Nebraska abortion rights opponents hope that what happens in Iowa, stays in Iowa.
To make sure, they plan to pursue legislation next year that would prevent a pioneering Iowa telemedicine program from crossing the Missouri River.
The proposal would bar Nebraska doctors from prescribing and dispensing abortion-inducing drugs via the Internet, as Planned Parenthood of the Heartland has done for more than 2,000 women in Iowa since the summer of 2008.
Nebraska lawmakers can expect to see that and other abortion-related legislation when they return to Lincoln on Jan. 5.
Abortion rights opponents look to build on their success in 2010, when they saw Nebraska passage of a first-of-its-kind ban on abortions beginning at 20 weeks after fertilization.
For 2011, opponents plan to pursue a telemedicine bill and at least two proposals that would restrict insurance coverage of abortion under the federal health care overhaul.
The opponents also might make another attempt to increase screening requirements for women seeking abortions.
Julie Schmit-Albin, executive director of Nebraska Right to Life, said her group is talking with several state senators about the telemedicine issue. She declined to name the senators or give details of a proposal.
The goal is to prevent Planned Parenthood from expanding its remote access abortion program to Nebraska. The Des Moines-based organization operates clinics in Nebraska and Iowa.
“The abortion industry keeps coming up with new ways to kill unborn children, and this is one of them,” Schmit-Albin said. “What happens in Iowa, I kid you not, is headed for Nebraska.”
Through Planned Parenthood, a woman can go to one of 16 clinics around Iowa, get a pregnancy test, undergo an ultrasound and be examined by a nurse. The patient then talks with a doctor via a secure Internet connection.
The doctor, after reviewing the woman’s medical records and talking with her, can remotely open a container to provide her with pills. The process is similar to what would occur if a woman saw a doctor in person for a drug-induced abortion.
Two drugs — mifepristone and misoprostol — are combined to cause abortion during the first nine weeks of pregnancy. The combination, approved in 2000, now accounts for about 15 percent of all U.S. abortions.
Schmit-Albin said women are put at risk when they don’t see a doctor face-to-face to obtain the medications.
But Kyle Carlson, legal director for Planned Parenthood of the Heartland, said restrictions on the use of telemedicine for dispensing abortion drugs could hurt the growing use of Internet video hookups in medicine.
“To make an argument that telemedicine is unsafe because the physician is not present is not an attack on abortion, it’s an attack on telemedicine,” he said.
Carlson said Planned Parenthood expects to fight such legislation, as well as bills planned by Sens. Annette Dubas of Fullerton and Beau McCoy of Omaha that would bar health plans offered through the new federally mandated insurance exchanges from offering abortion coverage.
The bills would take advantage of a state option added to the new federal health care law by U.S. Sen. Ben Nelson, D-Neb.
Dubas said her proposal would bar abortion coverage unless an abortion was necessary to save a woman’s life. She said the bill would not apply to other private health plans.
McCoy said he is still working on his proposal.
Without the legislation, health plans available through the insurance exchange could include abortion coverage.
Most would not do so, however, if current practices are any guide. State Insurance Director Bruce Ramge said few companies offer such coverage.
Carlson said Planned Parenthood believes that the state should not stand in the way of such coverage if a private company wants to offer it.
“What this policy does is inherently unfair,” he said, because it means women who need subsidized health insurance could not get abortion coverage.
People would get help paying for insurance under the new health law, but only if they bought insurance through an exchange.
Under the federal law, public subsidies could not be used to pay premiums for abortion coverage. Policyholders would have to send separate payments for that portion of their insurance policies, and the money would have to be accounted for separately.
Dubas said her constituents feel strongly about tax dollars going toward abortion, even indirectly. She said her proposal would also ease the burden on state insurance regulators.
Whether a new proposal on screening requirements makes it into the hopper this year is up in the air.
Greg Schleppenbach, a lobbyist for the Nebraska Catholic Conference, said he doesn’t know if interested parties can reach agreement before the bill introduction deadline passes.
Nebraska lawmakers passed a law this year that would have required extensive screening of women seeking abortions and have held doctors civilly responsible if a screening fell short.
But a federal judge blocked implementation of the law, ruling it was unconstitutional. Nebraska officials decided not to appeal.
Martha Stoddard
WORLD-HERALD BUREAU