The Alan Guttmacher


Updated January 15, 2004

Introduced refers to the administrative procedures that allow a bill to enter the legislative process and be considered by the legislature.

Moved indicates that the legislation has received serious consideration by state legislators (e.g., it has been voted on in a legislative committee or chamber, or has been amended or substituted by a vote). Additional action may not be expected either because the legislature has adjourned for the year, the legislature or legislative committee has defeated the bill or action on the provision is considered unlikely given the legislative environment in that state.

Enacted indicates that the legislation has been signed into law by the governor.

Vetoed indicates that the governor has blocked enactment of the legislation.

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  Pregnancy & Birth
  Prevention & Contraception


Bans on "Partial-Birth" Abortion
Introduced: 13 states
Enacted: MI, VA

In October, Michigan Gov. Jennifer Granholm (D) vetoed a measure that would have restricted so-called partial-birth abortions. Under the legislation, a physician would have been liable for prosecution for performing an abortion in which the fetus had been partially delivered through the vagina and showed evidence of life, unless the procedure had been necessary to protect the woman's life or prevent an "imminent threat" to her health. The legislature is considering attempting to override the veto.

In April, the Virginia legislature enacted a ban on "partial-birth" abortion that includes an exception to save the life of the woman, but no exception to protect the health of the woman. While the bill refers to "partial-birth infanticide," it is intended as a "partial-birth" abortion ban. In June, the Center for Reproductive Rights filed a lawsuit challenging the statute on the grounds that it is overly vague and does not include an exception to protect the woman's health. On July 1, the U.S. District Court for the Eastern District of Virginia temporarily enjoined enforcement of the law while the litigation is pending and set a trial for November 4. (Virginia's previous ban on "partial-birth" abortion was eventually struck down in 2000 by the U.S. Court of Appeals for the Fourth Circuit.)

Legislation Concerning Medical Abortion
Introduced: 4 states
Enacted: IA

In April, the Iowa legislature enacted legislation requiring the inclusion on abortion reporting forms of mifepristone as a method of providing abortion.

Restrictions on Postviability Abortion
Introduced: 7 states

Limitations on Public Funding of Abortion for Low-Income Women
Introduced: 12 states
Enacted: IA and TN

In May, the Iowa legislature reenacted long-standing restrictions on the use of public funds for abortion. As a result, the state will continue to pay for abortions only in cases of life endangerment, rape, incest and fetal abnormality.

In June, the Tennessee legislature codified longstanding restrictions on the use of public funds for abortion. Tennessee will continue to pay for abortions in cases of life endangerment, rape and incest.

Restrictions on Private Insurance Coverage of Abortion
Introduced: 6 states

Using Revenue from "Choose Life" License Plates to Fund Crisis Pregnancy Centers
Introduced: 20 states
Enacted: AR and TN

In March, the Arkansas legislature enacted legislation establishing "Choose Life" license plates to support organizations that promote adoption. Profits generated from these license plates will be deposited into the "Choose Life" Adoption Assistance Program, created by the state Department of Health. Funds will be allocated to qualified organizations that provide counseling and meet "the physical needs of pregnant women who are committed to placing their child for adoption."

In June, the Tennessee legislature enacted legislation establishing "Choose Life" license plates. Unlike other state laws, the Tennessee law does not expressly prohibit abortion-related organizations from taking part in the program, but rather lists the organizations that may receive the proceeds. The list, which includes nearly 50 organizations, consists mostly of crisis pregnancy centers and religious organizations, and does not include any family planning clinics.

Requirements that Abortions be Performed only by Physicians
Introduced: 6 states

Requirements for Parental Involvement in Minors' Abortions

Parental Consent Requirements:
Introduced: 13 states
Enacted: VA

For several years, Virginia law had required that the parents of a minor be notified before an abortion is performed. In April, the Virginia legislature amended the law to require that one parent consent before a minor may obtain an abortion. The law also includes a judicial bypass provision as an alternative and provides an exception when the minor is abused or neglected, or when the procedure is necessary to preserve the life or health of the minor.

