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Together with the House Health and Government Operations Committee Leadership and Senate Finance Committee Chair Dolores Kelley (D-10, Baltimore County) and Vice-Chair Brian Feldman (D-15, Potomac) we have developed a meaningful response that will protect abortion access in Maryland- even if the Supreme Court severely restricts or overturns Roe.
Today's Washington Post Opinion, I wrote along with Senator Kelley explains the pressures on Maryland abortion providers and challenges facing Maryland patients- and why Maryland needs to act now, before we inevitably face an influx of patients from out of state. You can also see local and national news coverage of these initiatives here, here, and here.
From Washington Post Opinions:
The provisions of these bills are not new or novel. These bills embody the
same tried and true strategies that we have used to address access issues for
other healthcare services. This legislative package not only protects access,
but also seeks to ensure that Marylanders of all income levels have equal
access to abortion care.
Here's the background
You may remember back in 1991 the Maryland General Assembly passed legislation codifying Roe vs. Wade into Maryland law. This was a major election issue in the fall of 1990. After a number of anti-choice Democratic legislators were unseated, newly elected pro-choice members (including new House of Delegates and "Choice Team" member Chris Van Hollen) guaranteed the passage of this important legislation.
The legislation was then sent to referendum in 1992 when 62% of voters across the state supported the law (This was Maryland's original Question 6 referendum campaign, Marriage Equality delightfully was also Question 6!). Today, polling on this question shows support has grown in Maryland to 72%. After the voters validated the legislature's stance, the issue appeared to be settled. In fact, that is the language we have seen countless anti-choice candidates for office in Maryland use when dodging questions about their position on abortion. Have you ever heard someone say "We're not going back. That is settled law in Maryland"? I've heard it a lot over the last 30 years from candidates on both sides of the aisle.
Here's the problem
While the voters in Maryland have spoken clearly already on this issue, we don't live in a bubble. The actions of our neighboring states and the hostile political climate do have an impact on us, our providers, and our patients. We can not avoid that any more.
Since 1992-- 30 years ago-- the Maryland General Assembly has not brought a single piece of abortion related legislation to the floor for a vote. We have passed no restrictions (thankfully) and we have done nothing to ensure access and affordability either. That means the right to choose has been slowly eroded through the often harassing and sometimes terrorizing tactics of anti-choice activists. The number of abortion providers in Maryland has declined, while our population has grown. Wait times for appointments have increased. The number of fake clinics (so called "crisis pregnancy centers") have grown to outnumber legitimate abortion providers 2 to 1. Rising deductibles and nonsensical federal insurance rules have created new and burdensome financial barriers to care.
This is all BEFORE the Supreme Court decision expected this Spring. After that decision, 26 states are expected to severely restrict or ban abortion care. New abortion bans in our neighboring states will mean increased wait times for Maryland patients. In the month after the Texas abortion ban went into effect, the clinics in neighboring states saw wait times for their in-state patients increase an additional 19-22 days.
So What Happens Now?
I have served as Chair of the Health Occupations Subcommittee for seven years. I have served on the Insurance subcommittee for twelve years, and I served for four years on the Health Disparities subcommittee. In this capacity, I have addressed all types of issues impacting our health care workforce and patients, including provider shortages, access to care, equity and affordability.
We know what we need to do to protect Abortion Care Access in Maryland.
We need to eliminate unnecessary barriers to care. We need to ensure clinicians are practicing at the top of their license. We need to support clinical training- especially for rural and minority providers. We need to eliminate insurance deductibles and ensure state Medicaid policy is equivalent in protections to our private insurance law. These are all tried and true techniques for preserving and increasing equitable access to care.
HB1171 - Right to Reproductive Liberty
Speaker Jones
This is a constitutional amendment that will go to the voters in the fall. It would enshrine reproductive liberty, including the right to prevent, continue, or end a pregnancy in the Maryland constitution. It gives Marylanders a chance to again voice their support for the full range of reproductive options at the polls. Elevating our law to constitutionally protected will make it significantly harder for an anti-choice Governor or Legislature in the future to roll back these protections.
HB937 - The Abortion Care Access Act
Delegate Kelly
This health occupations legislation would remove an outdated an unnecessary restriction in Maryland law preventing Advance Practice Clinicians from providing abortion care. It codifies an Attorney General's opinion from Brian Frosh in 2020 allowing these clinicians to provide medication abortion. It also allows the same providers to provide procedural abortion care. This will increase our number of qualified licensed healthcare providers in Maryland. The legislation also sets up a clinical training fund so medical professionals who practice in Maryland but were educated in states that have banned or severely restricted abortion access will be able to access the training they need to provide abortion care. This legislation is supported by the Maryland Chapter of the American College of Obstetricians and Gynecologists.
HB952 - Abortion Care Access to Insurance Act
Delegate Kelly
This insurance legislation requires all private insurance plans (except those with legal exemptions) regulated in Maryland to provide abortion coverage without cost sharing or deductibles. It also requires the same of Maryland Medicaid. Deductibles lead to delays in accessing care. Maryland Medicaid has covered Abortion Care since 1979, but it is subject to budget debate every year. This would make the coverage permanent, because low-income women should not have their rights up for debate annually. In addition it substantially eliminates the administratively burdensome and stigmatizing $1 a month co-pay required exclusively for abortion coverage under the federal ACA law. This ridiculous cost-sharing requirement was created for the sole purpose of stigmatizing abortion care, and results in people who are otherwise eligible for 100% subsidies under Obamacare falling through the cracks and losing coverage.
The House is hearing all three of these once in a lifetime pieces of legislation tomorrow. It is my goal to have them all passed out of both chambers and on the Governor's desk before the Supreme Court decision in Dobbs vs. Jackson Women's Health is released this Spring. You can support our efforts here.
Best,
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