ABORTION SERVICES S.B. 474 (S-3)-477 (S-1), & 593:
SUMMARY AS PASSED BY THE SENATE
Senate Bill 474 (Substitute S-3 as passed by the Senate)
Senate Bill 475 (Substitute S-1 as passed by the Senate)
Senate Bill 476 (Substitute S-1 as passed by the Senate)
Senate Bill 477 (Substitute S-1 as passed by the Senate)
Senate Bill 593 (as passed by the Senate)
Sponsor: Senator Sarah Anthony (S.B. 474)
Senator Stephanie Chang (S.B. 475)
Senator Erika Geiss (S.B. 476 & S.B. 593)
Senator Mary Cavanagh (S.B. 477)
Committee: Housing and Human Services
Date Completed: 10-30-23
INTRODUCTION
The bills would amend, repeal, or codify provisions related to abortion in various acts. Senate Bill
474 (S-3) would repeal several sections of the Public Health Code governing pre-abortion
screenings and post-abortion reporting requirements, among others. It also would delete
rulemaking requirements of the Department of Health and Human Services (DHHS) related to
freestanding surgical outpatient facilities providing abortions. Senate Bill 475 (S-1) would delete
sentencing guidelines related to felonies for violations of some of those repealed sections, among
other felony violations. Senate Bill 477 (S-1) would delete a provision prohibiting a pregnant and
parenting student services office at an institution of higher education from providing referrals for
abortion services. Senate Bill 593 would largely codify Section 28 of Article I of the State
Constitution of 1963 (see BACKGROUND).
BRIEF RATIONALE
The passage of Proposal 22-3, which enshrined the individual right to reproductive freedom in the
Michigan Constitution, invalidated State laws that conflicted with the Proposal's amendments.
According to testimony before the Senate Committee on Housing and Human Services, there are
still barriers to reproductive healthcare that exist, and it has been suggested that various State
laws be amended or repealed to agree with the Proposal's provisions.
BRIEF FISCAL IMPACT
The bills likely would have an indeterminate, minor fiscal impact on State government. The repeal
of the certificate of need exception under Senate Bill 474 (S-3) could result in increased fee
revenue and decreased administrative costs for the DHHS. Senate Bill 593 could result in a
potential increase in litigation costs for the Attorney General but also could increase civil filing fee
revenue that supports various State departments. It also could result in fewer arrests and
convictions, which would reduce costs for State and local governments in relation to law
enforcement, courts, and corrections facilities. Local health departments could lose funding due
to the loss of grant award priority, but the fiscal impact on any given unit likely would be of
moderate magnitude.
MCL 333.2690 et al. (S.B. 474) Legislative Analyst: Eleni Lionas
762.10d et al. (S.B. 475) Fiscal Analyst: Ellyn Ackerman
333.1071 (S.B. 476) Elizabeth Raczkowski
390.1595 (S.B. 477) Michael Siracuse; Josh Sefton
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CONTENT
Senate Bill 474 (S-3) would amend the Public Health Code to do the following:
-- Replace the definition of "elective abortion" with the definition of "abortion"
within provisions related to the disposal of fetal remains, among other provisions.
-- Delete a prohibition against the DHHS awarding ultrasound equipment grant
money if the equipment were to be used in assisting an elective abortion.
-- Delete various rule promulgation requirements for rules related to abortions.
Additionally, the bill would repeal Sections 2835, 2836, 2837, 17014, 17015, 17015a,
17017, 17515, 17517, and 22224.
Senate Bill 475 (S-1) would amend the Code of Criminal Procedure to delete
sentencing guidelines for violations of disclosing confidential information regarding
abortion and performing an abortion resulting in death.
Senate Bill 476 (S-1) would amend the Born Alive Infant Protection Act to modify the
definition of "abortion".
Senate Bill 477 (S-1) would amend the Pregnant and Parenting Student Services Act
to delete a prohibition against a pregnant and parenting student services office at an
institution of higher education from providing referrals for abortion services.
Senate Bill 593 would create a new Act to do the following:
-- Codify Section 28 of Article I of the State Constitution of 1963.
-- Prohibit a governmental entity from violating Section 28 of Article I of the State
Constitution of 1963.
-- Specify that an individual or entity could bring a civil action for injunctive relief,
damages, or any other appropriate remedy for a violation of Section 28 or Article
I of the State Constitution of 1963.
-- Repeal Section 323 of the Michigan Penal Code, which specifies that any person
who administers to a woman pregnant with a quick child any medicine, drugs, or
instrument with the intention to terminate the pregnancy could be charged with
manslaughter.
-- Repeal the Legal Birth Definition Act which defines legal birth and legal
personhood.
-- Repeal Public Act 360 of 2002, which prioritizes the allocation of funding through
grants or contracts for educational and other programs and services pertaining
to family planning and reproductive health services.
