to think before coming to a conclusion.

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Blair Miller
Blair Miller

Blair Miller is a reporter based in Helena who primarily covers government, climate and courts. He's been a journalist for more than 12 years, previously based in Denver, Albuquerque and mid-Missouri.