Several bills brought forward this session in the Montana Legislature aim to restrict access to abortions, a move that supporters say protects life and opponents say will disproportionately impact Montanans who already face challenges accessing health care.
The bills cover a variety of subjects related to abortion, like when the procedure can be done, how it can be paid for and how it can be prescribed. With Republicans holding a large majority in both the House and Senate and a Republican in the governor’s seat for the first time in more than a decade-and-a-half, many Republican lawmakers are pushing bills similar to ones that have been shot down in the past.
As of Feb. 12, six bills had been introduced that would restrict access to abortion or change how the procedure is done. Five had passed the House and are in various stages in their journeys to the Senate floor. House Bill 337, a proposed constitutional amendment to change the definition of "person," was heard by a committee on Feb. 9.
All of the bills are opposed by Planned Parenthood of Montana for a slew of reasons, according to the organization's weekly legislature updates. The organization said that the bills are government intrusion into private health care decisions that will restrict access to safe, legal abortions, with the goal of banning abortions altogether.
House Bill 136, sponsored by Rep. Lola Sheldon-Galloway, R-Great Falls, would ban abortions in most cases after 20 weeks.
There are some exceptions included in the bill — if the fetus died, or if an abortion would save the life of the mother — but not many.
“When a doctor goes into a pregnancy monthly checkup, he is treating two patients,” Sheldon-Galloway said. “He takes the mother’s heartbeat and growth and takes the child’s heartbeat and growth to prove that those are two separate individuals, and we keep getting that clouded with somebody not wanting to be pregnant … this is about the child and only the child.”
Sheldon-Galloway said science has advanced significantly since the landmark Roe v. Wade Supreme Court decision was made in 1973 and that if that case were revisited by the highest court, “science would side with us on our position on pro-life.”
“The Democratic side is always misrepresenting this bill when it comes to the rights of the mother. It has nothing to do with that,” Sheldon-Galloway said. “It has to do with the rights of the child.”
Abortions done after 21 weeks gestational age make up around 1% of abortions done, according to the nonprofit health organization Kaiser Family Foundation.
A vast majority of abortions — 91% — are done at or before 13 weeks gestational age, which is measured from the first day of a person’s last menstrual period. And 8% of abortions are done between 14 and 20 weeks.
The rare abortions that take place after 21 weeks are done for a variety of reasons, according to the KFF. The most common factors are women not being able to afford the procedure until later in the pregnancy or not knowing about the pregnancy. Other factors include having a hard time finding a facility to do the procedure and having a hard time getting to that facility, according to KFF.
Abortion pill restrictions
House Bill 171, sponsored by Rep. Sharon Greef, R-Florence, would require people seeking abortions via abortion pills to get that prescription in person instead of of over telehealth.
Greef told the Chronicle in an email that she was not available to talk about the bill.
Her bill is intended to protect women from the potential of uncommon side effects from taking the abortion pill to terminate a pregnancy.
“I am not here today to stop abortion. The law says it’s legal,” said Greef in a Jan. 19 House Judiciary Committee meeting. “I am here today to try to put some safeguards in place to protect the woman who has made the decision to end her pregnancy.”
Supporters of Greef’s bill said it will protect women and unborn babies, but opponents say that it raises additional barriers for women attempting accessing reproductive health care, including raising the cost of a medical abortion because of the travel necessary to obtain it.
That’s an issue that Montanans who are Black, Indigenous or people of color and Montanans living in rural areas run into obtaining any kind of health care, not just reproductive health care, said Keaton Sunchild, the political director of Western Native Voice, a nonprofit and nonpartisan Indigenous advocacy organization.
“A lot of it boils down to health care costs and access to affordable and adequate health care. That’s kind of where the root of a lot of these problems are,” Sunchild said. “I think that a lot of the times when these bills are being brought forward, they’re not thinking of the impacts it will have on the people who live 90-plus miles from the nearest health care center.”
