FRANKFORT, Ky. — Republican lawmakers advanced two bills Wednesday adding limited medical exceptions to Kentucky’s near-total abortion ban after three years of refusing calls from doctors to do just that.

A House committee approved House Bill 414 on a 12-4 vote — the first time the GOP supermajority has allowed such a bill to be heard since the legislature made abortion illegal in 2022. Democrats voted against the bill, saying it didn’t go far enough.

It now goes to the full House for consideration.

Hours later, that same language was added to another bill, House Bill 90, to lower barriers for freestanding birthing centers, in the Senate Standing Committee on Licensing and Occupation, which met just after 8 p.m. once the Senate adjourned. The committee approved the addition.

Republican Rep. Nancy Tate’s committee substitutes in both bills delineate between elective abortion, which is still completely banned in Kentucky, and abortions deemed by doctors as “medically necessary” when a pregnant woman faces serious and life-threatening complications.

Both versions help define “what is not an abortion,” said Kentucky Right to Life Executive Director Addia Wuchner, who presented the additions alongside Tate.

The bill provides much needed “medical clarity” to the existing near-total ban, said Rep. Kim Moser, R-Taylor Mill, before the first committee vote in the House Standing Committee on Health Services Wednesday afternoon.

Abortion has remained illegal in Kentucky since July 2022 under a trigger law and six-week ban, or fetal heartbeat law, which amount to a near-total ban, except in medical emergencies threatening a pregnant woman’s life.

But even before it was outlawed, the Republican-led legislature enacted a patchwork of laws making it increasingly difficult to access and provide the procedure — bills for which Tate crusaded.

A member of the Pro-life Caucus since she took office in 2019, Tate, of Brandenburg, has emerged as a stalwart champion of laws “defending life,” even publicly encouraging lawmakers not to kowtow to dilute the laws by adding exceptions for rape, incest, or that allow doctors more autonomy in medically-necessary abortions to patients with severe pregnancy complications.

Tate changed her tune Wednesday.

Her new bill will “give us the opportunity to provide additional care for women and their families in the event they have a pregnancy that turns out to be not exactly perfect,” she said.

Tate presented the new versions of these bills alongside Kentucky Right to Life Executive Director Addia Wuchner, Middletown Republican Rep. Jason Nemes, and Dr. Jeffrey Goldberg, a gynecologic oncologist in Louisville and legislative advocacy chair for the Kentucky Chapter of the American College of Obstetricians and Gynecologists.

It was an unlikely grouping, Nemes acknowledged Wednesday.

“We have people that don’t always trust each other . . . come up with this really good bill that will save women and save babies, and that’s the point,” said Nemes, who filed an unsuccessful bill to add abortion ban exceptions in 2023.

Not all Democrats were convinced.

Sen. Karen Berg, D-Louisville, called out the semantics used by Tate, Wuchner and Nemes defining “what is not an abortion” in order to make it more palatable to themselves and their constituents, before criticizing the larger anti-abortion charge the GOP has embraced for years, bringing the state to this point.

“So much of the confusion here is because non-medical people are trying to make medical decisions. When you say that we’re talking about abortions that aren’t abortions. They are abortions,” Berg, who is a doctor, said. “The definition of an abortion is the termination of a pregnancy prior to viability.”

“You’re confusing people when you say these aren’t abortions when they are. This is the misspeak that is so confusing, and in part, leads to the chaos (caused) by the bills you have brought forth in this state,” she said. “This is a makeshift attempt at fixing problems that we, ourselves, made by passing bad legislation to begin with.”

Goal is to make ‘doctors feel comfortable’

Tate also filed a perinatal palliative care bill last year, but it didn’t pass.

It would’ve required hospitals to provide or refer pregnant patients with nonviable pregnancies to palliative care programs as “alternatives to pregnancy termination.”

When she presented that bill in committee, Democrats walked out in protest because they said the intention was to pressure women with doomed pregnancies into carrying them to term.

Tate’s bill this year requires all hospitals to refer women who have miscarriages or whose pregnancies won’t survive to optional specialized perinatal palliative care programs to deal with that loss.

