Maryland lawmakers voted over the weekend to override Gov. Larry Hogan's veto of a bill that would allow health practitioners outside of physicians — including nurse practitioners, midwives and physician's assistants — to perform abortions.
Maryland House members voted 90-46 on Saturday to reverse the governor's decision, while state Senate members voted 29-15.
Hogan is a Republican, while the majority of both the state's chambers are Democrats. The bill will now become law and take effect on July 1.
House Bill 937, known as the Abortion Care Access Act, says that "qualifying providers" include those whose medical licenses or certifications include the performance of abortions.
"Thank you so much to my House colleagues for voting to override the Governor's veto on my legislation to protect our public health officials from undue political influence," said Democratic House Delegate Joseline A. Pena-Melnyk on Twitter. "It is imperative that we guide our policy by science."
In his veto, Hogan wrote that "The bill risks lowering the high standard of reproductive health care services received by women in Maryland. These procedures are complex, and can, and often do, result in significant medical complications that require the attention of a licensed physician."
The bill also establishes the Abortion Care Clinical Training Program, in which the state must contract an organization to develop abortion care training programs at at least two community sites.
The bill has $3.5 million going to the program each year.
The purpose of the program is to "expand the number of health care professionals with abortion care training and increase the racial and ethnic diversity among health care professionals with abortion care training," the bill says.
The Maryland Health Department may not disclose who is participating in the program. The contracted organization, which must be a nonprofit and have previous experience coordinating abortion programs, must submit an annual report to the health department.
In most cases, a physician or other qualified provider cannot carry out an abortion on an unmarried minor without giving notice to the minor's parent or guardian.
However, a medical provider can bypass parental permission if the minor doesn't live with their parent or guardian and "a reasonable effort to give notice to a parent or guardian is unsuccessful," the bill says.
The procedure can also be greenlighted if the medical provider has reason to believe the minor would suffer abuse after notifying a parent, the minor is "mature and capable of giving informed consent to an abortion," or if requesting permission simply isn't in the minor's "best interest," according to the bill.
The bill does not specify at what number of weeks an abortion can no longer be performed, but it defines a "viable" pregnancy as one in which a medical provider determines "there is a reasonable likelihood of the fetus's sustained survival outside the womb."
The bill says the state cannot intervene on a woman's decision to have an abortion before the fetus is viable, or at any other time during a woman's pregnancy if an abortion is deemed necessary to save a woman's life or health, or if the baby "is affected by genetic defect or serious deformity or abnormality."
Qualifying insurers under the bill are insurers, nonprofits and health maintenance organizations that provide labor and delivery coverage under state healthcare policies or contracts.
Insurers who fall within these parameters must cover abortions without demanding a deductible, coinsurance, copayment or "any other cost-sharing requirement," according to the bill.
They must also inform consumers about covered abortion services by explicitly using "abortion care" in their language.
Insurers that do not qualify include multistate plans that don't provide abortion coverage, a high-deductible plan or an organization that is eligible for an exclusion from abortion coverage.