-- Repeal the Abortion Insurance Opt-Out Act, which requires the purchase of
coverage for elective abortion in a health care plan to be an optional rider only
with an additional premium and requires notice to employees for whom elective
abortion coverage is purchased by their employer.
Senate Bill 475 is tie-barred to Senate Bill 474.
Senate Bill 474 (S-3)
Financial Benefit from Fetal Remains
Generally, the Public Health Code prohibits a physician or a person, such as an employee of a
physician or a private physician practice, from knowingly financially benefitting from
performing an elective abortion.
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The Code defines "elective abortion" as the intentional use of an instrument, drug, or other
substance or device to terminate a woman's pregnancy for a purpose 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 fetus that has died because of natural causes, accidental trauma, or a criminal
assault on the pregnant woman. Generally, the term does not include the use of a prescription
drug, the use of an instrument to terminate a woman's pregnancy for the safety of the woman,
or treatment for a miscarriage. The bill would delete this definition and replace references to
"elective abortion" in the provision above to "abortion" as defined below.
Under the bill, "abortion" would mean a medical treatment that is intended to terminate a
diagnosable intrauterine pregnancy for a purpose other than to produce a live birth. The term
would not include the use or prescription of a drug or device that prevented pregnancy or a
medical treatment used to remove a dead fetus or embryo whose death was the result of a
spontaneous abortion.
Ultrasound Equipment Grants and Abortions
The Code requires the DHHS to establish and administer a grant program to provide grants
for the purchase of ultrasound equipment. The Code prohibits the DHHS from awarding a
grant if the equipment would be used to assist in the performance of an elective abortion.
The bill would delete this prohibited use of grant-awarded ultrasound equipment.
Repealed Sections
Section 17014 of the Code provides Legislative findings related to the enactment of Sections
17015 and 17515. Section 17015 prohibits a physician from performing an abortion otherwise
permitted without the patient's informed written consent. Section 17015a generally requires
a physician to orally screen a patient for coercion to abort a pregnancy. Section 17017
previously prohibited a physician from prescribing an abortion without personally performing
a physical examination on the patient. Sections 17515 and 17517 require a physician to
comply with the provisions described above before performing an abortion.
Section 2835 of the Code requires a physician who performs an abortion to report such to the
DHHS and prescribes the information that the report must include, such as the age of the
individual at the time of the abortion, the individual's race, and the individual's general
residence; however, the report cannot contain identifying information of the individual.
Section 2836 of the Code generally requires all remains resulting from abortions to be
disposed of by interment or cremation and allows the disposal to occur without the supervision
of a funeral director. Section 2837 of the Code requires a written report to the DHHS for each
patient who comes into a physician's care and who suffers a physical complication or death
resulting from an abortion. Section 22224 of the Code specifies that a health facility required
to be licensed as a freestanding surgical outpatient facility due to performance of abortions
at the facility does not need to obtain a certificate of need to be granted a license.
The bill would repeal all these sections. In addition, the bill would delete all references to
these sections in the provisions described below.
Disposal of Fetal Remains
The Code requires a funeral director or person assuming responsibility of a dead fetus to
obtain from the parents an authorization for final disposition before the disposition of the dead
fetus unless the mother has provided written consent for research on the dead fetus and
except as provided by Section 2836.
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The Code specifies that a person who violates the requirement to dispose of fetal remains resulting from
an abortion as prescribed by Section 2836 or by failing to obtain the proper authorization for final
disposition of a dead body is responsible for a State civil infraction and may be ordered to pay a fine of
not more than $1,000.
Grounds for Disciplinary Subcommittee Action
Under the Code, the Department of Licensing and Regulatory Affairs (LARA) must investigate any
allegation that one or more grounds for disciplinary subcommittee action exist against a licensed health
professional. Among other grounds, the disciplinary subcommittee must proceed on any of the following
grounds:
-- A violation of Section 17015.
-- A violation of Section 17015a.
-- A violation of Section 17017.
-- A violation of Section 17515
-- A violation of Section 17517.
After finding the existence of one or more grounds for disciplinary subcommittee action as described
above, the Code allows the subcommittee to impose sanctions, such as licensure revocation, denial,
and victim restitution.
The bill would delete these grounds for disciplinary subcommittee action and their sanctions.
Departmental Rules
The Code requires the DHHS to promulgate rules to differentiate a freestanding surgical outpatient
facility from a private office of a physician, dentist, podiatrist, or other health professional. In those rules
it must specify that a facility including a private practice office must be licensed under the Code as a
freestanding surgical outpatient facility if that facility performs 120 or more surgical abortions per year
and publicly advertises outpatient abortion services. The DHHS must promulgate rules that in effect
republish other specified rules, but the rules must set standards for a freestanding surgical outpatient
facility or private practice office that performs 120 or more surgical abortions per year and that publicly
advertises outpatient abortion services. The DHHS must assure that the standards are consistent with
the most recent United States Supreme Court decisions regarding state regulation of abortions. The
Code allows the DHHS to modify some of these rules for specified facilities.
