House OKs expanded access to abortions GENERAL ASSEMBLY

Legislation to expand access to abortions in Maryland and mandate that most health insurance plans cover the procedure cost-free for patients easily passed the House of Delegates on Friday, a step toward broadening access in Maryland even as the U.S. Supreme Court mulls allowing severe restrictions on abortion in other states.

Delegates also backed enshrining the right to abortion - as part of "the fundamental right to reproductive liberty" alongside contraception and prenatal care - in the state's constitution, something that would require the approval of voters in November.

Maryland law has explicitly protected a woman's right to obtain an abortion since 1992, when voters statewide approved a referendum on the issue by a nearly 2-to-1 margin.

But abortion rights supporters have argued that the procedure remains too difficult to obtain for many women, rendering it a choice in name only, and that adding the right to the state constitution would safeguard against any future political efforts to curtail or restrict it.

The proposed Abortion Care Access Act would allow nurse practitioners, nurse midwives and physician assistants to perform abortions and create a program at the Maryland Department of Health, backed by a $3.5 million annual budget, to train medical professionals on how to provide abortion care. Private insurance companies, except those with legal exemptions, would be required to waive deductibles or cost-share charges to completely cover the procedure.

A veto-proof majority of delegates backed the proposal after several days of intense, often emotional debate in the chamber and protests outside the State House. The Maryland Senate, where Democrats also hold a veto-proof majority, has not yet considered either proposal.

As elsewhere, the issue intensely divided delegates along stark moral terms, as a matter of ensuring a woman's basic human rights and autonomy or tantamount to endorsing the murder of an innocent child.

"We have a fundamental right to control our own decisions around pregnancy," said Del. Ariana Kelly, a Montgomery County Democrat who sponsored the Abortion Care Access Act and spoke in support of the constitutional amendment as well.

Kelly and other supporters argued that the limited number of clinics offering abortions and the cost of the procedure for lower-income women with high insurance deductibles leave some unable to actually make those difficult decisions themselves.

Kelly said rules allowing only physicians to perform abortions are "outdated" and were written before medical advances like medication abortions. Allowing nurses and other medical professionals to perform abortions could significantly expand the number of providers in the state and make abortions easier for patients to obtain.

The legislation "helps women by making sure that care is affordable, either through insurance or through Medicaid," Kelly told her colleagues on Friday, "because low-income women and middle-income women should have the same right to make their own choices about their reproductive lives as rich women do."

Del. Brooke Lierman, a Baltimore Democrat, recounted being raped while in college and recalled agonizing over the thought of what she might do if she became pregnant as a result.

"What happened to me that night was not my choice, but the choice of what was going to happen to my body in the future was my choice," said Lierman, arguing Maryland should guarantee that every woman can freely make that same choice.

Republican opponents objected to spending public money to teach medical professionals how to provide abortions and to mandating special enhanced insurance coverage for the procedure.

The Democratic majority rejected numerous efforts to amend the legislation.

The abortion proposals go "too far" and upset a longstanding moderate balance in the state, said Del. Jason Buckel, an Allegany County Republican. He acknowledged most Marylanders support legal abortion, but said he worried the state is moving toward "the furthest extreme" of those who believe "abortion must be allowed under any circumstance, for anyone, at any time and paid for by the taxpayer."

Del. Teresa Reilly, a Republican representing Cecil and Harford counties, said both bills ignored "so many people in our state that believe this is a form of killing the innocent," while Del. Rick Impallaria, a Republican for Baltimore and Harford counties, said the proposed amendment would turn the state's constitution into "a satanic document."

The move to cement abortion rights in Maryland comes as legal access to abortion - guaranteed by the 1973 landmark U.S. Supreme Court decision in Roe v. Wade - is again at issue nationally. The Supreme Court is considering whether to uphold a Mississippi law that would ban all abortions after 15 weeks of pregnancy, a decision that could roll back or even overturn Roe v. Wade.

That could allow tight restrictions or outright bans on abortion in dozens of conservative, Republican-controlled states to go into effect - but would not affect access to abortions in Maryland, where abortion's legality has been considered settled law for decades.

House Speaker Adrienne A. Jones, the sponsor of the proposed constitutional amendment, acknowledged during hearings last month it's "hard to imagine ... a Texas- or Mississippi-style law in Maryland." But the Baltimore Democrat described the amendment as a guarantee against future politicians trying to scale back abortion access or using abortion funding as a political bargaining chip.

Constitutional amendments require the support of three-fifths of members in both chambers of the General Assembly and approval by voters, a high threshold that would make Jones' amendment - if passed - far more difficult to repeal. It also would give voters the opportunity to weigh in on any future move to roll back abortion rights.

Gov. Larry Hogan, a Republican, is an opponent of abortion but has repeatedly called it "a matter of settled law" in Maryland. A spokesman for Hogan, who holds the power to potentially veto the expanded access law but not a proposed constitutional amendment, did not respond to questions about the proposals on Friday.