Alaska House votes to defund Medicaid abortion services despite court rulings requiring it

JUNEAU — Defying court rulings, the Alaska House of Representatives voted 21-18 on Wednesday to cut Alaska’s Medicaid budget by $350,000 in an attempt to eliminate state funding for abortion services.

The vote is the latest in a yearslong series of attempts by Alaska legislators to cancel public funding for abortion services. Prior votes have had little effect. The state has shifted Medicaid funding from other sources and continued to provide abortions. In 2021, according to the latest available figures, Medicaid funded 537 of 1,226 abortions in Alaska.

Despite the limited effects of prior amendments, this year’s proposal could have significant effects if signed into law. Last year, as they considered a similar amendment, lawmakers were warned that the language of the restriction could endanger all state funding for Medicaid if it were challenged in court. They ultimately decided to use different wording proposed by the state Senate.

The Alaska Supreme Court has repeatedly ruled that the right to an abortion is protected by the state’s constitutional right to privacy, and the court ruled in 2001 that the state would violate the constitution’s equal protection clause and discriminate against poor women if it denied abortion services under Medicaid.

Speaking Wednesday, several legislators said they believe strongly enough on the topic to vote in favor of the budget amendment, even if it is unconstitutional.

“I don’t really care if we have to run it through the courts a hundred times,” said Rep. Kevin McCabe, R-Big Lake.

Rose O’Hara-Jolley, Alaska state director of Planned Parenthood Alliance Advocates, which advocates for abortion access, said the anti-abortion measure “is unethical, unconstitutional, and puts cruel and inequitable restrictions on abortion access for people with low incomes. The bottom line is that everyone — no matter how much money they make, how much wealth they have, or who provides their insurance — should be able to access the full range of reproductive health care, including abortion.”

The amendment came from Rep. Christopher Kurka, R-Wasilla. It was supported by all 18 members of the House’s Republican minority as well as independent Republican Rep. Sara Rasmussen, R-Anchorage. Majority Reps. Kelly Merrick, R-Anchorage and Josiah Patkotak, I-Utqiagvik, provided the 20th and 21st votes.

Access to abortion — state-paid or not — is legally protected in Alaska by several rulings of the Alaska Constitution and would not be immediately affected if the U.S. Supreme Court overturns its landmark 1972 decision in Roe v. Wade.

A decision on that issue is expected this summer, and Rep. George Rauscher, R-Sutton said he expects Roe to be overturned one day.

“People are going to realize that when there’s a heartbeat, this child is a person,” he said.

Rep. Ron Gillham, R-Kenai, said he believes life begins at conception and cited the language of the state constitution in saying that legislators have an obligation to protect unborn residents.

Rep. Sarah Vance, R-Homer, argued in support of the amendment, saying she unexpectedly became pregnant at 23 and lived in denial until she heard her daughter’s heartbeat.

“This is more than just dollars or just court orders. This is the very lives of our future,” she said.

Rep. Sara Hannan, D-Juneau, opposed the amendment, calling abortion “fundamental health care for women,” and Rep. Liz Snyder, D-Anchorage, shared the story of her own difficult pregnancy. She said her doctor told her that without modern medical care, she might have died.

“Don’t put women in that position,” she said.

The House is expected to consider further budget amendments through the end of the week. If the abortion-funding amendment remains, it and the rest of the budget will advance to the Senate, which is at work on a competing proposal.

That proposal, now in the Senate Finance Committee, contains a $180,000 cut to Medicaid services and language saying the state should not pay for non-mandatory abortions.

If House and Senate approve different proposals, the differences will be ironed out by a conference committee intended to write a compromise.