(REVISED 03.21.2018) In 2001, the Alaska Supreme Court held that withholding state Medicaid coverage for abortions while covering all other medically necessary care, including for pregnant women, violated the equal protection clause of the Alaska Constitution. The Court held the state must fund all medically necessary abortions for Medicaid recipients. In 2013, the Alaska Department of Health attempted to circumvent this ruling by adopting a regulation so restrictive that it would prevent most low-income women in Alaska seeking medically necessary abortion services from receiving Medicaid coverage.
The statute and regulation infringe upon physicians’ medical judgment and ethical obligations by limiting coverage for medically necessary abortions to situations in which the woman faces a serious threat of impairment of a major bodily function. For example, a woman with renal disease would only be eligible for coverage if her condition were so severe that she required dialysis treatment.
Withholding medical assistance funding forces low-income women either to delay medically necessary abortions while they raise funds, increasing risks to their health, or to carry a pregnancy to term despite their health conditions.
When abortion was first legalized in 1973, federal funds were available to low-income women seeking medically necessary abortions. But since 1977, under the “Hyde Amendment,” the U.S. Congress has eliminated federal funding for abortion except when necessary to save the woman's life or where the pregnancy results from rape or incest. Seventeen states, including Alaska, and the District of Columbia, provide broader coverage for abortions through state Medicaid programs.
Plaintiff(s): Planned Parenthood of the Great Northwest
Co-Counsel/Cooperating Attorneys: American Civil Liberties Union, Planned Parenthood of the Great Northwest, Planned Parenthood Federation of America, Susan Orlansky at Reeves Amodio, LLC, Tom Stenson (ACLU of Alaska)
Summary: In January 2014, the Center for Reproductive Rights, along with Planned Parenthood Federation of America and the ACLU, challenged the regulation in Alaska Superior Court on behalf of Planned Parenthood of the Great Northwest and its patients, and quickly obtained a temporary injunction blocking the regulation. Shortly thereafter, the Alaska legislature passed a statute adopting an even more narrow definition of “medical necessity.” A challenge to the statute was added to the case against the regulation. The current lawsuit argues that Alaska’s statute and regulation violate the Alaska Constitution’s guarantees of equal protection and privacy. Because a first trimester abortion costs between $650 and $900 in Alaska and may entail the additional costs of air travel and lodging for women living far from clinics, the new Medicaid regulation would make it difficult for many low-income women to access abortion care.