Senate File 508 - Introduced
SENATE FILE 508
BY CHAPMAN
A BILL FOR
1 An Act relating to abortion information and data, including
2 a public dashboard and public awareness measures, and
3 providing civil penalties.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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1 Section 1. FINDINGS AND INTENT.
2 1. The general assembly finds all of the following:
3 a. That, as stated in Planned Parenthood of Southeastern
4 Pennsylvania v. Casey, 505 U.S. 833, 846 (1992), “[t]he State
5 has legitimate interests from the outset of the pregnancy in
6 protecting the health of the woman”.
7 b. Specifically, as stated in Akron v. Akron Ctr. for
8 Reproductive Health, Inc. 462 U.S. 416, 428-429 (1983), “...
9 a State has a legitimate concern with the health of women who
10 undergo abortions...”
11 c. Abortion is an invasive, surgical procedure that can
12 cause severe physical and psychological, both short-term and
13 long-term, complications for women, including but not limited
14 to: uterine perforation, cervical perforation, infection,
15 bleeding, hemorrhage, blood clots, failure to terminate the
16 pregnancy, incomplete abortion (retained tissue), pelvic
17 inflammatory disease, endometritis, missed ectopic pregnancy,
18 cardiac arrest, respiratory arrest, renal failure, metabolic
19 disorder, shock, embolism, coma, placenta previa in subsequent
20 pregnancies, preterm delivery in subsequent pregnancies, free
21 fluid in the abdomen, adverse reactions to anesthesia and
22 other drugs, an increased risk for developing breast cancer,
23 psychological or emotional complications such as depression,
24 suicidal ideation, anxiety, sleeping disorders, and death.
25 d. To facilitate reliable scientific studies and research
26 on the safety and efficacy of abortion, it is essential that
27 the medical and public health communities have access to
28 accurate information both on the abortion procedure and on
29 complications resulting from abortion.
30 e. As stated in Planned Parenthood of Central Missouri v.
31 Danforth, 428 U.S. 52, 80 (1976), “Recordkeeping and reporting
32 requirements that are reasonably directed to the preservation
33 of maternal health and that properly respect a patient’s
34 confidentiality and privacy are permissible”.
35 f. Abortion and complication reporting provisions do not
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1 impose an “undue burden” on a woman’s right to choose whether
2 or not to terminate a pregnancy. Specifically, as stated in
3 Planned Parenthood of Southeastern Pennsylvania v. Casey,
4 505 U.S. 833, 900-901 (1992), “The collection of information
5 with respect to actual patients is a vital element of medical
6 research, and so it cannot be said that the requirements serve
7 no purpose other than to make abortions more difficult”.
8 g. To promote its interest in maternal health and life, the
9 state of Iowa maintains an interest in all of the following:
10 (1) Collecting certain demographic information on all
11 abortions performed in the state.
12 (2) Collecting information on all complications from all
13 abortions performed in the state.
14 (3) Compiling statistical reports based on abortion
15 complication information collected pursuant to this Act for
16 future scientific studies and public health research.
17 2. Based on the findings in subsection 1, it is the intent
18 of this Act to promote the health and safety of women by
19 increasing medical and public health knowledge through the
20 compilation of relevant information on all abortions performed
21 in the state, as well as on all medical complications and
22 maternal deaths resulting from these abortions.
23 Sec. 2. NEW SECTION. 146E.1 Definitions.
24 For the purposes of this chapter, unless the context
25 otherwise requires:
26 1. “Abortion” means the act of using or prescribing any
27 instrument, medicine, drug, or any other substance, device, or
28 means with the intent to terminate the clinically diagnosable
29 pregnancy of a woman with knowledge that the termination by
30 those means will, with reasonable likelihood, cause the death
31 of the unborn child. Such use, prescription, or means is
32 not an abortion if done with the intent to save the life or
33 preserve the health of an unborn child, remove a dead unborn
34 child caused by spontaneous abortion, or remove an ectopic
35 pregnancy.
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1 2. “Born-alive” means the complete expulsion or extraction
2 from the woman of a human infant, at any stage of development,
3 who, after such expulsion or extraction, breathes, has a
4 beating heart, or has definite movement of voluntary muscles,
5 regardless of whether the umbilical cord has been cut and
6 regardless of whether the expulsion or extraction was the
7 result of natural or induced labor, cesarean birth, induced
8 abortion, or other method.
9 3. “Complication” means any adverse physical or
10 psychological condition arising from inducing or performing an
11 abortion.
12 4. “Department” means the department of public health.