Parental Notification Requirements:
Introduced: 14 states
Enacted: CO and NH

In June, the Colorado legislature enacted legislation requiring parental notification 48 hours before a minor obtains an abortion. Although the measure does not include a traditional health exception, it does include an exception in the case of medical emergencies. (A previous parental notice law in Colorado was struck down in 2000 because it lacked a health exception.)

In December, a federal District Court judge in New Hampshire struck down the state's newly enacted parental involvement law that required a pregnant minor to notify one parent at least 48 hours prior to an abortion. The judge ruled that the law violated the state's constitution by failing to include a health exception. The law, which included a judicial bypass and an exception in the case of life endangerment, had been set to go into effect on December 31, 2003. In June, the New Hampshire legislature enacted the legislation. (Previously, New Hampshire's only abortion restriction limited public funds for abortions to cases of life endangerment, rape and incest. New Hampshire had been one of only eight states and the District of Columbia that had never mandated parental involvement.)

Mandatory Counseling and Waiting Periods Before Abortion

Women Required to Receive State-Directed Counseling
Introduced: 17 states
Enacted: AR, SD and VA

In April, the Arkansas legislature enacted legislation requiring physicians to inform women that they may view the ultrasound before an abortion is performed. The physician must certify in writing that the woman was given the option of viewing the ultrasound.

In March, the South Dakota legislature enacted legislation directing the state Department of Health to develop a Web site containing information concerning fetal development, fetal viability, abortion methods and risks, counseling to detect possible abortion risks, postabortion psychological complications and parental notification, possible assistance during pregnancy, child support and information about adoption.

In March, the Virginia legislature amended current law to require that any information given to women prior to an abortion include information on promoting adoption as a positive alternative to abortion. Adoption information should also include counseling services, benefits, financial assistance, medical care and contact information for adoption agencies or groups.

Requirements for State-Directed Counseling, Followed By a Waiting Period:
Introduced: 19 states
Enacted: MN, TX and WV
Veto Overridden: MO

In April, the Minnesota legislature enacted legislation requiring a 24-hour waiting period before a woman may obtain an abortion, except when the procedure is necessary to preserve the woman's health or life. The measure includes the provision of specified information to the woman.

In October, a U.S. District court judge temporarily blocked Missouri's new counseling and waiting period law, which required women seeking abortions to wait 24 hours after receiving counseling before having an abortion. The law is under a temporary restraining order until a hearing on January 27, 2004. The measure had become law when the legislature overrode Gov. Bob Holden's (D) veto in September.

In June, the Texas legislature enacted legislation requiring a woman to receive specific information and counseling, and then wait 24 hours before obtaining an abortion. Although the law goes into effect on September 1, it will apply to procedures provided on and after January 1, 2004.

In March, the West Virginia legislature enacted legislation requiring physicians to provide women 24 hours before an abortion with information on medical risks associated with abortion and carrying a child to term, the gestational age of the fetus and medical assistance benefits such as prenatal and neonatal care, childbirth and child support information. The law also directs the state Department of Health to develop content to be posted on its Web site on such topics as the medical risks of abortion and carrying a child to term, psychological effects of abortion, biological characteristics of the fetus and lists of adoption and pregnancy assistance agencies.

Protecting Access to Abortion Clinics
Introduced: 8 states

Requirements that Abortion Providers Report Statistical Information to State Agencies
Introduced: 13 states
Enacted: IA, LA and WV

In April, the Iowa legislature enacted legislation requiring the inclusion on abortion reporting forms of mifepristone as a method of providing abortion.

In June, both houses of the Louisiana legislature adopted a resolution that directs the state vital statistics office to include in the annual abortion report the number of abortions by parish (county) and municipality (even though the numbers are small enough that it might allow identification of individual providers), as well as information about abortion complications.

