SESSION OF 2019
SUPPLEMENTAL NOTE ON HOUSE BILL NO. 2274
As Amended by House Committee on Health
and Human Services

Brief*
HB 2274, as amended, would require certain
notifications be posted in facilities where medication abortions
that use mifepristone are provided and be given by
physicians providing such abortions. The bill would provide
relevant definitions and create civil and criminal penalties for
violating the notification requirements.

Definitions
The bill would define the following terms:
● “Medication abortion” to mean the use or
prescription of any drug for the purpose of inducing
an abortion;
● “Abortion” to mean the use or prescription of any
instrument, medicine, drug, or any other substance
or device to terminate the pregnancy of a woman
known to be pregnant with an intention other than
to increase the probability of a live birth, to
preserve the life or health of the child after live
birth, or to remove a dead unborn child who died
as the result of natural causes in utero, accidental
trauma, or a criminal assault on the pregnant
woman or her unborn child, and which causes the
premature termination of the pregnancy; and
____________________
*Supplemental notes are prepared by the Legislative Research
Department and do not express legislative intent. The supplemental
note and fiscal note for this bill may be accessed on the Internet at
http://www.kslegislature.org
 ● “Medical emergency” to mean a condition that, in
reasonable medical judgment, so complicates the
medical condition of the pregnant woman as to
necessitate the immediate abortion of her
pregnancy to avert the death of the woman or for
which a delay necessary to comply with the
applicable statutory requirements will create
serious risk of substantial and irreversible physical
impairment of a major bodily function. No condition
shall be deemed a medical emergency if based on
a claim or diagnosis that the woman will engage in
conduct that would result in her death or in
substantial and irreversible physical impairment of
a major bodily function.
Notification Requirements
The bill would require any private office, freestanding
surgical outpatient clinic, hospital, or other facility or clinic
where medication abortions that use mifepristone are
provided to post a conspicuous sign that is clearly visible to
patients, that is printed with lettering that is legible and at
least 3/4 of an inch boldfaced type, and that would read as
follows:
“NOTICE TO PATIENTS HAVING
MEDICATION ABORTIONS THAT USE
MIFEPRISTONE: Mifepristone, also known as
RU-486 or mifeprex, alone is not always
effective in ending a pregnancy. It may be
possible to reverse its intended effect if the
second pill or tablet has not been taken or
administered. If you change your mind and
wish to try to continue the pregnancy, you can
get immediate help by accessing available
resources.”
The notice would be required to include information
about the Kansas Department of Health and Environment
2- 2274
(KDHE) website, which is required to be maintained by law,
and other relevant telephone and Internet resources
containing information on where the patient can obtain timely
assistance to attempt to reverse the medication abortion.
Facilities
The bill would require any private office or freestanding
surgical outpatient clinic where medication abortions that use
mifepristone are provided to post the sign in each patient
waiting room and patient consultation room used by patients
for whom medication abortions are provided.
A hospital or other facility where medication abortions
that use mifepristone are provided that is not a private office
or freestanding surgical outpatient clinic would be required to
post the sign in each patient admission area used by patients
for whom medication abortions that use mifepristone are
provided.
Physician
The bill would prohibit a physician from providing,
inducing, or attempting to provide or induce a medication
abortion that uses mifepristone without informing the woman,
in writing as prescribed in the Woman’s-Right-to-Know Act
and by telephone or in person, at least 24 hours prior to the
medication abortion, except in the case of a medical
emergency, of the following:
● It could be possible to reverse the intended effects
of a medication abortion that uses mifepristone, if
the woman changes her mind, but that time is of
the essence; and
● Information on reversing the effects of a medication
abortion that uses mifepristone would be available
on KDHE’s website as required by law, and other
relevant telephone and Internet resources
3- 2274
 containing information on where the patient could
obtain timely assistance to attempt to reverse the
medication abortion.
The bill would require, after a physician dispenses or
provides an initial administration of mifepristone to a patient
for the purposes of performing a medication abortion, the
physician or an agent of the physician to provide a legible,
written notice to the patient that includes the same
information stated above.
The bill would require, when a medical emergency
compels the performance of a medication abortion that uses
mifepristone, the physician to inform the woman, prior to the
medication abortion, if possible, of the medical indications
supporting the physician’s judgment an abortion would be
necessary to avert the woman’s death or a 24-hour delay
would create serious risk of substantial and irreversible
impairment of a major bodily function, excluding
psychological or emotional conditions.
KDHE Website
The bill would require, within 90 days after the effective
date of the bill, KDHE cause to be published, in English and
in each language that is the primary language of 2.0 percent
of more of the state’s population, in print and on the website
required by law, comprehensible materials deigned to inform
women of the possibility of reversing the effects of a
medication abortion that uses mifepristone and information on
resources available to reverse the effects of a medication
abortion that uses mifepristone. The website would also
include other relevant telephone and Internet resources
containing information on where the patient could obtain
timely assistance to attempt to reverse the medication
abortion.


4- 2274
Criminal Penalties
The bill would provide that upon a first conviction of a
violation of failing to provide notification as outlined in the bill,
a person would be guilty of a class A person misdemeanor
and upon second or subsequent conviction of such violation,
a person would be guilty of a severity level 10, person felony.

Civil Penalties
The bill would require KDHE to assess a fine of $10,000
to any private office, freestanding surgical outpatient clinic,
hospital, or other clinic or facility that fails to post the sign.
Each day the required sign is not posted would be a separate
violation. KDHE would be required to remit all moneys
received from fines to the State Treasurer. The State
Treasurer would be required to deposit the entire amount of
money remitted in the State Treasury to the credit of the State
General Fund.

