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Lawmaker revives telemedicine bill that could restrict abortions

FILE: Representative Ken Ivory speaks in the Utah House of Representatives in 2015. On Monday, Jan. 30, 2017, Ivory presented to the House Public Utilities, Energy and Technology Committee a bill meant to modernize the reimbursement models for doctors who
FILE: Representative Ken Ivory speaks in the Utah House of Representatives in 2015. On Monday, Jan. 30, 2017, Ivory presented to the House Public Utilities, Energy and Technology Committee a bill meant to modernize the reimbursement models for doctors who offer their services via teleconference.
Scott G Winterton, Deseret News

SALT LAKE CITY — A bill that seeks to expand telemedicine services in Utah found itself at the center of a debate over abortion Monday.

Rep. Ken Ivory, R-West Jordan, who presented HB154 to the House Public Utilities, Energy and Technology Committee, said the bill is meant to modernize the reimbursement models for doctors who offer their services via teleconference.

But four lines at the end of the bill have the attention of abortion rights activists.

Those lines state that a practitioner “may not issue a prescription through electronic prescribing for a drug or treatment to cause an abortion,” except in cases of rape, incest or life endangerment of the mother.

Lawmakers clashed in the meeting over whether the bill goes too far in restricting abortion access for rural women.

As the use of audio and video conferencing for doctors has become a more popular — particularly as a way to reach patients in rural areas — the question of whether it is a safe or appropriate avenue for abortions has grown.

Ivory ran a similar bill last year that passed the House but never made it to the Senate floor for debate.

Among other things, the bill would require insurance companies to state whether they cover telemedicine services.

Rep. Lynn Hemingway, D-Millcreek, said the abortion section of the bill “seemed like an add-on,” a concern that the Planned Parenthood Association of Utah also raised last year.

“I’m not a doctor, but is this a necessary part of this bill?” Hemingway asked. “… Do you think that’s fair to the patient who can’t get here?”

Ivory defended the restriction as a necessary condition “for safety and health.”

“An abortion being something that terminates a life, to do that without ever seeing the patient, without having contact with the patient — as a matter of state policy, we’re putting in code that we don’t believe that’s appropriate,” Ivory said.

A so-called medication abortion consists of two pills. The first blocks a hormone called progesterone. The second, usually taken a day or two later, causes cramping and emptying of the uterus, similar to a miscarriage.

Together, the two steps are sometimes referred to as the “abortion pill.”

About 31 percent of abortions in the U.S. in 2013 were medication abortions, according to the Guttmacher Institute. The rest were in-clinic procedures.

The American Congress of Obstetricians and Gynecologists supports the use of telemedicine to administer medical abortions and says it can be done safely and effectively.

But Rep. Keith Grover, R-Provo, argued that some members of the national organization — including his wife — take issue with its official stance.

Rep. Patrice Arent, D-Millcreek, proposed an amendment to strike the last four lines of the bill, arguing that they mar an otherwise strong bill.

“We should not be impairing the ability of physicians to provide the most appropriate treatments that are legal,” Arent said. “There is a constitutional right to safe, legal abortion.”

The committee voted to give the bill a favorable recommendation, 9-2, along party lines.

If passed, the bill may have little impact in Utah currently, where telehealth services are still growing. The Planned Parenthood Association of Utah does not offer medical abortions via telemedicine because it does not have a telemedicine system set up, according to spokeswoman Katrina Barker.

The reproductive health organization still opposes the bill, which amounts to a new "trap law," according to Barker. In a statement, Planned Parenthood Association of Utah President Karrie Galloway said that "no matter where a woman lives, she should be able to access safe, quality health care."

A similar law in Idaho was declared unconstitutional by a federal district court judge earlier this month.