In March, the West Virginia legislature enacted legislation directing the state Department of Health and Human Resources to develop an abortion reporting form. (Previously, the state collected such information on a voluntary basis.)


Legalizing Infant Abandonment
Enacted: CO, LA, NH, VA and WY

In March, the Colorado legislature amended its infant abandonment law to require a hospital or fire station that receives an abandoned infant to contact the local department of child services within 24 hours.

In June, the Louisiana legislature amended its infant abandonment provisions to allow a parent to relinquish an infant using the 911 emergency system. A person receiving the infant must ask for the infant's medical history and the act of relinquishment is considered consent to a medical examination, including testing for HIV and prenatal exposure to drugs or alcohol.

In May, the New Hampshire legislature enacted legislation allowing a parent to leave an infant seven days or younger at a hospital, police station, fire station or a church that is attended by the parent or by the 911 system.

In March, the Virginia legislature enacted legislation allowing a parent to leave an infant 14 days or younger either at a hospital that provides emergency services or with emergency medical technicians.

In March, the Wyoming legislature enacted legislation allowing a parent or a parent's designee to leave an infant 14 days or younger at a fire station, hospital, police station or designated facility.

Combating Substance Abuse During Pregnancy
Introduced: 6 states
Enacted: ND

In March, the North Dakota legislature enacted legislation establishing requirements for testing and reporting of pregnant women suspected of substance abuse. Among others, health care providers caring for pregnant women are required to report suspected cases of abuse. The legislation mandates the state Department of Human Services to assess the woman and offer services, if appropriate. The bill takes effect in August.

Requirements Regarding HIV Testing of Pregnant Women
Enacted CA, IL, IN and NM

In October,California Gov. Gray Davis (D) signed legislation amending the state's law governing HIV testing of pregnant women. Prior to the amendment, state law required physicians to offer pregnant women (except those already identified as HIV positive) information about and testing for HIV. The amendment requires physicians to notify state health officials when a pregnant woman receives a positive HIV test result. The amendment goes into effect January 1, 2004.

In August, Illinois Gov. Rod Blagojevich (D) signed a measure governing HIV testing of pregnant women and newborns. The new law requires health care professionals to provide HIV counseling and offer HIV testing to pregnant women if they give their informed consent. Within 48 hours of delivery, the parents of a newborn will receive HIV counseling; the infant will be tested for HIV if the mother's HIV status is unknown and if the parents consent.

In May, the Indiana legislature enacted legislation requiring health care professionals to counsel pregnant women about HIV and to provide testing unless an individual woman opts out. Women who meet certain qualifications and test positive for HIV may be eligible for publicly funded health care.

In May, the New Mexico legislature enacted legislation allowing health care providers to test pregnant women for HIV without obtaining informed consent.


Abortion-Related Restrictions on State Family Planning Funds
Introduced: 15 states
Moved: ID, MN, ND and VA
Enacted: MO, NE, OH, PA and TX

In June, the Missouri legislature enacted legislation deleting all state funds for family planning. However, along with deleting the funding, the measure also deleted the state's longstanding prohibition on using funds for abortion-related services and its requirement for physical and financial separation between family planning providers and agencies providing abortion.

In May, the Nebraska legislature enacted legislation that added a restriction prohibiting any family planning funds appropriated by the state from being used for abortion services, counseling or referral. (However, since the annual appropriations measure has long limited family planning services to cervical cancer diagnosis and STD diagnosis and treatment, it is not clear what the impact of the abortion restriction will be in practice.)

In June, the Ohio legislature enacting legislation restricting state family planning funds. The abortion-related restrictions applied to state family planning funds remained the same (a prohibition on counseling and referral, and a requirement that family planning providers be separate from agencies providing abortion). However, the legislature made two important changes to the measure. First, the line-item for family planning was renamed "women's health services," and includes a list of eight services for which the funding may be used, including pelvic and breast exams, sexually transmitted disease treatment and testing, education on sexual coercion and substance abuse, prenatal care and contraceptive services. Second, local health departments will have top priority in the allocation of funds. Any funds remaining after awards are made to local health departments may be distributed to agencies that provide either all of the eight listed services, or all except contraceptive services; the law specifically prohibits discrimination against agencies that do not provide contraceptives. The law applies to funds distributed on and after January 1, 2004.

