Stricter Medicaid abortion process up for debate in Montana
Medical providers, former patients and other opponents presented a wave of testimony Thursday against the state health department’s proposed rule change that would add requirements for an abortion to be covered by Medicaid, including submitting patient medical information to prove a procedure is medically necessary.
Notice of the administrative rule change was first published in late December, the day before Christmas Eve. The proposal is the Department of Public Health and Human Services’ response to a study requested by Republican lawmakers in 2021 into how Medicaid funds are being spent on abortions. While federal law prohibits Medicaid use for most abortions outside of rape, incest or a medical risk to the life of the mother, a state court in 1995 decided that Montana’s state Medicaid dollars must cover abortions if they are deemed “medically necessary.”
More than two dozen people spoke against the proposal during Thursday’s virtual hearing, with at least 90 people in attendance on the call. The sole proponent was Derek Oestreicher, lead counsel for the conservative policy group the Montana Family Foundation, who said the organization supports changing the process to ensure taxpayer funds are not covering “elective non-therapeutic procedures.”
Doctors, nurses and patients with personal abortion stories urged the department to reject its own proposal, saying the rule unfairly targets and delays care for some of Montana’s most financially vulnerable patients and interferes with the patient-provider relationship.
At times, physicians and former patients openly cried during testimony, explaining how personal and time-sensitive abortions can be. One opponent, Lorrie Morgan, recounted an abortion she had as a college student in 2002 when she was on Medicaid. Morgan said her baby had died following a complication during a prenatal medical procedure, though she didn’t realize until her doctor delivered the news during a later appointment.
“It was a very, very sad, shocking time. And I think any barrier to women, getting in between women and their physicians during this time, is unethical. Just period,” Morgan said. “Women and their doctors should be the only ones to be making these decisions. And we need to make these decisions promptly.”