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Utah Senate gives initial OK to expanding family planning services through Medicaid

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SALT LAKE CITY — The Senate gave initial approval to a bill that would allow more Utahns to receive family planning services and birth control under Medicaid, but not before amending the legislation to compromise with several Republican lawmakers who expressed concerns.

SB74 passed after a lengthy debate punctuated by bill sponsor Sen. Derek Kitchen’s decision to circle the bill part way through to address those concerns. Not long after, the Salt Lake Democrat brought an amended version of the legislation back to the floor where it was approved 19-6. The bill still needs to go before the Senate for final approval.

SB74 would require the state Division of Health Care Financing to apply for a Medicaid waiver or state plan amendment seeking a 90/10 match of federal government funds. If the federal government were to approve the waiver, Utah women making up to 250% of the federal poverty level — about $30,000 a year — would be granted family planning services.

“This is widely considered the level at which individuals and families are in need of family planning services the most,” Kitchen said.

Kitchen estimated that the savings on such a policy could possibly be “in the neighborhood of about about $10 million a year.”

Utah is also one of the few states without a publicly funded family planning service, he said, pointing out that similar policies have been implemented in both red and blue states.

“With this policy, we can prevent about 2,000 unintended pregnancies,” Kitchen said. “We can anticipate preventing about 730 abortions a year. It’s money well spent.”

Citing his “inherent opposition to abortion,” Sen. Curtis Bramble, R-Provo, said he’s had significant discussions with Kitchen about the legislation. He said he finds certain aspects of the bill favorable, but takes issue with one of its provisions.

“I understand that on one hand the notion that providing birth control will reduce abortions and I think that is very, very positive,” Bramble said. “My concern is will this mean under federal law that those contraceptions will be provided to minors with no parental involvement.”

Kitchen confirmed his concerns, saying there is a Supreme Court decision that makes publicly funded family planning services available to minors without parental consent. However, he pointed out that from a policy standpoint, that the requirement is for lower-income families.

“This is for a family that may have less stability than a lot of us here. The parents may be working multiple jobs — they may be hands off in a lot of ways that we aren’t as legislators with our children,” Kitchen said. “I’m looking at the demographics of the people in the state that this would apply to and I think that children under the age of 18 may actually have a greater need for some of these services.”

Bramble pushed back, saying the idea that the government knows better than parents and would provide such a policy without parental consent makes him pause.

Kitchen said he would be open to amending the legislation to apply only to those 18 and older, though Sen. Jacob Anderegg, R-Lehi, questioned whether such an amendment would hold up constitutionally, causing Kitchen to circle the bill.

He returned with the completed amendment a bit later.

“According to Health and Human Services and the office of legislative research, we can technically limit the program to 18 and older,” Kitchen said.

Sen. Kathleen Riebe, D-Cottonwood Heights, expressed some discomfort with the amendment because contraception’s benefits exceed solely dealing with having children.

She cited regulating a women’s cycle, banishing hormonal acne, reducing the risk of uterine cancer, managing endometriosis and reducing migraines as examples.

“I work in schools where our children do not have the benefit of having their parents in their lives all the time. They are on their own frequently, they have to make their own decisions and they have to advocate for themselves,” Riebe said, pointing out that giving minors access to contraception who wouldn’t otherwise have access allows them to take charge of their health care.

Sen. Deidre Henderson, R-Spanish Fork, also expressed concerns that the amendment would prevent anyone under the age of 18 from accessing contraceptives even with parental consent.

Kitchen said those who already qualify for medicaid up to 138% would still have access to those services, but agreed to look at it some more and potentially amend the bill to allow for parental permission on the final reading.

“I think it would be great if we could strike a balance between parental consent and being able to access birth control,” Henderson said.