Last week, Massachusetts’ Republican Gov. Charlie Baker signed a bill protecting the right to obtain an abortion and receive gender-affirming care into law.
Bay State lawmakers had proposed the bill in response to a recent U.S. Supreme Court decision overturning the court’s landmark 1973 decision in Roe v. Wade, which had protected the right to an abortion, regardless of the state where a person resides.
The decision to overturn Roe v. Wade makes abortion a state’s rights issue, and allows authorities to prosecute doctors who perform abortions in states with laws outlawing the practice, which heretofore had been blocked from being enforced under Roe. Some states have even gone further, with Missouri proposing a bill earlier this year that would have allowed private citizens to sue anyone who aids a Missouri resident in accessing an abortion, regardless of where the procedure occurs.
By signing the bill, Baker ensures that health care providers and those who assist people in obtaining abortions (and maybe, if some states go further, even patients themselves) will be shielded from lawsuits and investigations initiated by out-of-state jurisdictions that outlaw abortions or gender-affirming treatments, according to MassLive, a Massachusetts-based news website.
Under the bill, insurance providers, including Medicaid, must cover the cost of reproductive health care, including abortions, without imposing additional deductibles or co-pays. The bill orders the Department of Public Health to issue an order allowing any licenses pharmacists in the commonwealth to dispense emergency contraception, ad will allow public colleges and universities to provide medication abortion at on-campus health centers.
The bill also allows for abortions to be performed in certain cases after 24 weeks if the procedure is necessary to preserve the life of the patient, preserve their physical or mental health, if it is needed because of a lethal fetal abnormality, or if the fetus cannot sustain itself outside of the uterus without extraordinary medical interventions.
In addition to abortion, the bill also requires that gender-affirming health care treatments are protected under the law, meaning they must be covered by insurance, including the state’s Medicaid program. The bill defines “gender-affirming health care” as “all supplies, care and services of a medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, rehabilitative or supportive nature relating to the treatment of gender dysphoria.” That means puberty blockers, hormone treatment, gender confirmation surgery, and other surgical interventions that support a transition, such as voice therapy or facial feminization surgery, must be covered.
Transgender advocates hailed the move, noting that states have begun restricting gender-affirming care for adults and youth alike. For instance, some states prohibit the use of Medicaid dollars to cover transition-related health care treatments for adults, or have retained exceptions in government employee health care plans that prohibit coverage for gender-affirming treatments, forcing individual patients to pay out of pocket.
In recent years, as the visibility of transgender youth has increased, states have moved to restrict certain types of transition-related procedures for youth. Two states — Alabama and Arkansas — ban any and all types of gender-affirming care, including puberty blockers, hormones, and surgical interventions, on minors.
According to the Movement Advancement Project, a third state, Tennessee, bans providers from prescribing hormones to “pre-pubertal minors” — although current best practices dictate that youth should not begin hormone treatments until they start to undergo puberty, thereby demonstrating the futility of the law and lack of understanding around transgender care on which it is based. A fourth state, Arizona, only bans surgical interventions on minors.
Recently, state officials in Texas have attempted to use child welfare agencies to investigate parents for “child abuse” if their children who identify as transgender have been allowed to access gender-affirming care. Texas is expected to introduce a law in the next legislative session classifying such situations as “child abuse,” and other states with Republican-led legislatures may follow suit. Massachusetts’ law would protect people, especially parents of trans youth who move to the Bay State from those other states, from such government intervention.
“Pregnant people, trans people, and all people must be allowed to make their own health care decisions in consultation with their physician without fear,” Massachusetts Senate President Karen Spilka said in a statement. “Our fight to protect the rights and dignity of our residents cannot end today, however, and so the Senate will continue to explore ways to uphold our fundamental rights.”
Carl Sciortino, the executive vice president of external relations at Fenway Health, praised the bill’s passage in a statement.
“Fenway Health was founded on the principle that healthcare is a right, not a privilege, and we are as committed to that core belief now as we were when we opened our doors over 50 years ago,” Sciortino said. “We applaud the legislature and Governor Baker for enacting this law ensuring access to reproductive and gender-affirming care. We will continue to do everything in our power to protect that right and to ensure that the people who count on us — and people everywhere — have access to the health care they need.”
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