Abortion clinic ban will ‘put abortion out of the reach for as many Utahns as possible,’ lawmaker warns

A bill that would ban abortion clinics in Utah, and another that requires doctors to record how they verify that patients seeking an abortion are victims of rape or incest and have reported the crimes to law enforcement, along with offering victim services, passed out of a House committee on party-line Wednesday.

In front of a packed room, with others watching the hearing from an overflow room, the House Judiciary Committee approved Rep. Karianne Lisonbee’s, R-Clearfield, Abortion Changes and Rep. Kera Birkeland’s, R-Morgan, Victim Services Amendments with 9-2 and 8-2 votes, respectively. Both lawmakers sit on the committee.

While the two bills have vastly different purposes, both build on Utah’s abortion trigger ban passed in 2020 that is currently blocked in the courts, and both also restrict abortion access for victims of rape or incest to 18 weeks.

Lisonbee said her bill, publicly released just over 24 hours before the hearing, “strikes the very best balance of protecting innocent life and protecting women who experience rare and dangerous circumstances.”

If passed, abortion clinics in Utah would no longer be able to obtain a license starting in May, and no clinics would be allowed to operate in the state beginning in 2024. It would move all abortions in the state to hospitals, and would make violating Utah’s abortion laws unprofessional conduct for health care providers.

It would make several other adjustments to the blocked abortion law, including requiring that all abortions performed to preserve the life of the mother are done “by means of labor rather than in utero, unless the induction of labor poses an unacceptably higher risk to the mother than other methods.” The bill also redefines what constitutes a “medical emergency” under which an abortion may be performed.

The CEO of the Utah Medical Association, Michelle McOmber, and Gabby Saunders, a lobbyist for the American College of Obstetricians and Gynecologists, both thanked Lisonbee for working with OB-GYNs on the new definition, which is more clear for doctors who may be unsure about when they can legally provide an abortion. But both voiced concerns about other portions of the bill.

McOmber said the Utah Medical Association is “OK with the bill,” but that it is concerned that it left in a portion of the trigger law that makes performing an abortion in certain circumstances a second-degree felony. She also noted that “it is cheaper to do an abortion in an abortion clinic, and so forcing them into hospitals does still concern us.”

One OB-GYN who works in both hospital and clinic settings, Misha Pingasa, testified that when people are referred to her seeking an abortion at the hospital, their insurance typically quotes an out-of-pocket cost between $5,000 and $20,000.

“(Patients) ask me if because they can’t pay, they’re going to have to watch their baby be born, suffer through futile medical treatments and die,” Pingasa said. “Luckily, right now, I tell them that there’s another option. I tell them that we can take care of them at an outpatient clinic with the same doctors, the same procedures, the same excellent standards of care, but it will cost them much less.”

As debate on the bill wrapped up, its Senate sponsor, Sen. Dan McCay, R-Riverton, said that in-patient care at a hospital would not be the only way to get an abortion, and that they could seek it at other clinics that are not exclusively licensed for abortions.

Utah currently has two abortion clinics that offer surgical abortions, and four that provide abortion medication.

In addition to the health care providers who spoke against the bill, a few people showed up to oppose it because they felt it didn’t go far enough because it kept exceptions to the abortion ban intact, including one man who compared abortion to the Holocaust. Several anti-abortion activists spoke in favor of the bill.

Rep. Christine Watkins, R-Price, initially wavered before voting yes on the bill, saying there are a lot of people in her district who are “desperately poor,” and said she has “real concerned that they may be forced to do something from the old days” if they don’t have access to affordable abortions through clinics.

In response, Lisonbee said women in rural areas of the state, like Watkins’, would be able to access abortion pills with a prescription through local pharmacies. That would not be an option, however, if a federal lawsuit seeking to ban mifepristone — which Utah supported in a legal brief — is successful.

“I think the effect of the bill, pretty clearly, is to target this group of health care providers to put abortion out of the reach for as many Utahns as possible — to make it more expensive, to require a more intensive level of service, and as necessary as we’ve heard from some of the witnesses,” said Rep. Brian King of Salt Lake City, one of two Democrats on the committee.

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Birkeland voted in favor of the bill, and speaking to her vote said that she is committed to getting insurance companies to cover abortions when they are needed to save the life of the mother, “because there are times when it truly is necessary.”

Victim Services Amendments

Her own bill has evolved drastically since she announced in August that she was opening a bill file “to restrict a government entity from setting any procedure for reporting of a violent felony that doesn’t go through proper law enforcement agencies.”

Initially labeled “Felony Reporting Requirements,” she wrote in a Facebook post that it would have required that rape victims provide a law enforcement-generated case number when seeking an abortion, and mandated that law enforcement agencies investigate all sexual assault cases.

Speaking to The Salt Lake Tribune in October, her sister Samantha Hansen — who considered an abortion after being sexually assaulted — said of that version, “That is not a survivor bill, that is an anti-abortion bill. Let’s call a spade a spade.”

Under a second substitute, Birkeland’s bill only requires that doctors fill out a form to specify how they verified that an abortion patient is a victim of rape or incest — a change Hansen said she supports. It also provides more robust services for victims.

The bill would allow sexual assault hotlines to help victims find access to free emergency contraception, and would require law enforcement officers to undergo annual, one-hour training on responding to sexual trauma and investigating sexual assault and abuse. It also would provide for a “victim reparation award” to women who become pregnant from a sexual assault.

As with the previous bill, several medical providers had concerns.

Saunders, who said Birkeland has been working with her organization to improve the bill, said she was remaining neutral on it because “we’re hoping we can get away from the reporting requirements.” Putting women in a position where they have to report assaults to law enforcement can be dangerous, she noted, because police officers don’t always properly respond to cases and it puts them at risk of being retaliated against.

Fourth-year medical student, Kaitlin McLean, said the bill is another example of the Legislature stepping into the relationships between Utahns and their doctors, and added that giving health care providers extra responsibilities takes time away from patients.

“Reporting to law enforcement should be seen as a way to enact justice,” Birkeland said. “Not only that, it should be what we’re using to protect future women. But we do not want to ask women to do that alone, because we shouldn’t. I believe this bill strikes that balance.”