Members of the House Judiciary Committee discuss House Bills 136 and 171 on Tuesday, January 19, 2021. Credit: Mara Silvers / MTFP

HELENA — Republican lawmakers, encouraged by their party’s unified control of state government after the November elections, are advancing a number of bills that could, if enacted, dramatically limit access to abortions across Montana.

Some of the bills have had similar versions introduced in past legislative sessions only to be met with vetoes from the governor’s office. The election of Gov. Greg Gianforte, who took office in early January, has given advocates increased hope of passing new restrictions, given Gianforte’s record of opposing abortion in general and funding anti-abortion organizations through his family’s philanthropic trust.

The four bills passed by the House Judiciary Committee this week propose, among other things, restricting early pregnancy medical abortions, largely banning later-term abortions, and requiring medically unnecessary procedures and data collection for patients and providers. 

“The more information patients receive about medical procedures done on them, the less anxiety they will experience,” Rep. Amy Regier, R-Kalispell, said Wednesday when introducing House Bill 140, which requires medical providers to offer patients a fetal ultrasound before an abortion. “At three and a half weeks gestation, a heartbeat can be heard,” Regier said. “At six weeks, hands and feet can be seen developing. Helping a woman make the best choice should be the goal of every medical provider, as well as the Legislature.”

Additional measures passed by the committee Thursday, largely along party lines, include House Bill 171, which would require that all medications to induce an abortion be distributed in person, as opposed to via mail, and that extensive information be provided to and collected from the patient; House Bill 136, which broadly restricts abortions after 20 weeks of gestation; and House Bill 167, which would create a legislative referendum on the 2022 ballot that would place severe penalties on medical providers found not to have provided life-preserving treatment to an infant, a measure that opponents characterized in testimony as an unnecessary political stunt during an election year. 

Proponents and opponents delivered passionate and sometimes personal testimony at the bill hearings Tuesday and Wednesday. Advocates and lobbyists, armed with wide-ranging references to medical studies and striking anecdotes, presented fundamental disagreements about reproductive matters.

“You’ve been misled when you’ve been told that elective abortion is health care,” said Dr. Ingrid Skop, testifying before the committee as a member of the Charlotte Lozier Institute, a national anti-abortion group that has received at least $200,000 from the Gianforte family since 2015, according to public tax records

“Disrupting the normal physiologic process of pregnancy and ending the life of an unborn human being by induced abortion is the antithesis of health care,” Skop said, speaking in favor of HB 136, which would curtail procedures after 20 weeks unless the woman’s life is at risk. 

“None of the requirements of House Bill 171 are grounded in evidence-based medicine that protects or increases patient safety. Instead, this bill creates obstacles to health care and requires providers to give inaccurate and potentially harmful information to their patients.”

Martha Stahl, president and CEO of Planned Parenthood of Montana

According to the Centers for Disease Control and Prevention, roughly 1% of the abortions reported in 2018 occured after 21 weeks. Studies have shown that many patients seeking abortions later in pregnancy were delayed by lack of funds and difficulty accessing a provider, as well as medical complications and discoveries of fetal abnormalities.  

Skop and other advocates, including those from the Susan B. Anthony List and Pro Life Helena, also sought to convince committee members that earlier medical abortions are cause for safety concerns and additional restrictions, despite consistent and extensive research providing evidence to the contrary. In addition to requiring that medical abortion services be provided in person, HB 171, sponsored by Rep. Sharon Greef, R-Florence, would also implement a 24-hour waiting period and an extensive “informed consent” process before prevision of the medication.

“I am not here today to say ‘stop abortion.’ The law says that it is legal,” Rep. Greef said in her introductory statement. “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. And this bill does that.”

Opponents of HB 171 said the measure would harm patients who live in remote areas and rely on telemedicine consultations, as well as people navigating an abusive or violent relationship. 

“[HB 171] would create a scenario where you have survivors needing to drive back and forth to Billings several times from, let’s say, Glendive, to get information about a pill,” said Kelsen Young, executive director of the Montana Coalition Against Domestic and Sexual Violence. “Then House Bill 171 would require us to drive back again to Billings the next day to actually take the pill and then a week later, drive back again for another required medical visit.”

“What if my abusive partner was the one who forcibly impregnated me?” she continued. “Should I ask them to do the driving? How do you propose I get away from them three to four times for all these visits without further endangering myself and my children?”

Young, who said the bill is one of the “most offensive” she’s seen in 20 years of advocating in the Legislature, told the committee that survivors “do not need the Montana Legislature deciding what is in our best interest. We are perfectly capable of making our own decisions.”

Other opponents, including the ACLU of Montana, Planned Parenthood of Montana and the Montana Medical Association, echoed that point, testifying that by inserting itself into intimate deliberations between patients and their health care providers, the state Legislature threatens the autonomy of Montanans.

“None of the requirements of House Bill 171 are grounded in evidence-based medicine that protects or increases patient safety,” said Martha Stahl, president and CEO of Planned Parenthood of Montana. “Instead, this bill creates obstacles to health care and requires providers to give inaccurate and potentially harmful information to their patients.”

HB 171, along with two of the three other proposals heard this week, would punish violating physicians with felonies, prison time, or up to $50,000 in fines.

Across the country, experts on abortion law say, multiple state legislatures are pushing proposals that levy steep fines and criminal penalities for providers while adding more restrictions for patients, usually through copious “informed consent” provisions.

“I am not here today to say ‘stop abortion.’ The law says that it is legal. 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. And this bill does that.”

HB 171 sponsor Rep. Sharon Greef, R-Florence

Many of those informational requirements, including some outlined in HB 171, differ from the standards applied to other medical procedures by going beyond medically necessary patient information and verging into statements that could intimidate or increase guilt for the patient.

In theory, providing informed consent could include an explanation that “abortion is a safer medical condition than childbirth. By a long shot,” said Columbia University law professor Carol Sanger in a recent phone interview. Instead, “states have said no, no, that’s not what women need to know. They need to know that they’re killing their own baby, and the best way to get them to understand that is to make them look at a picture of it.”

“So it’s all about sort of infantilizing women or assuming that women don’t understand what an abortion is,” Sanger said. “Most women don’t need to know what their fetus looks like prior to an abortion because they understand they are pregnant.”

If passed by lawmakers in both the House and Senate, the Montana bills would face robust challenges in the courts, partly on the basis that they may violate Montana’s constitutional right to privacy, the ACLU of Montana said in testimony. 

In comments before the committee’s vote Thursday, Rep. Derek Skees, R-Kalispell, dismissed the prospects of such challenges, arguing that it is impossible to know what may be considered unconstitutional until a court issues a ruling on a given case.

Even if the measures are blocked by judges and fail to be enacted into law, ACLU of Montana Executive Director Caitlin Borgmann said, the process of putting the bills into the legal arena in the first place creates a significant public impact.

“With nearly 20 anti-abortion bills filed this session, and four already heard in the House Judiciary Committee this week, the state is likely to face numerous legal challenges to these unconstitutional measures,” Borgmann wrote in a statement to Montana Free Press. “That’s going to cost significant taxpayer dollars, and Montanans deserve to know that this is how the Legislature is deciding to spend its time.”

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.