In March, the Pennsylvania legislature enacted legislation including the same family planning funding restriction from last year. Under the measure, family planning funds may not be used to counsel or refer for abortion or to promote or encourage abortion; organizations that receive these funds must be physically and financially separate from entities providing abortion services. The law specifically exempts hospitals as well as organizations receiving Title X funds that provide nondirective counseling as required by federal law.

In June, the Texas legislature enacted new restrictions on family planning funds going through the state treasury. The restrictions prohibit the funds from being distributed to organizations that provide or contract with other groups to provide elective abortions. The measure appears to apply to federal funds as the state does not have any state-only family planning funds. Soon after enactment, six Planned Parenthood affiliates filed suit; a state court has issued a preliminary injunction blocking enforcement of the measure pending resolution of the litigation. Without the injunction the measure would have gone into effect in September, the beginning of Texas's fiscal year.

Expanding Access to Emergency Contraception

Offering Emergency Contraception Services to Sexual Assault Victims in Emergency Rooms
Introduced: 13 states
Moved, additional action not expected in 2003: AZ, AR, CO, MN and NM
Enacted: NM, NY, OR
Vetoed: HI

In March, the New Mexico legislature enacted legislation requiring hospitals that provide emergency care to rape victims to supply medically accurate information on emergency contraception and to provide the method upon the victim's request. The law is now in effect.

In September, New York's Gov. George Pataki (R) signed into law a bill requiring hospitals to provide EC on request to sexual assault victims. A hospital will not have to provide EC to a rape victim who is pregnant, a clause added to reflect current practice at many Catholic hospitals. These hospitals administer a standard pregnancy test that, if used within the EC window of effectiveness, would only determine if the woman had been pregnant prior to the rape. The law will go into effect in January 2004.

In September, Oregon's Gov. Ted Kulongoski (D) signed a measure requiring the state Department of Justice to pay for the provision of EC to sexual assault victims when dispensed as part of a medical assessment. The measure does not require medical professionals to provide EC to sexual assault victims. The law goes into effect in March 2004.

Allowing Pharmacists to Provide Emergency Contraception without a Prescription:
Introduced: 10 states
MD and NY
Enacted: CA, HI

In September, the California legislature enacted two measures amending current law governing the provision of EC by pharmacists. Under the measures, pharmacists will be allowed to dispense EC under a specific EC drug therapy protocol established by the state's pharmacy and medical boards even if they are not acting under a specific collaborative practice agreement with a physician. Pharmacists will be required to undergo one hour of EC drug therapy training and will be barred from seeking unnecessary medical information from patients. In addition, pharmacists will be limited to charging no more than $10 as an administrative fee for dispensing EC, including any patient consultation provided. Gov. Gray Davis (D) signed the bills on October 2; they will go into effect in January 2004.

In June, the Hawaii legislature enacted legislation allowing pharmacists to dispense emergency contraception without a prescription; the measure went into effect immediately.

Providing Contraceptive Coverage
Introduced: 26 states
Moved: AZ, AR, LA, MN, NJ, ND, OK, UT and WV
Enacted: IL and TX

In July, the Illinois legislature enacted legislation mandating that insurers cover prescription contraceptive drugs, devices and outpatient visits if they cover prescription drugs, devices and outpatient visits generally. Although the new law does not include a specific refusal clause, the state's long-standing refusal clause--under which insurers are exempt from covering any service that violates their conscience--applies to the requirements of the new law. The measure goes into effect in January 2004.

