KY passes bill clarifying when abortions are legal. Opponents say women will still 'suffer'

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This story has been updated to include information about a second bill amended on Wednesday.

An amended House bill that would make it easier for freestanding birthing centers to open in Kentucky has passed the legislature with a measure adding clearer language clarifying medical exceptions to the state's near-total abortion ban.

House Bill 90, sponsored by Republican Rep. Jason Nemes, originally would remove the certificate of need requirement for freestanding birth centers, among other measures. A provision added Wednesday during a Senate Licensing and Occupation meeting outlined medical conditions and obstetrical complications that are not considered an abortion under Kentucky law.

The amended bill passed the Senate on Thursday and was approved in the House shortly after. It now goes to Gov. Andy Beshear to sign or veto. Lawmakers will have a chance to override any vetoes at the end of the month.

House Bill 414, which started off as legislation addressing perinatal palliative care, also had a similar provision added Wednesday.

The provision identifies miscarriage management; removal of ectopic and molar pregnancies; sepsis treatment; hemorrhage control; and management of fetal demise and stillbirth as protected medical treatments.

Speaking on the House floor, Nemes said the bill addresses "a very real and present problem" that puts lives at risks.

“Kentucky’s a pro-life state and we will stay as such," the Louisville representative said," ... (but) this will save lives.”

When the U.S. Supreme Court overturned Roe v. Wade in 2022, Kentucky's trigger law went into effect, banning abortions unless a mother's life is at risk.

Supporters said the legislation is necessary to address misinformation that has caused Kentucky women to fear they will be denied necessary medical treatment, as well as confusion within the medical community on what procedures are allowed.

At a committee hearing for HB 414 on Wednesday, Nemes said the added provision broadens a doctor's ability to use their "reasonable medical judgement" and ensure these conditions are treated without "legal ambiguity."

According to the bill, "reasonable medical judgement" is defined as "the range of conclusions or recommendations that licensed medical practitioners with similarly sufficient training and experience may communicate to a patient based upon current available medical evidence."

Dr. Jeffery Goldberg, a gynecologic oncologist in Louisville and the legislative advocacy chair for the Kentucky Chapter of the American College of Obstetricians and Gynecologists, said while the bill isn't perfect, "it's an acceptable short-term solution for dealing with a really serious problem that's in front of us."

Sen. Julie Raque Adams, R-Louisville, said the language is needed to address misinformation.

"There is a lot of misinformation out there in the medical community, and doctors just need to be doctors," Raque Adams said. "So, this language that's before us today adds a much need clarity for the medical community, and it's also embraced by the medical community."

The measure passed the Senate with 29 "yes" votes and 5 "pass" votes from Democrats. In the House later Thursday morning, it passed 74-17, with Republican Reps. Kim King of Harrodsburg and Vanessa Grossl of Georgetown joining several Democrats in opposition.

Democratic Sen. Cassie Chambers Armstrong said she had to pass on voting because she has received mixed messages from the medical community and was disappointed by the bill's process.

"It is an intentional choice by the majority party the way this legislation has moved to disenfranchise me and the people I represent on this very important issue," Chambers Armstrong said.

Speaking at a press conference Thursday morning, Beshear said the efforts in the bill "don't go far enough."

"When this one reaches my desk I’m going to have some questions, because we were told by those that passed the trigger law originally that it provided an exception for the life of the mother, and now this bill is saying that it needs to be passed through law," Beshear said "One of the questions I’m going to have is, 'Is it more or less restrictive than the current standard in the medical community that we have right now?'"

House Democrats express concerns over abortion law changes

Some Democrats on Wednesday raised concerns about the bill's language and said it doesn't address the root of the problem.

"I think the effort was to clarify, but I think what it does is to codify the woman has to suffer a lot before the doctor is able to treat that," Rep. Lisa Willner, D-Louisville, said.

House Democratic Whip Lindsey Burke said she couldn't vote "yes" on the bill because she didn't believe it solves the problem they're trying to fix.

She called the bill "at best a rough draft" because "not everyone was given a seat at the table" to weigh in on it.

"We need hospital general counsel to weigh in," Burke said. "Those are the people who are telling the doctors they can't act. So unless they're at the table, we don't have a solution."

Rep. Mary Lou Marzian, D-Louisville, also voted against the bill and pointed out that Kentuckians voted "no" on a 2022 ballot measure that would eliminate the right to abortion in the state constitution.

"We're losing medical students," Marzian said. "We're losing residents, we're losing pediatricians. It may not hurt Louisville or the urban areas, but rural, y'all are going to suffer and women are going to die out there. Hospitals are going to be a mess."

Speaking Thursday in House, Burke said freestanding birthing center legislation is "something we should have passed a long time ago," but the bill that ended up on the chamber's floor was a "Frankenstein" that combined several pieces of other bills in the final hours of the session and included nonmedical language that doesn't provide total clarity.

Medical professionals, students, others call for reversal on abortion restrictions

Others are calling for a change to Kentucky's abortion law all together — Rep. Matthew Lehman, D-Newport, said the legislature is the reason women are in danger due to a lack of abortion access, and legislators "shouldn't get credit for putting out a fire (they) started."

In his press conference Thursday, Beshear said more access is "what I'll always push for. And the Kentucky Physicians for Reproductive Freedom led a press conference Wednesday, where members presented a letter sent to legislators to repeal the state's abortion bans.

Dr. Janet Wygal, a board-certified OBGYN in Kentucky, said current laws contradict the guidance of medical organizations, including the American Medical Association and the American College of Obstetricians and Gynecologists.

"No physicians should be forced to wait until someone becomes sick enough to intervene with basic necessary health care because the government says so," Wygal said.

Shriya Dodwani, a medical student from the University of Louisville, said she is concerned future doctors are leaving Kentucky, an issue that could create a shortage of medical professionals.

"The Accreditation Council for Graduate Medical Education requires that OBGYN residents have access to abortion training," Dodwani said. "... This is about ensuring that we have the comprehensive skills needed to provide the best care possible for our patients. Without this training in Kentucky, we're left with no choice but to leave our home state to practice elsewhere."

Reporter Lucas Aulbach contributed. Reach reporter Hannah Pinski at hpinski@courier-journal.com or follow her on X, formerly known as Twitter, at @hannahpinski.