HELENA, Mont. 鈥 Montana is proposing wide-ranging rules for licensing abortion clinics under a disputed state law, raising a new potential obstacle for patients even as a constitutional amendment to protect access appears headed for the November ballot.
, released July 26 by the state Department of Public Health and Human Services, would set requirements for facilities that perform abortions for or provide medication abortion to at least five patients a year, excluding hospitals and outpatient surgical centers. Clinics would have to meet minimum limits for the size of their rooms and hallways, submit to annual state inspections, maintain written patient transfer agreements with hospitals, and be led by a medical director who is a licensed physician.
Nurse practitioner Helen Weems, who runs All Families Healthcare in Whitefish, one of three organizations that provide abortions in Montana, said the proposed regulations were unnecessary and would limit access to abortion in the state.
鈥淭hese requirements, including the requirement that abortion clinics have a physician medical director, are not about patient health or safety 鈥 they are purely about creating havoc and hardship for abortion providers,鈥 said Weems, in 2018 to strike down a law requiring that abortions be performed only by physicians or physician assistants.
Many of the proposed rules are similar to laws and regulations passed in , and their supporters call them necessary safeguards for patient safety.
鈥淭heir objections to very reasonable requirements 鈥 like annual inspections, having lit exit pathways, and making sure a facility director is in good standing 鈥 show their disregard for the women who walk through their doors,鈥 said Kelsey Pritchard, director of state public affairs for Susan B. Anthony Pro-Life America, a group opposed to abortion.
In the public notice of the rules, state health officials said most of the proposed requirements are based on those for outpatient surgical centers or on minimum standards imposed on all health care facilities and 鈥渞epresent the appropriate level of regulatory requirements to impose on abortion clinics.鈥
Health department spokesperson Holly Matkin said department officials can鈥檛 comment further because of pending litigation.
Abortion rights advocates say the rules would do nothing to protect patients while raising costs for clinics. They call such rules 鈥, which stands for targeted restrictions on abortion providers.
鈥淟aws targeting abortion providers result in closure disproportionately affecting independent abortion clinics and the communities they serve,鈥 said Erin Grant, co-executive director of , an association representing independent abortion clinics.
Similar rules were popular in the 2010s among states whose political leaders opposed abortion, but few states have passed them Roe v. Wade in 2022, allowing for more restrictive state bans.
鈥淭hey鈥檙e a blast from the past,鈥 said , a women鈥檚 health policy analyst at KFF, a health information nonprofit that includes 杨贵妃传媒視頻 Health News. 鈥淭heir main goal was to make it difficult to provide abortion services.鈥
The Guttmacher Institute, a nonprofit abortion rights research group, cites TRAP laws as a main factor behind a from 2011 to 2017.
Attempts by Montana鈥檚 Republican-led legislature and Republican governor to pass an abortion ban or more severe restrictions on access have been stymied by a that extended the state constitution鈥檚 privacy protections to a person鈥檚 medical decisions 鈥 including abortion.
The proposed regulations were drafted to accompany a state law, , that creates licenses for clinics that perform abortions. It was among several anti-abortion laws the state passed in 2023 that the courts have blocked. Others include a ban on abortions after 15 weeks of pregnancy, a ban on dilation-and-evacuation procedures, and a measure that made it more difficult for the state鈥檚 Medicaid program to pay for abortions.
Weems, her clinic, and the in Missoula, which also provides abortions, sued to block the licensure law from taking effect, arguing it would unconstitutionally discriminate against abortion clinics by singling them out for regulation. Planned Parenthood, which provides abortions and has clinics in Billings, Great Falls, and Helena, is a plaintiff in lawsuits challenging other state anti-abortion laws.
granted All Families and Blue Mountain a temporary restraining order against HB 937 because the rules hadn鈥檛 yet been drafted. Now that they have been released, the rules go through a 30-day public comment period, including an Aug. 16 public hearing, before they can be finalized by the health department.
Judge Chris Abbott鈥檚 order blocks the law from taking effect until 60 days after the state health department adopts the regulations and both sides review them.
The Montana rules also would require the state to investigate any complaint against a clinic, and require clinics to keep employee and patient files that can be inspected by state regulators, conduct background checks and annual training of employees, and document that patients gave informed consent and were given a hotline number to help people who may be victims of sex trafficking or are being coerced into having an abortion.
Some of the rules could be waived depending on the scope of abortion services provided 鈥 for example, if a clinic has a policy not to abort a fetus over a certain gestational age, according to the draft.
It鈥檚 unclear what will happen to the licensure rules if they鈥檙e adopted and voters in November approve a ballot measure to amend the state constitution to explicitly protect abortion rights. The secretary of state鈥檚 deadline to certify the proposed constitutional amendment, , is Aug. 22, according to Richie Melby, a spokesperson for the office. Organizers say needed to place the question on the ballot.
The ballot initiative would say, in part, that the right to abortion 鈥渟hall not be denied or burdened unless justified by a compelling government interest achieved by the least restrictive means.鈥
If both the constitutional amendment and the abortion license regulations are adopted, it would likely spark a legal battle around whether the rules are a justifiable burden, Gomez said.
