Alaska's Peculiar Battle Over Abortion

On June 4, a 15-denomination coalition of Alaska's religious faithful gathered in prayer outside Gov. Sean Parnell's downtown Anchorage office. They were there to protest the governor's veto of a bill that would provide state funding for abortions.

"Is there no balm in Gilead? Is there no physician there?" recited Pastor Lisa Smith of Central Lutheran Church, opening the service with passage from the book of Jeremiah.

Parnell's veto should have been popular, or at least uncontroversial, in a red state where the marquee initiative on the August ballot would potentially jail doctors who fail to notify parents of teenagers seeking abortions. But the funding wasn't just for abortion. Senate Bill 13 was an expansion of the Denali KidCare program, the state children's health insurance program (SCHIP) that covers low-income children and pregnant women. The outcry over what should have been a politically safe move points to the difficulty conservatives face when they pursue limits on abortion in state-funded health care.

Denali KidCare currently serves about 8,000 children, and SB 13 would have expanded coverage for 1,300 more by increasing the income threshold from 175 percent of the federal poverty line to 200 percent. Alaska is one of a handful of states that has yet to raise their SCHIP threshold, and it ranks an abysmal 48 out of 50 in children's health. If health care is a problem everywhere in the United States, it's especially so here, given the additional expense of providing service in remote areas. The bill was an easy fix to an obvious problem. It would allocate $2.9 million to covering those at the margins, with two-thirds of that money coming not from the state but from matching federal funds. The state legislature approved the measure overwhelmingly.

Because of a 1993 court order, Alaska is required to fund abortions determined medically necessary if it is to fund any health services at all. Only a fraction of a percent of Denali KidCare's funding goes toward abortion-related services -- in 2009, it was 0.18 percent. Every year, the state legislature tries to include language that excludes abortion funding. And every year, a fatigued Department of Law tells the legislature it can't do that. (The exhaustion is palpable in the 2008 budget review addressed to former governor Sarah Palin: "This year's budget, as did the past several years' budgets …" "As we opined before …" ) It shouldn't have surprised Parnell that Denali KidCare would be bound by this rule, especially since he worked on health-care legislation while in the State Senate and voted for Denali KidCare when it was first introduced. But the governor registered shock that this was the case.

"I want to be able to provide those services. But if your governor doesn't stand for life and liberty, as he understands it in his conscience, then you don't have a governor," Parnell said, explaining why he vetoed funding for KidCare.

He sounded remarkably like Rep. Bart Stupak during the throes of the health-care reform debate. An opportunity existed to improve health care for a huge swath of people, and the sticking point was mostly a worry that someone somewhere might get an abortion on the taxpayers' dime.

"There are certainly parallels with the fight over the Stupak amendment. The Stupak amendment was also trying to disavow the status quo. But in the Stupak case, we were talking about private funds," says Adam Sonfield of the Guttmacher Institute in Washington, D.C. "In this case, we're talking about state funds. If we take this to its logical conclusion, Parnell is saying that we shouldn't have the Denali KidCare program -- or a Medicaid program -- at all."

The other big difference is that Stupak eventually caved, accepting a White House concession on abortion instead of undermining a plan that would radically reduce the number of uninsured. Parnell actually spiked the funding in question.

"This type of move -- to say that we're going to cut, essentially, a broad-based health-care program -- is unprecedented. I can't think of any state that has done anything near this extreme because of abortion," says Sonfield.

While some state legislators are trying to organize an emergency session to override the veto, the president of the State Senate is hostile to the idea of calling a special session and doesn't think it's possible to get the necessary three-quarters of the chamber on board. The only thing KidCare's sponsors can really do is start over and wait for a new budget, and maybe a new governor. Parnell is up for reelection in the fall and his political opponents have called the veto a pander to social conservatives, particularly those in the lower 48 that might offer campaign funding. Two Democratic candidates for governor, Ethan Berkowitz and State Sen. Hollis French, have criticized Parnell's state-funded visit with evangelical Christian group Focus on the Family immediately following the veto. Bill Walker, a Republican challenger who has used his campaign to push for the parental notification initiative, also expressed skepticism about how the trip "furthers the interest of the state."

Alaska's two National Right to Life affiliates still have not met to formally discuss the KidCare funding veto, but Alaska Right to Life President Christie Eberhardt lays out her organization's stance in black and white terms -- repeatedly, with emphasis, and without mentioning KidCare. "We don't support any taxpayer money going to abortion."

But within the movement there is still some misgiving about the impact on KidCare. "It would be dishonest to say I have no concerns," says Paul Renschen, a member of Alaska Interior Right to Life. "It's a mixed decision. It does some harm as well as some good."

If opinion is fractured among Alaska's anti-abortion advocates, it is near monolithic outside the movement. State media has blasted Parnell. In language lifted straight from the Stupak debate, Anchorage Daily News columnist Elise Patkotak seethed, "So the conclusion one must draw about this veto is either the governor doesn't know what he's supporting when he supports it or, in a crass attempt to polish his credentials with the far right, he threw a bunch of low-income women and children under the proverbial bus."

The argument around the KidCare veto is familiar: How can the governor be pro-family and pro-life if he's willing to leave vulnerable children and pregnant women without the care doctors say they need? The reaction against the veto has also avoided treating abortion like some exotic procedure. KidCare supporters continually stress that this is about improving a broad-based program, and this broad-based program happens to provide abortions recommended by physicians as mandated by the law. "If he was truly motivated by an opposition to abortion, he would eliminate all of Denali KidCare" says Berkowitz. "Abortion under these circumstances is a health-care issue."

The anti-abortion movement consistently declares that it is on the side of children and mothers. But when abortion restriction comes in the context of hurting kids and hurting mothers, backlash is likely, even in conservative states. In the case of Denali KidCare, abortion seemed tangential -- irrelevant, even -- to providing much-needed health services to low-income children and pregnant women. It isn't. Maybe it won't take another state-level Stupak to remind people of this.