Access to health care and racial inequity in the health care system puts Indigenous and Black communities at a higher risk for a lot of medical issues. That includes being more likely to lack access to reproductive health care, but it also includes being more likely to contract COVID-19 and having more serious symptoms.
Having access to affordable reproductive health care through the Affordable Care Act has proven to lower abortion rates by between 9% and 14%, according to a 2017 study by University of Michigan researchers.
“The lack of infrastructure across the board leads to a lack of services everywhere,” Sunchild said.
Black and Indigenous people are also more likely to face discrimination when trying to obtain health care, said Judith Heilman, the executive director of the Montana Racial Equity Project.
“Access to medical care is a lot harder for BIPOC people across the nation, including Montana,” Heilman said. “This health care and access to abortion, the whole thing about a woman’s right to choose her own health and make her own health decisions is super, super important, especially for BIPOC.”
Today, Black women are three to four times more likely to die of complications due to childbirth than white women are, and Indigenous women are about twice as likely, according to the CDC.
Heilman said that’s at least in part because doctors are less likely to believe Black people when they say they’re in pain or need help, something she experienced directly after a surgery.
“That happens over and over and over again with Black, Indigenous and people of color, women and men,” Heilman said. “I learned early on that I had to have an advocate with me if I found myself in the hospital having surgery … because I wasn’t getting the pain medication that I needed to have, and the doctors wouldn’t believe me.”
Additional abortion-related bills
House Bill 229, sponsored by Rep. Jane Gillette, R-Bozeman, would prohibit health insurance plans offered through the Montana health insurance exchange from covering abortion services.
Gillette said in an email to the Chronicle that the bill brings Montana into compliance with the federal Hyde Amendment. That amendment, passed shortly after the Roe v. Wade decision, does not allow federal funds to be used for abortions except in cases of rape, incest or if the pregnancy endangers a woman’s life.
Because it impacts federally funded programs, the Hyde Amendment means that abortions are already rarely covered by Medicaid, CHIP and Indian Health Services.
“HB299 brings our state into compliance with federal law which prohibits, with a couple of exceptions, the use of federal funds for abortion,” Gillette wrote. “Additionally, it brings continuity between our other federally funded programs such as Medicaid and CHIP (Children’s Health Insurance Program).”
The bill and Gillette drew fire for not originally including terminating pregnancies that resulted from rape or incest in the list of exceptions, despite the inclusion of those exceptions in the bill Gillette said she modeled her bill on. Those exceptions were later added to the bill.
As reported by the Daily Montanan in early February, only one insurance plan offered through the exchange offers abortion coverage.
Other bills in the Legislature aim to change requirements for the procedure or deal with very rare late third trimester abortions.
Rep. Amy Regier, R-Kalispell, is sponsoring House Bill 140, which would require health care workers providing an abortion to offer patients the ability to look at a fetal ultrasound and, if possible, listen to a fetal heartbeat before they can get an abortion.
“The key to this bill is offer,” Amy Regier said in a Jan. 10 House Judiciary Meeting. “The patient is not required to view or hear.”
The bill exempts abortions that are done to save the life of the woman.
The bill would also require health care workers and patients obtaining abortions to sign a certification that confirms that the patient was offered the ultrasound and fetal heartbeat.
And Rep. Matt Regier, R-Kalispell, who is Amy Regier’s brother, is sponsoring House Bill 167, which would create a referendum for Montanans to vote on that would require doctors to care for any infants that are born alive and implement punishment if they do not.
Opponents of the bill say it’s unnecessary because it parrots existing federal and state legislation, while Matt Regier says that legislation does not go far enough.
“Some states are allowing abortions up to the point of birth and maybe even beyond,” Matt Regier said.
And the most recently introduced bill, House Bill 337, sponsored by Rep. Caleb Hinkle, R-Belgrade, proposes a constitutional amendment to the definition of the word "person." It would amend the definition of the word "person" to include fetuses at any stage of development, "beginning at the stage of fertilization," and regardless of dependency.
Because it's a referendum, it would need to receive a two-thirds majority vote to be placed on the ballot.