It defines those programs as a “coordination of care” between health care providers and specialists tasked with offering resources and counseling at the request of a pregnant woman who is “preparing a plan of care for the baby, which may include medical interventions . . . and neonatal hospice.”

The committee sub codifies giving health care providers more freedom to administer “medically necessary” abortions to these patients.

Between both meetings Wednesday, a group of OB-GYNs gathered in the Capitol annex, representing more than 430 health care providers across the state, to call on lawmakers to repeal Kentucky’s “dangerous” laws restricting abortion.

Not only are those laws putting patients at risk, they’re driving providers away from the state, they said.

“I want to be clear: abortion is essential health care,” said Dr. Janet Wygal. “No physicians should be forced to wait until someone becomes sick enough to intervene with basic, necessary health care because the government says so.

“Women’s lives are being put at risk,” Wygal said. “It is long past time for our lawmakers to listen to the experts.”

Since the bans were enacted almost three years ago, OB-GYNs have told the Herald-Leader their narrow, vague exceptions, often referred to as “life of the mother” exceptions, do not reflect the range of pregnancy complications that require a pregnancy be terminated.

Not all nonviable pregnancies — meaning the fetus will not survive — immediately threaten the life of a pregnant person. In the past, many of those patients were treated in hospitals.

But since Kentucky’s ban took effect, doctors, nervous to be charged with a crime, continue to refer patients in this category out of state to get abortions — a form of treatment that’s otherwise considered to be the standard of care.

Tate, Nemes and Wuchner’s updated version of both bills seeks to heed this call from doctors, they said.

And Goldberg, who helped craft the new legislation, is one of those doctors who has called on lawmakers to broaden the law.

He told the committee — and has several times told the Herald-Leader — Kentucky’s current abortion ban has routinely prevented doctors from providing the standard of care to patients whose pregnancies are diagnosed as nonviable.

The parameters around when a medically necessary abortion is permissible under the law are “as clear as mud,” Goldberg told committee members.

“There is no definition of what is high enough risk to meet the statutory requirement,” he said.

The language added to Tate’s bill seeks to clarify those parameters, as well as define when providers can intervene and terminate a pregnancy “without fear of being charged with a felony,” Goldberg said.

For example, a doctor is allowed to use their “reasonable medical judgment” when choosing when an abortion is necessary, but that phrase is not defined in the law.

Tate’s bill offers that definition, and then some, to bolster doctor autonomy, she said.

Goldberg said the language of the bill “wasn’t perfect,” but “we’re simply trying to make sure that on a day to day basis, doctors feel comfortable providing evidence-based care for women with complications in pregnancy that have nothing to do with elective abortions, but without the fear of severe penalties attached to providing those elective abortions.”

Tate said she understood not everyone would be happy with the bill, “but we’re trying to work on making these laws as palatable as possible in order to ensure women in Kentucky are safe.”

But Democrats on both committees voted against it, saying it either doesn’t go far enough in restoring abortion access, or they’re unconvinced it will actually protect women or doctors’ ability to treat them, despite Goldberg’s testimony.

Others were dismayed that bill sponsors didn’t consult with hospital general counsel before proposing the bill.

“I’m glad we’re finally all on the same page that our current laws aren’t cutting it,” House Minority Whip Lindsey Burke of Lexington said. “But this is at best a rough draft. It doesn’t solve the problem we’re trying to fix.”

Rep. Lisa Willner, D-Louisville, said it still “leaves a really unclear landscape for health providers.”

“Even though it doesn’t go as far as I would like it go to, if I thought it was the fix I would so happily vote for it,” she said. “But I’m not convinced, having not heard from the hospital attorneys. I’m not convinced this protects doctors, and I’m sure it does not protect pregnant people.”

Outside the meeting room after Republicans advanced the bill Wednesday afternoon, Nemes said lawmakers undoubtedly “want to get the legal liability” right.

“But that’s secondary,” he said. “What’s primary is making sure we get the point of care taken care of, and that is: what does this doctor know he or she can do, and can they save a woman’s life?”

Nemes said the bill addresses a real problem, and legislators are trying to fix it by working with an expert like Goldberg.

“I know people want to go further, but this was brought to us by real examples,” he said. “If you vote ‘no,’ the blood is on your hands.”

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