13 5. “Gestational age or probable gestational age” means the
14 age of the unborn child as calculated from the first day of the
15 last menstrual period of the pregnant woman.
16 6. “Health care provider” means an individual licensed under
17 chapter 148, 148C, 148D, or 152, or any individual who provides
18 medical services under the authorization of the licensee.
19 7. “Hospital” means the same as defined in section 135B.1.
20 8. “Medical facility” means the same as defined in section
21 146B.1.
22 9. “Physician” means a person licensed under chapter 148
23 to practice medicine and surgery or osteopathic medicine and
24 surgery in this state.
25 10. “Pregnant” means the female reproductive condition of
26 having an unborn child in the woman’s uterus.
27 11. “Unborn child” means the same as defined in section
28 146B.1.
29 Sec. 3. NEW SECTION. 146E.2 Abortion reporting requirements
30 —— physicians.
31 1. A physician who performs an abortion shall file with
32 the department a report that includes all of the following
33 information with respect to each abortion and each woman upon
34 whom an abortion is performed:
35 a. The date of each abortion.
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1 b. The procedure used.
2 c. The gestational age or probable gestational age of the
3 unborn child.
4 d. The age of the woman.
5 e. The race and ethnicity of the woman.
6 f. The gender of the unborn child, if known.
7 g. The woman’s county of residence, if in this state; the
8 woman’s state of residence, if not this state; or, if the woman
9 is not a citizen of the United States, the woman’s country of
10 origin.
11 h. The woman’s level of education.
12 i. Whether the father by operation of law or the putative
13 father of the unborn child, if known, was notified of the
14 abortion prior to the performance of the abortion; and whether
15 the woman refused to disclose whether such father or putative
16 father, if known, was notified of the abortion prior to the
17 performance of the abortion.
18 j. The woman’s marital status and whether the woman refused
19 to provide her marital status.
20 k. Whether the woman, prior to seeking an abortion, received
21 all of the following:
22 (1) Any state-mandated informed consent counseling for
23 abortions.
24 (2) Any verbal or written counseling related to the risks
25 and complications of abortion.
26 (3) Any information related to alternatives to abortion.
27 (4) An ultrasound imaging of the unborn child.
28 l. The specific reasons for the abortion, including but not
29 limited to the following:
30 (1) Whether the pregnancy was the result of rape or incest.
31 (2) Economic reasons.
32 (3) Whether the woman does not want the child at the present
33 time.
34 (4) Whether the woman’s physical health is endangered
35 and the specific reason her physical health is endangered,
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1 including any preexisting condition.
2 (5) Whether the woman’s psychological, mental, or emotional
3 health is endangered and the specific reason her psychological,
4 mental, or emotional health is endangered, including any
5 preexisting condition.
6 (6) Whether the woman will suffer substantial and
7 irreversible impairment of a major bodily function if the
8 pregnancy continues, specifically identifying the potential
9 impairment.
10 (7) The actual or presumed gender of the child.
11 (8) The diagnosis, presence, or presumed presence of a
12 genetic anomaly, specifically identifying the anomaly.
13 m. Whether the woman refused to provide a reason for the
14 abortion under paragraph “l”.
15 n. The number of the woman’s prior pregnancies, live births,
16 spontaneous terminations of pregnancy, and abortions.
17 o. Whether the abortion was paid for by any of the
18 following:
19 (1) Private health insurance.
20 (2) Public health insurance including Medicaid.
21 (3) Self-pay, including not being billed to or paid for
22 through insurance.
23 p. Complications, if any, from the abortion, including if
24 the abortion resulted in death.
25 q. If a drug-induced abortion was accomplished using
26 telemedicine, the medical facility code of the location the
27 woman used and the medical facility code of the physician
28 prescribing, dispensing, or otherwise providing the
29 abortion-inducing drug.
30 r. If the abortion resulted in a born-alive infant, all of
31 the following:
32 (1) What medical actions were taken to preserve the life of
33 the infant.
34 (2) Whether the infant survived.
35 (3) If the infant survived, the status of the infant, if
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1 known.
2 s. The medical specialty of the physician performing the
3 abortion.
4 t. Whether the woman took possession of the tissue and
5 remains resulting from the abortion in order to conduct a
6 proper burial.
7 2. a. A physician shall report the required information on
8 forms provided and in accordance with section 146E.4.
9 b. A physician may submit completed reports to the
10 department on a weekly basis, but shall submit completed
11 reports for the entire preceding month no later than 11:59 p.m.
12 on the first day of the subsequent month.
13 Sec. 4. NEW SECTION. 146E.3 Abortion complications ——
14 reporting requirements.