In June, the Texas legislature enacted a measure that effectively negates state mandates that require insurance plans to cover contraceptive services and supplies, and other services such as treatment for chemical dependency and complications of pregnancy. The law allows insurers to offer two health plans to employers seeking to purchase coverage for their employees. Although one plan would have to include coverage of all mandated services, the other would not; employers would be entitled to choose between the two plans. The measure will affect insurance plans as of January 2004.

Allowing Health Professionals to Refuse to Provide Services

General Exemptions for Health Professionals for All Services:
Introduced: 6 states
Moved: WI

Exemptions Allowing Refusal to Participate in Abortion Services
Introduced: 6 states
Moved: VA and WI

Provisions Allowing Pharmacists to Refuse to Provide Services
Introduced: 9 states
Moved: NV and WI

Provisions Allowing Medical Students to Refuse to Participate in Abortion
Introduced 1 state


Parental Consent Requirements for Minors Seeking Contraceptive Services
Introduced: 5 states
Moved: VA

Sex Education
Provisions Requiring Sex Education

Introduced: 15 states
Moved: IL, MN, MS, ND and VA
Enacted: CA, FL

In September, the California legislature enacted a measure that will consolidate and modify state laws on sex and HIV/AIDS education. Under the measure, sex education courses in the state are required to include information on emergency contraception and cover abstinence. Previously, state law had required that abstinence be stressed. The measure also prohibits school districts from requiring parental consent before enrolling students in sexuality or HIV/AIDS education courses, although parents will be allowed to opt their children out of the courses. On October 2, Gov. Gray Davis (D) signed the bill into law; it will go into effect in January 2004.

In June, the Florida legislature enacted legislation amending its existing sexuality education law by adding parenting skills to the required curriculum. The new law also allows high school students to take the required family life education anytime throughout high school, rather than in ninth or 10th grade, as had previously been permitted. The law takes effect in July.

Provisions Requiring HIV Education
Introduced: 3 states
Moved: IL

Provisions Requiring that Sex Education Curricula Be Medically Accurate
Introduced: 8 states
Moved: AZ, HI and WA

Requirements for Child Abuse Reporting
Introduced: 6 states
Enacted: TX

In June, the Texas legislature enacted legislation requiring all agencies receiving funds (including family planning funds) from the state health department to make "good faith efforts" to comply with child abuse reporting requirements.


Penalizing Assault on Fetuses and Pregnant Women
Introduced: 23 states
Enacted: CO, CT and TX

In June, the Colorado legislature enacted a fetal homicide provision and amended the state's assault law. The new provision classifies intentionally terminating a woman's pregnancy as a crime (with the exception of legal abortion). In addition, the law provides for an enhanced penalty for assault, if the assault is against a pregnant woman and if the perpetrator had knowledge of the pregnancy. (Previously the assault statute only applied in cases of domestic violence; the new law makes it applicable in all cases.) The laws take effect in July.

In May, the Connecticut legislature enacted legislation that makes knowingly harming a pregnant woman in a manner that ends the pregnancy a more serious crime than an assault on a pregnant woman that does not result in the termination of the pregnancy. The law takes effect in October.

In June, the Texas legislature enacted legislation that classifies a fetus from fertilization as a victim for purposes of the state's murder and assault statutes. The new law goes into effect on September 1.

Regulating Stem-Cell and Embryo Research

In September, California Gov. Gray Davis (D) signed two bills affecting stem cell research. One statute requires the state Department of Health Services to develop guidelines for human stem cell research conducted in the state. All stem cell research projects will need to be reviewed and approved by a state-organized Institutional Review Board using the guidelines. The other measure establishes a state-run registry that lists embryos available for stem cell research and requires medical professionals providing fertility treatment to inform patients of the option to donate unused embryos. Payment for the donation of embryos for research is prohibited. Both laws go into effect on January 1, 2004.

Production of the State Update is made possible by support from The David and Lucile Packard Foundation and the Prospect Hill Foundation.

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