Montana seeking prior authorization for Medicaid abortions

HELENA, Mont. (AP) — State officials in Republican-controlled Montana want to require prior authorization before its health department pays for abortions for people covered by Medicaid, a proposal critics say would reduce access and delay or even prevent abortion care for low-income women in the state.

The Department of Public Health and Human Services is taking public comment Thursday on the proposed rule to require doctors to provide more medical information before Medicaid would agree to pay for an abortion to save a woman's life or any other medically necessary reason. The information would include the number of her pregnancies and children.

Montana is one of 16 states whose Medicaid program is required to cover the costs of “medically necessary” abortions based on state law or a court order, according to the Guttmacher Institute.

A 2019 federal report said seven states at that time, which were not listed, required prior authorization before Medicaid would cover abortion services.

The Centers for Medicare & Medicaid Services did not immediately respond to a phone message Wednesday seeking more information.

“Given the time sensitive nature of abortion care, requiring doctors to obtain prior authorization before providing care creates an unnecessary obstacle that may result in delays in care and increase in costs for patients,” said Cat Duffy with the National Health Law Program.

In Montana, abortion is legal until 24 weeks of gestation. A 2021 law that sought a reduction to 20 weeks is being challenged in court while the state also indicated it wants the Montana Supreme Court to overturn a ruling that the state Constitution's right to privacy guarantees access to legal abortion.

The proposed rule would only allow physicians — not physician assistants or...