Republicans advance ‘backdoor abortion ban' despite voter-approved protections

Yahoo

20-03-2025

A protester at a Planned Parenthood Great Northwest rally in Boise, Idaho, holds up a sign about the EMTALA case on April 21, 2024. Photo by Otto Kitsinger | Idaho Capital Sun
Last year, Arizonans took away the ability of lawmakers to restrict abortion. Now, Republicans are trying to prohibit any doctor in the state from ever mentioning the procedure as an option for their patients, in what critics are calling a 'backdoor abortion ban.'
Both state and federal law already bar most abortions from being paid for with public funds. Only procedures performed in rape or incest cases or to save a woman's life are covered with federal money under Medicaid.
But the sweeping change to state law would forbid the state and any of its political subdivisions, including state agencies and cities, from entering into contracts with or awarding grants to any person or facility that provides or 'promotes' abortions. That would eliminate Medicaid funding to any hospital, health care facility or doctor who sees AHCCCS patients — virtually every health care provider in Arizona — if they so much as tell a pregnant patient about abortions.
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House Bill 2547 flies in the face of the constitutional amendment voters approved last year. In November, 62% of Arizonans voted to enshrine the right to abortion in the state constitution via Proposition 139. Along with making the procedure a fundamental right, the initiative also explicitly prohibited the passage or enforcement of any law that infringes on a woman's ability to obtain an abortion unless that law's intent is to improve or maintain her health, is rooted in evidence-based medicine, and preserves her autonomous decision-making.
Republicans have sought to frame the bill as preventing taxpayers from footing the bill for abortions. Rep. Lupe Diaz, R-Benson, who sponsored the measure, acknowledged that abortion rights were added to the Arizona Constitution, but said the state should have no part in bolstering the entities that advocate for or perform it, singling out the state's largest abortion provider.
'(Abortion) is legal,' he said to lawmakers on the Senate Government Committee on Wednesday. 'In my mind, that's now in the marketplace and we need to let the marketplace go ahead and afford it rather than state funds support it. We don't need state funds to support Planned Parenthood.'
While the proposal has been widely regarded as a particular attack on Planned Parenthood, which receives some federal funding for a range of family planning services its clinics offer and treats Medicaid patients, reproductive rights groups have warned it also functions as a gag rule for medical providers across the state — including in hospital emergency rooms.
Rep. Lauren Kuby, D-Tempe, questioned whether the bill would cause emergency room doctors to avoid performing abortions in life-threatening cases rather than have the facility's funding pulled.
Diaz claimed that emergency situations would be exempt from the bill's prohibition, despite the fact that no such exception is included in its text.
And federal protections for doctors and hospitals are unlikely to bridge the gap. While the Emergency Medical Treatment and Active Labor Act has long been understood as mandating that hospitals which receive federal money must stabilize patients facing life-threatening complications, even when an abortion is warranted, the Trump administration recently appeared to abandon that interpretation.
On top of that, Diaz's bill also promises the rescinding of state and local funding for facilities that violate its provisions.
Kuby grilled Diaz on what constitutes 'promotion' of abortion, saying she was concerned that even doctors responding to questions from their patients about abortion clinics could be perceived as falling afoul of the bill.
'If a patient asks: 'Where could I get an abortion in Maricopa County?' is that promoting abortion?' she asked.
Diaz agreed that it would be. He claimed that the majority of abortions are 'for convenience' and not performed due to an emergency.
'There's a difference between promoting an abortion and then also saying that 'You need medical attention.' I think that's totally different,' he said. 'What you're looking at is a healthy fetus, a healthy baby inside the womb, and the doctor can't say, 'Well, I recommend that you go and get an abortion because you're suffering psychologically.''
The protections in Prop. 139, however, have no such restrictions. Under the voter-approved constitutional provisions, both abortions performed up to the point of fetal viability — generally regarded to be between 23 and 24 weeks of gestation — and those beyond that time are constitutionally protected if a doctor deems one is necessary to safeguard a woman's life, physical or mental health.
Kuby pointed out that the proposal is in direct conflict with the Arizona Constitution, but she was quickly cut off by Chairman Jake Hoffman, a Queen Creek Republican and long-time opponent of abortion.
'There's no reason to talk about (Prop.) 139 because this doesn't deal with 139. This deals with public funding,' he said.
A member of Arizona's federal delegation also spoke out in defense of the proposal and downplayed any violations of Prop. 139.
'This bill does not litigate Prop 139,' U.S. Rep. Andy Biggs told lawmakers on the panel. 'It doesn't condemn Prop. 139 nor does it advocate for Prop 139.'
The Congressman from Arizona's 5th congressional district argued that doctors should not benefit from public funding if they're going to discuss abortion with their patients.
Kuby pressed Biggs on why, even for patients who wouldn't be eligible for Medicaid, health care providers should censor themselves. Biggs argued that the bill doesn't prevent doctors from offering information to any of their patients, it simply establishes that the state won't support them in doing so.
'There's nothing in this that says that he can't say, 'You can go get an abortion and you can go to this clinic,'' Biggs said. 'What it says is … we're not going to pay for that doctor who is providing that reference.'
Biggs, a former state lawmaker and one-time president of the state Senate, is running for governor in 2026.
Reproductive rights groups urged lawmakers to reject the proposal, warning that it would harm low-income Arizonans who rely on Medicaid health care.
Jodi Liggett, a lobbyist for Reproductive Freedom for All and Camelback Family Planning, one of just a handful of private abortion clinics in the state, reminded lawmakers that public funding is already mostly barred from being used to pay for abortions, except in limited cases for patients covered under the state's Medicaid plan, the Arizona Health Care Cost Containment System.
