By Jim Saunders
4/30/2010 © Health News Florida
Ending a legislative session shadowed by major financial and health-care issues, lawmakers Friday approved a $70 billion budget for the upcoming year and passed a controversial bill that would require ultrasounds before women can have abortions.
In the closing hours of the session, senators also quietly confirmed the appointment of Agency for Health Care Administration Secretary Tom Arnold --- reversing the Senate's position earlier this week that it would not take action on the appointment. The 60-day session ended at 8:47 p.m.
The abortion issue touched off a fierce --- and often emotional --- debate in the House. Along with mandating ultrasounds, the bill also would require women to sign forms if they don't want to view the results. What's more, the bill would tighten abortion restrictions on women who eventually get insurance under a new federal health-reform law.
House members debated the bill for about four hours before passing it. Senators approved it Thursday, which means the measure will go to Gov. Charlie Crist. The St. Petersburg Times quoted Crist as saying he had "very serious concerns" about the bill.
Critics particularly focused on the ultrasound issue, which they argued infringes on the rights of women.
"This (ultrasound) amendment is a mean-spirited invasion of privacy to the highest degree,'' said Rep. Audrey Gibson, D-Jacksonville.
But supporters said the requirement would provide increased information to women and help protect their health care. Some also said they hoped requiring ultrasounds could make abortions more rare.
"I believe abortion is wrong, and I don't make any apologies for that statement,'' said Rep. Mike Horner, R-Kissimmee.
The graphic nature of the debate caused House leaders to send young pages out of the chambers during the debate. Also, Rep. Ron Reagan, a Bradenton Republican who presided over part of the morning session, warned parents who were watching the debate that they might want to take their children out of the House seating gallery.
"This is a very delicate, sensitive subject that we're discussing,'' Reagan said.
At one point, Umatilla Republican Alan Hays compared abortion to the Holocaust that killed millions of Jews during World War II. That drew a quick response from Miami Beach Democrat Richard Steinberg, who is Jewish.
"I am deeply disheartened to hear parallels of this issue to the Holocaust,'' he said.
Steinberg also called on Crist, who broke with the Republican Party this week to run as an independent for the U.S. Senate, to veto the bill.
While abortion touched off the biggest debate of the session's final day, the only measure that lawmakers had to pass was the budget. With the economic recession dragging down tax revenues in recent years --- and facing increased costs for programs such as Medicaid --- legislative leaders struggled throughout the session to patch together the budget.
The budget approved Friday will cut hundreds of millions of dollars in Medicaid payment rates to hospitals and nursing homes and also make smaller cuts in numerous other health and human-services programs. But Republican lawmakers and some Democrats defended the overall budget, saying it was fiscally responsible and did not raise taxes on Floridians who are struggling economically.
"This budget, it's lean, but it's not mean,'' said Rep. John Legg, R-Port Richey.
The abortion issues emerged this week, touching off hours of debate in both chambers. House members voted 76-44, largely along party lines, to approve the bill Friday.
The Senate's 23-16 vote on Thursday came at the end of a day filled with turmoil about the measure. Since today is the final day of the annual legislative session, House Democrats tried to use procedural moves to slow the flow of bills to a crawl, in hopes that would spur the Senate to scrap the abortion proposals.
But in a debate that focused almost exclusively on the ultrasound requirement, senators pushed forward.
"All this (ultrasound) amendment says is, if you're going to be informed, let's really be informed,'' said Orlando Republican Andy Gardiner, the sponsor of the ultrasound proposal.
Bradenton Republican Mike Bennett countered that the ultrasound requirement was aimed at making women more "miserable'' as they choose whether to have abortions.
"We should not be debating this issue,'' said Bennett, one of four Republicans who opposed the bill. "We should keep the government out of these women's business.''
The bill started out as a little-debated health care measure, but it became a lightning rod after Senate Republicans added the abortion proposals as amendments Wednesday.
House Democrats tried to use their ability to slow votes on bills as leverage to get senators to reconsider. In the final days of each legislative session, bills typically bounce back and forth between the House and Senate --- with lawmakers trying to pass as many as possible before time runs out.
The bill would require women to undergo ultrasounds for first-trimester abortions, which would substantially expand a current requirement that applies to later-term abortions. It also would require that the health providers explain the fetal images and give women the choice of seeing the images.
In addition, the bill would ban abortion coverage in policies purchased through state-based insurance exchanges that are a crucial part of the new federal health-reform law. That provision would take effect in 2014, when exchanges begin, and goes further than abortion restrictions approved by Congress and President Obama.
The ban would affect policies "purchased in whole or in part with state or federal funds through an exchange.'' The definition of federal funds includes tax credits that many small businesses will receive to help pay for employee insurance, which abortion-rights advocates say would effectively prevent those small businesses from offering policies that include abortion coverage.
Merritt Island Republican Mike Haridopolos, the Senate sponsor of that proposal, said Wednesday the federal health law allows states to take such steps.
"We choose not to have tax dollars pay for abortions,'' Haridopolos said.
But critics blasted the proposal, which had not been considered in Senate committees. Miami Beach Democrat Dan Gelber called it "irresponsible in the extreme.''
"This is a mistake,'' Gelber said. "It is a stain on this Legislature.''
Only one Senate Democrat, Gary Siplin of Orlando, voted for the bill. Also, all but two of the Senate supporters --- Lakeland Republican Paula Dockery and Valrico Republican Ronda Storms --- were men.
That gender gap threaded through the debate. "You make decisions, men, that hurt us,'' Miami Democrat Larcenia Bullard said.
But supporters said the ultrasound requirement would lead to using technology to help provide information to women seeking abortions. Eustis Republican Carey Baker said it was a "little ridiculous'' to argue that the requirement would prevent women from having abortions.
Aside from the abortion issue, senators also tacked another amendment onto the bill to target the federal Patient Protection and Affordable Care Act (ACA). It states that it is the "public policy'' of Florida that residents should not be required to buy health insurance, an attack on the so-called individual mandate.
Some lawmakers say the bill could bolster a federal lawsuit filed by Attorney General Bill McCollum that challenges the reform law. Senate Democrats, however, described the lawsuit Wednesday as "frivolous.''
The issue of abortion coverage almost derailed the push by congressional Democrats and President Obama to pass the massive ACA. In the end, however, they reached agreement on a plan to avoid using federal funds to pay for abortions.
The health exchanges are critical to the reform law as they are designed to give individuals and small businesses more purchasing power. Individuals and small businesses often lack power to pool risks, which drives up their insurance costs.
Capital Bureau Chief Jim Saunders can be reached at 850-228-0963 or at jim.saunders@healthnewsflorida.org.