Civil Action
The bill would allow the following individuals to bring a
civil action against a physician who provided a medication
abortion using mifepristone in violation of the provisions in the
bill for actual damages, exemplary and punitive damages,
and any other appropriate relief:
● A woman to whom such medication abortion has
been provided;
● The father of the unborn child who was subject to
such medication abortion; or
● Any grandparent of the unborn child who was
subject to such medication abortion, if the woman
was not 18 years of age or older at the time the

5- 2274
 medication abortion was performed or if the woman
died as a result of the medication abortion.
The bill would require such civil action be commenced
within two years after the later of:
● The date of the discovery of the violation; or
● The conclusion of a related criminal case.
A court would be required to award reasonable attorney
fees and costs to a prevailing plaintiff or a prevailing
defendant upon a finding that the action was frivolous and
brought in bad faith.

Anonymity
In any civil or criminal proceeding or action brought
under the provisions of bill, the bill would require the court to
rule whether the anonymity of any woman to whom a
medication abortion has been provided, induced, or
attempted to be provided or induced would be preserved from
public disclosure, if she does not give her consent to such
disclosure. The bill would require the court, upon motion of a
party or on its own accord, to make such a ruling and, upon
determining the woman’s anonymity should be preserved, to
issue orders to the parties, witnesses, and counsel and to
direct the sealing of the record and exclusion of individuals
from courtrooms or hearing rooms to the extent necessary to
safeguard the woman’s identity from public disclosure. The
bill would require each such order to be accompanied by
specific written findings explaining why the anonymity of the
woman should be preserved from public disclosure, why the
order is essential to that end, how the order is narrowly
tailored to serve that interest, and why no reasonable less
restrictive alternative exists. In the absence of written consent
of the woman to whom a medication abortion has been
provided, induced, or attempted to be provided or induced,
any person, other than a public official, who brings an action

6- 2274
under this section would be required to do so under a
pseudonym. The bill would not be construed to conceal the
identity of the plaintiff or witnesses from the defendant.

Severability Clause
The bill would provide that if any provision of the bill, or
any application thereof to any person or circumstance, would
be held invalid by court order, then such invalidity would not
affect the remainder of the bill and any application thereof to
any person or circumstance that could be given effect without
such invalid provision or application, and to this end, the
provisions of the bill would be declared to be severable.

Background
The bill was introduced by the House Committee on
Health and Human Services at the request of
Representatives Eplee, Arnberger, Awerkamp, Barker,
Bergquist, Blex, Burris, Capps, B. Carpenter, W. Carpenter,
Clark, Collins, Corbet, Croft, Delperdang, Dietrich, Donohoe,
Dove, Ellis, Erickson, Esau, Finch, French, Garber, Hawkins,
Helmer, Highland, Hoffman, Howard, Huebert, Humphries,
Jacobs, Johnson, Karleskint, Kelly, Landwehr, Lewis, Lynn,
Mason, Mastroni, Owens, Patton, Proehl, Rahjes, Ralph,
Resman, Rhiley, Ryckman, Samsel, Schreiber, A. Smith, E.
Smith, Sutton, Tarwater, Thimesch, Thomas, Toplikar, Vickrey,
Warren, and Wasinger.
In the House Committee hearing, representatives from
Kansans for Life and Family Policy Alliance of Kansas
testified in favor of the bill, generally stating women who
begin a medication abortion should be provided information
about protocols for abortion pill reversal. Proponent written-
only testimony was provided by representatives of American
Association of Pro-life Obstetricians and Gynecologists,
Concerned Women for America of Kansas, Kansas Catholic
Conference, a private citizen board-certified obstetrician and

7- 2274
gynecologist, a private citizen medical doctor, and a private
citizen.
Opponent testimony was provided by a private citizen
obstetrician and gynecologist and representatives of
American Civil Liberties Union of Kansas, Planned
Parenthood Great Plains Votes, and Trust Women
Foundation, Inc. The opponents generally stated abortion
reversal has not been studied and has not been proven safe
for patients. Opponent written-only testimony was provided by
a private citizen board-certified obstetrician and gynecologist
and representatives of Mainstream Coalition and University of
California at San Francisco.
The House Committee amended the bill by inserting an
additional notification requirement, in written form, to be
provided to a woman 24 hours prior to a medication abortion.
According to the fiscal note prepared by the Division of
the Budget on the bill, as introduced, KDHE indicates
consultation with a medical provider to develop
comprehensible, accurate content to be added to existing
print and online resources and materials would be required.
KDHE also indicates the agency would need staff to
coordinate and review materials, printing, distributing, orders,
and other activities, but these expenses would be absorbed
within existing resources. Printing, postage, and contractual
services for the agency is estimated to cost $27,450 from the
State General Fund (SGF) for FY 2020. Additionally, KDHE
states it is not possible to estimate the revenue to the SGF.
The Office of Judicial administration (Office) indicates the bill
has the potential for increasing litigation in the courts because
of the new violation created by the bill. If that happens, the
Office indicates there would be a fiscal effect on the operation
of the court system. Further, it is not possible to predict the
number of additional court cases that would arise or how
complex and time-consuming they would be; therefore, the
precise fiscal effect cannot be determined. Any fiscal effect
associated with enactment of the bill is not reflected in The
FY 2020 Governor’s Budget Report.
8- 2274