15 1. A hospital, medical facility, or health care provider who
16 provides care to a woman who reports any complication, requires
17 medical treatment, or suffers death that the hospital, medical
18 facility, or health care provider has reason to believe is a
19 primary, secondary, or tertiary result of an abortion, shall
20 file a written report with the department. The report shall
21 be completed and signed by the hospital, medical facility,
22 or health care provider who attended the woman and shall be
23 transmitted to the department within thirty days of the death
24 of the woman or of discharge of the woman reporting or being
25 treated for the complication. The reports submitted shall
26 comply with section 146E.4.
27 2. Each report of a complication, medical treatment, or
28 death following abortion required under this section shall
29 contain, at a minimum, all of the following information:
30 a. The age of the woman.
31 b. The race and ethnicity of the woman.
32 c. The woman’s county of residence, if in this state; the
33 woman’s state of residence, if not this state; or, if the woman
34 is not a citizen of the United States, the woman’s country of
35 origin.
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1 d. The number of the woman’s prior pregnancies, live births,
2 spontaneous terminations of pregnancy, and abortions.
3 e. The date the abortion was performed, as well as the
4 reason for the abortion and the method used, if known.
5 f. Identification of the physician who performed the
6 abortion, the facility where the abortion was performed, and
7 the referring physician, agency, or service, if any.
8 g. The specific complication that led to the treatment
9 or death including but not limited to failure to actually
10 terminate the pregnancy, missed ectopic pregnancy, uterine
11 perforation, cervical perforation, incomplete abortion
12 (retained tissue), bleeding, infection, hemorrhage, blood
13 clots, cardiac arrest, respiratory arrest, pelvic inflammatory
14 disease, damage to pelvic organs, endometritis, renal failure,
15 metabolic disorder, shock, embolism, free fluid in the
16 abdomen, acute abdomen, adverse reaction to anesthesia or
17 other drugs, hemolytic reaction due to the administration
18 of ABO-incompatible blood or blood products, hypoglycemia
19 where the onset occurred while the woman was being cared for
20 in the facility where the abortion was performed, physical
21 injury associated with therapy performed in the facility where
22 the abortion was performed, coma, death, and psychological
23 or emotional complications including but not limited to
24 depression, suicidal ideation, anxiety, and sleep disorders.
25 h. The amount billed for the costs of treatment of the
26 specific complication, including whether the treatment was
27 billed to public health insurance including Medicaid, private
28 health insurance, self-pay including not being billed to
29 private health insurance, or other payment source. The amount
30 billed shall include charges for any physician, hospital,
31 emergency room, prescription or other drugs, laboratory tests,
32 and any other costs for the treatment rendered.
33 Sec. 5. NEW SECTION. 146E.4 Forms and requirements for
34 reporting of abortion-related information.
35 1. The department shall assign a code to any health care
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1 provider, hospital, or medical facility that may be required
2 to report information or that may be identified under section
3 146E.2 or 146E.3. An application procedure shall not be
4 required for assignment of a code to a health care provider,
5 hospital, or medical facility.
6 2. A health care provider, hospital, or medical facility
7 shall assign a report tracking number to each report which
8 enables the health care provider, hospital, or medical facility
9 to access the woman’s medical information without identifying
10 the woman.
11 3. The department shall develop and make available to health
12 care providers, hospitals, and medical facilities reporting
13 forms to collect the required information under section 146E.2
14 and 146E.3.
15 4. The information collected and reported, the data
16 compiled under section 146E.2 and 146E.3, and the reports
17 submitted shall comply with the limitations and confidentiality
18 requirements established pursuant to section 144.29A.
19 Sec. 6. NEW SECTION. 146E.5 Abortion data public dashboard
20 —— declaration of abortion pandemic —— public awareness measures
21 —— reports.
22 1. a. The department shall develop a public dashboard to
23 inform the public on a monthly basis of statewide aggregate
24 data compiled based on the information included in reports
25 submitted by health care providers under this chapter. The
26 dashboard shall have the capacity to be updated on a weekly
27 basis.
28 b. The department shall maintain and update the dashboard in
29 accordance with this section.
30 c. The dashboard shall provide statewide aggregate data,
31 which shall be available in a downloadable format, relating to
32 all of the following:
33 (1) The number of abortions performed during the prior
34 month.
35 (2) A running total of the number of abortions performed to
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1 date in the current calendar year.
2 (3) The type of procedure used to perform the abortion.
3 (4) The gestational age or probable gestational age of the
4 unborn child in weeks.