Health department holds hearing on abortion licensure rules

HELENA — Proponents and opponents of new licensure requirements for Montana abortion clinics testified Friday in a virtual public hearing, offering conflicting views on how the state should regulate one group of health care providers. 

The hearing, a requirement for state agencies that draft new administrative rules, comes after a 2023 Republican-backed law, House Bill 937, to license abortion clinics was blocked in court due to vagueness — the law was slated to go into effect before the state Department of Public Health and Human Services had written licensure rules.

The 17-page rule packet the department has now put forward outlines changes to lighting, hallway width and other physical infrastructure, as well as staff training, emergency medical protocols, and a requirement that the chief medical officer of an abortion clinic be a physician.

“Most of the proposed requirements for abortion clinics are based on the licensure and regulatory requirements for outpatient centers for surgical services, while some are derived from the regulatory requirements and minimum standards imposed on all health care facilities,” the proposed rules state. “In the department’s judgment, these current regulatory requirements represent the appropriate level of regulatory requirements to impose on abortion clinics.”

Opponents have said the rules single out abortion clinics from other private physician offices for licensure and amount to what abortion rights groups refer to as a “TRAP law,” or “targeted restriction of abortion providers,” aimed at eventually closing clinics down.

Six proponents spoke in favor of the regulations, including two physicians affiliated with the Charlotte Lozier Institute, an anti-abortion think tank and policy group, and a representative of the Montana Family Foundation, which backs restrictive abortion bills in Montana, including HB 937.

“Abortion centers need to be held to the same standards as similar medical facilities. A woman seeking an abortion should not receive a lower standard of care than she would for other procedures,” said Kathi Aultman, a retired medical doctor from Florida and Charlotte Lozier contributor.

Eleven people spoke against the rules, including abortion providers who reiterated that they are licensed by Montana medical boards and do follow state and federal regulations required for health care providers, even if the clinics themselves do not have special state licenses.

Helen Weems, an advanced practice registered nurse and abortion provider in Whitefish, said her clinic, All Families Health, could be forced to shut down if the licensure requirements were to take effect. 

“All Families does not have a large operating room, nor do we have a physician medical director. We do not have and cannot have six-foot-wide hallways. These requirements are not necessary for the safe delivery of abortion care,” Weems said. “The most telling is that these requirements apply only to abortion providers, not the multitude of providers across the state who offer miscarriage management. Miscarriage management and abortion care are medically identical.”

In the rules packet, the health department stated that the standards are expected to impact five abortion clinics in the state, but did not name specific facilities.

Other opponents took issue with a part of the requirements that directs abortion providers to obtain a physical examination of patients, arguing that the standard would prohibit mailing abortion medicine and having telemedicine consultations.

“The practical consequence is restricted access, increased patient costs and delays in accessing care,” said Stephanie McDowell, executive director of Bozeman’s Bridgercare. “These restrictions do not reduce the demand for abortion. Instead, they make it more likely that patients will face delays, travel long distances, and when they cannot access a provider at all, they will resort to unsafe or self-induced abortions.”

The lawsuit over HB 937 is at a standstill while the health department’s rules go through the required public comment period. The law is blocked from taking effect for 60 days after the health department formally adopts the new regulations, at which point attorneys for the plaintiffs, including All Families Health, and the state will review them.

The deadline for submitting written comments to the department about the proposed rules is Aug. 23.