The Code also requires the DHHS to provide to LARA by January 15 of each year specified information
concerning abortions in the State, such as the name and location of facilities performing abortions, the
total number of abortions performed in that calendar year, and whether a facility performing abortions
publicly advertises its services.
The bill would delete all the provisions described above.
Senate Bill 475 (S-1)
The Code of Criminal Procedure prescribes the following sentencing guidelines for felony convictions for
violations of Section 2835(9) of the Public Health Code and Section 323 of the Michigan Penal Code:
Violation Category Class Statutory
Max
Disclosing confidential information – abortion
Public Trust C 3
(333.2835(9))
Abortion resulting in death (750.323) Person C 15
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The bill would delete these sentencing guidelines.
Senate Bill 476 (S-1)
The Born Alive Infant Protection Act requires that, if an abortion results in a live birth and the
mother expresses a desire not to assume custody, the newborn must be considered
surrendered to an emergency service provider. The Act defines "abortion" as that term is
defined in Section 17015 of the Public Health Code, which Senate Bill 474 would repeal.
Instead, under the bill, "abortion" would mean a medical treatment that is intended to
terminate a diagnosable intrauterine pregnancy for a purpose other than to produce a live
birth. The term would not include the use or prescription of a drug or device that prevented
pregnancy or a medical treatment used to remove a dead fetus or embryo whose death was
the result of a spontaneous abortion.
Senate Bill 477 (S-1)
Generally, the Pregnant and Parenting Student Services Act allows an institution of higher
education to establish a pregnant and parenting student services office that must meet
specified requirements, such as identifying public and private service providers qualified to
provide health and parenting services and providing referrals on prenatal care, foster care,
and family planning. The Act prohibits an office from providing referrals for abortion services.
The bill would delete this prohibition.
BACKGROUND
During the 2022 election cycle, a group called Reproductive Freedom for All circulated
petitions and collected enough signatures for a proposed constitutional amendment to be
placed on the 2022 November general election ballot. The amendment establishes an
individual right to reproductive freedom, including the right to make and carry out all decisions
about pregnancy, such as prenatal care, childbirth, postpartum care, contraception,
sterilization, abortion, miscarriage management, and infertility; allows the State to prohibit
abortion after fetal viability unless needed to protect a patient's life or physical or mental
health; prohibits State discrimination in enforcement of the right; prohibits the prosecution
of an individual, or a person helping a pregnant individual, for exercising rights established
by the amendment; and invalidates State laws that conflict with the proposed amendment. 1
Proposal 22-3 passed with 56.66% of electors in favor of the proposal. 2
FISCAL IMPACT
Senate Bills 474 (S-3) through 477 (S-1) would not have a significant fiscal impact LARA. The
Department conducts investigations and may hold hearings in relation to licensee violations
such as those proposed to be eliminated under the bill. As a result of the changes, LARA could
experience a reduction in the number of cases that require investigation or disciplinary action;
however, this reduction would be unlikely to have a significant impact on LARA's costs or
staffing levels.
Senate Bill 474 (S-3) could result in a positive fiscal impact on the DHHS, although the impact
would likely be minimal. The bill would repeal MCL 333.22224, which created the certificate
of need exception for freestanding surgical outpatient facilities that provide 120 or more
1 "November 2022 Ballot Proposal 22-3", Senate Fiscal Agency.
2
"2022 Michigan Election Results", The Office of Secretary of State Jocelyn Benson. Available at:
https://mielections.us/election/results/2022GEN_CENR.html. Retrieved on 2-28-2023.
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abortions per year and prohibits the DHHS from counting abortion procedures towards the
minimum number of procedures required to obtain a certificate of need. Repealing the
exception could increase the number of freestanding surgical outpatient facilities that meet
the minimum number of procedures. An increase in applications would result in an increase
in certificate of need fee revenue for the State. The Fiscal Year 2023-2024 DHHS budget
includes $3.1 million of certificate of need fee revenue. Additionally, the DHHS could see a
minor positive fiscal impact because of the bill from reduced information sharing and reporting
requirements which would reduce the administrative burden on the DHHS.
Senate Bill 593 would have no fiscal impact on the DHHS but could have a negative fiscal
impact on local units of government. The Allocation of Funds to Family Planning Services Act
requires the DHHS to give priority for the allocation of funds for family planning or
reproductive health services to entities that perform or allow the performance of elective
abortions, refer a pregnant woman for an elective abortion, or maintain a policy that includes
elective abortion as a part of the continuum of family planning or reproductive health services.
This prioritization has generally made it harder for non-State entities that provide elective
abortions or abortion services to be awarded grants over local health departments. By