As abortion bills surface, new debates over women's health

Legislators have introduced half a dozen bills that place new restrictions on Minnesota abortion clinics, with supporters and opponents claiming to champion women's health from opposite sides of a perennially contentious debate.

Two of the bills would require facilities that perform 10 or more abortions per month — a total of five clinics, by 2013 figures — to meet the standards of outpatient surgical centers. Others would prohibit the use of state money to fund abortions, while another would require physicians to be present when abortion-inducing drugs are administered. All are awaiting hearings in the House Health and Human Services Reform Committee.

In 2012, Gov. Mark Dayton vetoed four similar bills, and more vetoes seem likely this year. "The governor opposes any law restricting further a woman's right to make her own medical decisions," said Matt Swenson, Dayton's press secretary.

But a new Republican majority in the House could give the debate fresh energy this year.

Rep. Debra Kiel, R-Crookston, author of a bill that would require abortion clinics to be licensed like outpatient surgical centers, said the measure is meant to ensure the safety of patients in worst-case medical scenarios.

"I live in a really rural area. I've had basic things done in a clinic, like a cut stitched up," Kiel said. But for a more serious procedure, she said, "I certainly would've wanted to be in a facility that could handle other things that can happen — and there are things that can happen with that procedure, unexpectedly."

Of the 9,903 abortions performed in Minnesota in 2013, 65 had medical complications, either during or immediately after the procedure, according to the Minnesota Department of Health.

Laurie Casey, executive director at Women's Health Center of Duluth, said her clinic — the only one in northern Minnesota that provides 10 or more abortions monthly — likely would close under the bill due to "burdensome fees" and "impossible" construction standards. "By legislating mandated hallway width or a bathroom for each sex in your waiting room — how is that looking out for women? How is that making abortions safer?" she said.

Passage of similar laws in other states has forced dozens of abortion clinics to close, according to Stephanie Shea, marketing manager for Whole Woman's Health in Minneapolis, whose Minnesota location performed about a third of the state's abortions in 2013.

In Texas, Shea said, Whole Woman's Health had five locations that also provided services such as gynecology, birth control and counseling. She said two of the clinics closed after the state passed several laws, among them one requiring abortion facilities to meet ambulatory center standards.

"If you can't get the million dollars to renovate, and you can't comply, then your clinic closes … and then there's one less provider," Shea said.

Rep. Peggy Scott, R-Andover, author of a clone of Kiel's bill, said the bill simply requires abortion clinics to abide by the same laws that other outpatient clinics have to follow.

"If people would … substitute the word 'abortion' and put any other medical procedure in [its] place … and take out the hypersensitivity around this issue," Scott said, "I don't see any reason why this wouldn't pass."

Planned Parenthood Minnesota, North Dakota, South Dakota — Minnesota's largest abortion provider — opened a $16 million facility in 2011, after a five-year fundraising effort, built to ambulatory-center standards, including employee locker areas, bathrooms for each sex in the waiting area, and compliance with particular doorway widths and heating, cooling and ventilation systems.

If Minnesota cuts off state funding for abortions, Duluth's Casey said, it would steer low-income women away from safe procedures. Casey said that half of the women who use abortion services at Women's Health Center have low incomes and that many of them receive some sort of medical assistance. The cost of an abortion, according to Planned Parenthood, can range from $300 to $900.

That bill's author, Rep. Tama Theis, R-St. Cloud, said it's not an attack on low-income women, but simply another effort in a years-long attempt to make Minnesota a state where abortion, as an elective procedure, is not funded by taxpayers.

"Taxpayers should not be on the hook for this," Theis said. "In this day when everyone's counting their pennies, we [should] be fiscally responsible to our taxpayers."

Theis said that Minnesota has spent $20 million on abortions over the past 10 years and that she would rather see the money spent on increased nursing home staffing, transportation and education.

Shea, of Whole Woman's Health, argued that taken together, the bills are an attempt to shut down abortion clinics without directly banning them. "You don't have to outlaw something that's impossible to provide and impossible to access," she said.

Marion Renault • marion.renault@startribune.com

Marion Renault is a University of Minnesota journalism student on assignment for the Star Tribune.