A bill that critics say would constrain significantly access to medically needed abortions easily passed the Tennessee General Assembly last week, but legislators appear starkly divided in their assessments of what the bill actually does.

The language of the bill, which is awaiting approval or veto from Gov. Phil Bredesen, prohibits the coverage of abortion in any health plan offered through the state insurance exchange that would be created in 2014 under the federal health care reform bill. The text of the bill makes no mention of any exception for the case of rape, incest or if the mother's health is in danger.

But a number of the bill's supporters said they thought the bill was primarily intended to ensure that taxpayer dollars would not be used for abortion coverage in the state health insurance exchange. They also believed that it did not affect long-standing exceptions for extreme cases, such as rape.

"My 'yes' vote was based on that it didn't change anything in Tennessee law ... and that it's consistent with what we've been doing in the legislature for the past several years," said Sen. Bo Watson, R-Hixson, who voted for the bill.

He said his support of the legislation was based on his belief that the bill is "consistent with" President Barack Obama's executive order assuring that taxpayer dollars would not be used to pay for abortion under the health care reform legislation. He referred to the assurance from Senate sponsor Diane Black, R-Gallatin, that the bill would allow exceptions in the case of rape, incest and health of the mother.


His and other supporters' takes on the bill are notably different from the interpretation by the bill's opponents and the American Civil Liberties Union in Tennessee.

Critics argue that the actual text of the one-paragraph-long bill includes no mention of financing mechanisms or taxpayer dollars, and it provides no exceptions.

One of the bill's House opponents, Rep. Jeanne Richardson, D-Memphis, said she believes those who voted for the bill had little interest in its substance but were motivated by a desire to tout an anti-abortion vote in an election year.

"I believe they came up with this bill because they needed some avenue to vote against abortion," she said. "They didn't care what it said, really. If it made them look like they were voting against abortion, it didn't matter if it was rational or made sense."

Repeated efforts to reach Sen. Black and the bill's House sponsor, Rep. Matthew Hill, R-Jonesborough, over two days were unsuccessful.

On the Senate floor last week, Sen. Black said that, under the bill, women could still get public funding for abortions in cases such as rape or incest. Her answer came in a response to a query from Sen. Beverly Marrero, who voted against the bill.

Sen. Black didn't address how the bill affects private plans that would be offered through the state health insurance exchanges.

Sen. Tim Barnes, D-Adams, said he voted for the bill based on those assurances from Sen. Black that the legislation does allow for exceptions, in keeping with federal law on federal funding for abortion.

"That's the only reason I voted for it," he said last week in a phone interview.

This year, 10 states introduced legislation to ban or limit abortion coverage in the exchanges. Arizona became the first to enact such a law last week, said Elizabeth Nash, public policy associate with that Guttmacher Institute, a nonprofit research group that supports abortion rights.

Arizona's law allows for exceptions for the health of the mother. Tennessee and South Carolina's bills are the only ones that do not provide any exceptions, she said.

"The words of the bill do not provide for any exceptions," even though Tennessee legislators "seem to imply there were some," Ms. Nash said.

The federal health care reform law allows states to regulate abortion coverage in the exchanges, but that's not an expansion of power, Ms. Nash said. States have had the power to regulate insurance coverage within their borders since 1945.


If enacted, the abortion bill would apply to women purchasing private health plans with private funds through the exchange, said Hedy Weinberg, executive director of the Tennessee American Civil Liberties Union. The group sent a letter to the governor last week asking that he veto the bill.

"It's a very disturbing bill," Ms. Weinberg said. "Women who get health care coverage through TennCare will actually have more comprehensive coverage than the women who use private dollars to purchase insurance through the exchange."

TennCare covers abortions in the cases of rape, incest and danger to the health of the mother.

"Basically, politicians are dictating to the private insurance companies what benefits and coverage they can offer to their clients," Ms. Weinberg said.

Sen. Doug Overbey, R-Maryville, voted in favor of the bill. But he said in a phone interview last week that he's been so wrapped up in the legislation regarding a hospital assessment fee, which passed the Senate on Thursday, that he doesn't know what exactly the abortion bill does and whether it contains exceptions.

"Frankly, I don't quite understand what the exchanges are," he said.

The governor's office would not comment on the substance of the bill, but spokeswoman Lydia Lenker said Gov. Bredesen has until early this week to make a decision on the bill.

Rep. Joe Armstrong, D-Knoxville, who voted against the bill, cited concern for the health of women and his sense that the bill is rooted more in opposition to national health reform than well-thought out policy.


A federal provision, the Hyde Amendment, prohibits the use of federal funds for abortion coverage, except in the case of rape, incest and danger to the mother's health.

"I think this bill needed further studying to really look at the scope of it. A lot of members (of the legislature) are just against the federal health care reform bill and this is - I thought - it was more of a protest bill," he said.

On the House floor earlier this month, Rep. Gary Odom, D-Nashville, proposed an amendment to the bill that would ensure exemptions in the case of rape, incest or the health of the mother, if the health plan was purchased with private money. He said the legislation as written would prevent women from accessing abortion even under those conditions.

"I think the language in the sponsor's bill would outlaw even a life-saving abortion," Rep. Odom said.

Rep. Eric Swafford, R-Pikeville, called the amendment unnecessary and politically motivated, and called for legislators to table it, which they did.