The Delaware legislature passed over seven bills this session focusing on protecting and expanding access to women’s reproductive healthcare.
House Majority Leader Melissa Minor Brown (D-New Castle) has championed reproductive rights legislation since entering office in 2018, but notes women’s health has been particularly on her mind this year.
“It has been literally like a women’s reproductive healthcare session, and we’ll continue to do that. So I don’t really know what’s coming down the pike yet, but I know, like I said, as we look around the country and we see women’s reproductive rights being under attack, we’re going to continue to do whatever we need to do in this state to protect women’s rights.”
Although some of the bills prompt extra costs through the state’s group health insurance plan and the state’s portion of Medicaid, Minor-Brown says by focusing on access, healthcare costs will eventually decline.
“We know that Medicaid is driving our budget, but if we don’t focus on prevention, we’ll never get that number down, and the only way we’re going to focus on prevention is to really address the disparities that exist and that is education and access.”
Legal protections for fertility providers
State Rep. Kendra Johnson's (D-Bear) legislation would ensure medical professionals cannot face legal challenges for providing fertility treatment, even if such services are deemed illegal in another state.
Her legislation comes after a February Alabama Supreme Court ruling declaring frozen embryos could be considered children, leaving many in vitro fertilizer (IVF) providers across the nation concerned.
The Alabama decision stemmed from three couples suing for wrongful death after their frozen embryos were destroyed in an accident at a fertility clinic.
This accident aside, providers explain discarding non viable embryos is commonplace in the practice, and many halted services after the ruling for fear they could face legal challenges.
Alabama’s legislature has since passed a bill granting criminal immunity for IVF service providers and receivers, similar to Johnson’s bill.
The bill passed with bipartisan support, 29-11 in the House and 20-1 in the Senate.
Expanding access to medication for termination of pregnancy and emergency contraceptives on college campuses
State Sen. Kyle Evans Gay's (D-Talleyville) bill would necessitate public universities with a student health center provide abortion medication and contraception on-site, although consultation to provide them may be performed by a contracted external agency.
During the bill's hearing in the Senate, Evans Gay explained the legislation does not affect the scope of practice for providers, ask universities to offer medication on campus if they feel they are not capable of it or ask universities to pay for the procedures.
“It is simply a bill to encourage and consider the needs of students on campus and recognize that they too deserve access to healthcare and that it is our responsibility to fill any gaps for them that exist," she said.
Republican senators feel the bill is state overreach considering public universities are already allowed to provide medication on their own accord and expressed objections to making abortion services more readily available.
The bill passed on near party-line votes in both chambers with only Democratic support.
Requiring insurance providers to cover nonprescription birth control medication
Evans Gay sponsored additional legislation requiring insurance providers to cover over-the-counter non-emergency contraceptive pills.
The bill was written following the Federal Drug Administration's July 2023 approval of the first nonprescription daily oral contraceptive.
The bill passed with unanimous bipartisan support in the Senate and garnered five no votes from House Republicans.
Mandating crisis pregnancy centers disclose they are not licensed medical facilities
Evans Gay's final bill would require crisis pregnancy centers in Delaware to post signage that they are not licensed medical facilities.
Crisis pregnancy centers are typically non-profit limited service medical facilities that aim to persuade pregnant people not to pursue abortion services.
“71% of these types of crisis pregnancy centers use deceptive means to spread debunked information, and 38% do not clearly state on their homepage — their web page — that they don’t provide abortion care," Gay said during the bill's Senate hearing.
She said the state is endangering access to public health by not notifying pregnant individuals where they can receive access to licensed medical care.
Republican senators argue the bill could be challenged in court as a free speech violation and feel the signage places an unfair burden on the crisis centers.
The legislation passed in both chambers with only Democratic support.
Requiring insurance providers to cover abortion services
Delaware could become the 18th state to direct Medicaid to pay for abortion services and the 5th state to require state-regulated private health plans to do the same.
In April, Minor Brown’s legislation requiring Medicaid to cover termination of pregnancies cleared the House Appropriations Committee.
She then substituted that bill with a new version requiring all health benefit plans delivered or issued for Medicaid, private health insurance plans and state employee insurance plans to cover abortion in Delaware.
The bill requires that patients seeking pregnancy termination are not subject to any deductible, copayment or coinsurance up to the $750 coverage maximum.
The bill outlines an exception for religious employers if the coverage requirement "conflicts with the religious organization’s bona fide religious beliefs and practices," but exclusions are not applicable for termination of pregnancies that are necessary to preserve the life or health of a covered individual.
House Minority Whip Lyndon Yearick (R-Magnolia) joined several of his colleagues during Floor debate in arguing the state does not mandate insurance providers to cover or provide the same cost-share exemptions to other elected health services.
“The requirement to mandate that every entity must provide this elective service and no questions asked unless they’re a faith based institution — I’m disappointed in that. I’m sure there’s very few elective services that we require other companies through their healthcare to provide," Yearick said.
"I think that it is unfair to force taxpayers who are opposed to this procedure to have to pay for that procedure," State Rep. Charles Postles (R-Milford) added.
Republicans went on to argue this requirement would only add to the state’s ballooning healthcare spending, noting the bill carries roughly a $500,000 annual fiscal note.
But Minor Brown said there will be back-end cost saving measures, saying women denied abortion services often lacked the means to cover basic living expenses years following the denial and saw lowered credit scores, increased debt and negative public financial records.
The bill passed with two Republican representatives defecting in the House and passed the Senate with only Democratic support.
Expanding access to doula services
Minor-Brown championed a law signed last summer requires doula services to be covered by Medicaid in the First State, but she introduced two new pieces of legislation this session to expand on that work.
Her first bill adds upon requiring Medicaid coverage of doula services to also include all private health insurers.
The second requires Medicaid to cover additional postpartum doula visits recommended by a licensed healthcare provider — Medicaid currently covers three postpartum visits.
Data from the CDC shows that 53% of pregnancy related deaths measured over 2 years occurred 7 days to 1 year after pregnancy, and Minor-Brown says doulas can help prevent those deaths
“So that extra set of eyes with the doula being present allows for early warning signs to be identified," she said during the bill's committee hearing in March. "Sometimes moms may experience cardiovascular issues, postpartum depression, anxiety disorders, substance use disorders, and many other unfortunate symptoms.”
Both bills passed unanimously in the House and Senate among members present.
All of the bills await Gov. John Carney’s signature to officially become law.