But despite very few abortions being eligible for federal funding, the bill would affect nearly all Arizonans because the vast majority of doctors and health care facilities accept AHCCCS and would be subject to the proposal's requirements.
'It will function effectively as a backdoor abortion ban,' Liggett said. 'No state dollars of any kind could be granted or spent under contract at any facility that performs or refers out to abortions.'
She criticized the bill for seeking to regulate a practice that the state is otherwise not involved in, and said patients deserve to know their doctors are telling them about all the care available.
'This is an overreach into information and care that the state isn't paying for and limits patients' access to complete information about their health care options,' she said.
Jeanne Woodbury, speaking on behalf of the Arizona chapter of Planned Parenthood, said that the organization offers a wide range of health care services at its seven clinics that would likely be jeopardized because of the abortions it provides.
'The kind of services we provide, aside from abortion, that are funded through Medicaid for patients who have AHCCCS include STI testing, wellness exams, and basic essential reproductive health care,' she said. 'That is what would be defunded by this bill — not abortion, which is already not funded by the state. So, if you're worried about your tax dollars going to something you don't agree with, they're already not. '
Along with abortion rights advocates, multiple health care groups have opposed the bill, including the Maricopa County Medical Society, the Arizona Medical Association and the American College of Obstetricians and Gynecologists.
Dr. Sheena Galhotra, a member of ACOG and a local OB-GYN, criticized Republicans for advancing a proposal that so clearly flouts the mandate issued by voters in Prop. 139.
'It threatens the health and lives of Arizonans, it imposes dangerous restrictions on medical care and it directly contradicts the will of Arizona voters,' she said.
Galhotra added that the provisions in HB2547 would have wide-ranging consequences for medical providers and patients. She noted that roughly half of all babies born in Arizona are born under Medicaid, nearly every hospital and OB-GYN accepts AHCCCS and virtually every OB-GYN has performed an abortion in emergency situations.
She shared that she has performed abortions for patients who were hemorrhaging or who experienced a prematurely ruptured membrane that later caused a life threatening infection. Galhotra warned lawmakers that approving the proposal would lead to delayed care, as doctors weigh the risks of forfeiting public funding, which could prove dangerous for women across the state.
'This bill strong-arms doctors into withholding care, forcing them to let women die, robbing families of wives, daughters and mothers,' she said. 'If passed, this would effectively defund hospitals.'
In the end, the GOP-majority committee greenlit the bill by a vote of 4-3, with only Republicans in favor. It next goes before the full Senate for consideration.
But even if it makes it through that final stage, it's headed straight for a veto. Gov. Katie Hobbs is a strong proponent of abortion access and has consistently rejected proposals that seek to restrict the procedure.
Also approved on March 18 was House Bill 2439, which would require AHCCCS to include a link on its website that leads to a list of organizations that assist women through pregnancy and information on the state's adoption system. Agencies that perform or refer women to abortion services are prohibited from being included.
The Arizona Department of Health Services is already required to maintain a similar link, but the bill's sponsor, Rep. Rachel Keshel, said it's important for women covered by the state's low-income health care program to have every opportunity to learn about alternatives to abortion.
'This will ensure that those women have the same resources in front of them when they go to the AHCCCS website,' the Tucson Republican said. 'It's frustrating, because we like to use the term 'pro-choice,' but honestly, it seems like on our side of the aisle, we're more pro-choice because we want women to have other options.'
Liggett acknowledged that, while the same information is already available on ADHS' website, reproductive rights advocates are opposed because the exclusion of abortion as an option unfairly tilts the conversation towards anti-abortion resources.
'Government resources of information, we feel, should be impartial, not given limited or slanted information,' she said.
Liggett added that some of the agencies that are included in the list are crisis pregnancy centers — religious organizations whose sole purpose is to deter women from seeking abortions.
The largest crisis pregnancy center provider in Arizona, Choices Pregnancy Centers of Greater Phoenix, which has clinics across the Valley, showed up to support the bill. Josh Chumley, the organization's chief advancement officer, said that Choices wants women to be aware of all their options, and added that he would be in favor of widening the list to include even abortion providers like Planned Parenthood.
Kuby asked Chumley whether the organization is equally open to keeping patients informed about their ability to obtain an abortion, but Chumley sharply refuted that, saying that women aren't counseled about or referred to abortion providers, but are instead given the 'full story' about the procedure.
Kuby voted against the bill, which also passed with only Republican support, and said that it undermines the newly-enshrined fundamental right to abortion.
'We have a constitutionally protected right to understand what our options are whether that's abortion, whether that's adoption — all reproductive health care,' she said. 'So, for the state to skew that information in violation of Prop. 139 is not a road we should be taking.'
Republicans, however, defended the bill as nothing more than providing Arizonans with other health care options besides abortion, and rebuked reproductive rights advocates for what they perceived as an attempt to limit access to information. Hoffman accused advocates who spoke against the bill of wishing to uphold only abortion care and said a veto from Hobbs would just serve to reinforce that.
'This bill seeks to provide alternate options for pregnancy support services and adoption,' he said. 'Seems like a very reasonable thing. I doubt that our unreasonable Katie Hobbs will actually sign it, but we're going to send it to her and make her veto it. You know why? Because it's not a good look for you guys.'
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