Doctors and medical students with Kentucky Physicians for Reproductive Freedom gather at the Kentucky Capitol to advocate for a full restoration of abortion access, March 12, 2025. (Kentucky Lantern photo by Sarah Ladd)
FRANKFORT — With four days left in the 2025 legislative session, House Republicans moved to clarify Kentucky’s abortion law and reassure health care providers that they are free to treat complex pregnancies.
House Bill 414 originally required insurance coverage for and referrals to perinatal palliative care programs in cases when newborn babies are unlikely to live long. It was amended to add clarifying language on Kentucky’s near-total abortion ban.
In its current form, which passed out of the House Health Services Committee Wednesday along party lines, the bill states that “there is a need to clarify the distinction between an elective abortion and illegal termination of the life of an unborn child protected under Kentucky law and medically necessary interventions that affirm the fundamental right to life.”
Democrats voted against the bill, arguing it didn’t go far enough and further “muddies the waters” for medical providers.
“If I thought this was the fix, even though it doesn’t go as far as I would like it to go … I would so happily vote for it,” said Rep. Lisa Willner, D-Louisville. “I’m not convinced. Having not heard from hospital attorneys, I’m not convinced that this protects doctors, and I’m sure that it does not protect pregnant people.”
The proposed clarification comes in response to reports from across the country, including in Kentucky, of women who say they were denied access to medication to treat miscarriages and other complications because of state abortion bans, leading in some cases to preventable deaths. Kentucky OB-GYNs have said the state’s abortion ban is forcing them to violate their oath as physicians and causing “devastating consequences” for patients.
Also on Wednesday, doctors and medical students with Kentucky Physicians for Reproductive Freedom came to Frankfort to advocate for a full restoration of abortion access. They brought with them a letter signed by more than 400 health care providers asking the legislature to repeal its ban on abortion.
Dr. Nicole King told her fellow physicians gathered in the Capitol annex that they are “stuck between doing what is right and doing what is legal.”
A military veteran and anesthesiologist with high-risk obstetrical experience, King said Kentucky’s law is “not just cruel, it is medically dangerous.”
“Delayed care increases the risk of severe blood loss, uterine infection, multi organ failure and death,” King said. “We must continue to fight, not just for the patients who are able to speak out, but for the countless others suffering in silence, trapped by unjust laws.”
‘In a terrible state.’
In the committee, Majority Whip Jason Nemes, R-Middletown, said the proposed reassurances for medical providers in HB 414 “will save lives” and acknowledged the bill is a compromise for many.
“I know that some people want elective abortions,” said Nemes, who in 2023 attempted to add exceptions for rape and incest to the ban.
But he said restoring abortion rights is not politically feasible in the Kentucky legislature. “There’s a baby involved, and that’s not going to pass this General Assembly.”
Dr. Jeffrey M. Goldberg, the legislative advocacy chair for the Kentucky chapter of the American College of Obstetricians and Gynecologists (ACOG), testified in support of the new version of HB 414 over Zoom.
While he reiterated the language in HB 414 isn’t perfect, “current statute has a tremendous amount of ambiguity” and needs updating, he said.
“We’re all in agreement that the current situation for caring for women in the commonwealth who have complications of pregnancy is in a terrible state,” he said. “While it may not have been the intention of the legislature — when writing laws either restricting elective abortion when it was still legal or subsequently making it against the law — to make it difficult to properly care for women who have pregnancy complications that have nothing to do with elective abortion, nonetheless, that has been the outcome.”
Sponsor Rep. Nancy Tate, R-Brandenburg, said the latest version “gives us the opportunity to provide additional care for women and their families in the event that they have a pregnancy that turns out to be not exactly perfect.”
Addressing several Democratic lawmakers who questioned the language in the bill, Goldberg said, “We already work within statutory restrictions that are, from a medical perspective, very ambiguous.”
“There’s a great deal of work to be done. This is not perfect. I don’t want to give anybody the illusion that we all think this is great,” he said. “We think it’s an acceptable short term solution for dealing with a really serious problem that’s in front of us.”
There isn’t much time for it to pass. Wednesday marked the 26th day of the 30-day session. Lawmakers break Friday for a veto period, then return on March 27-28 to override vetos. In order to be veto-proof, the bill would need to clear the House, a Senate committee and the full Senate in two days’ time.
What’s in the bill?
Tate’s HB 414, as amended in committee, proposes striking several phrases from abortion law. For example, it would replace the “no abortion shall be performed” with“no action that requires separating a pregnant woman from her unborn child shall be performed, except the following when performed by a physician based upon his or her reasonable medical judgment.”
Those exceptions are laid out to include:
- Lifesaving miscarriage management, which includes medically necessary interventions when the pregnancy has ended or is in the unavoidable and untreatable process of ending due to spontaneous or incomplete miscarriage.
- Sepsis and hemorrhage emergency medical interventions required when a miscarriage or impending miscarriage results in a life-threatening infection or excessive bleeding.
- The removal of a molar pregnancy.
- The removal of an ectopic pregnancy or a pregnancy that is not implanted normally within the endometrial cavity.
- And more.
The bill still directs medical professionals to “make reasonable medical efforts under the circumstances to preserve both the life of the mother and the life of the unborn child.”
Addia Wuchner, the executive director of Kentucky Right to Life, said that “although we’ve always said that current model does not restrict medical care for miscarriage management, ectopic pregnancy, molar pregnancy, sepsis (and) hemorrhage,” the bill is to address confusion around these conditions.
Committee chair Kim Moser, R-Taylor Mill, agreed.
“This is a step in the right direction for medical clarity,” she said.
Doctors rally against ‘unjust laws’
After the committee’s discussion of Tate’s bill, 19 members of Kentucky Physicians for Reproductive Freedom gathered in the Capitol Annex and lamented the state’s “extreme” stance on abortion.
Among them was Dr. Janet Wygal, a Kentucky OB-GYN.
“No physician should be forced to wait until a woman becomes seriously ill to intervene with basic necessary health care because the government says so,” Wygal said. “These laws create an environment of fear and uncertainty, not only for doctors and their patients seeking abortion care, but also for those needing the full spectrum of health care, including IVF, contraception and cancer screenings.”
In 2022, the U.S. Supreme Court overturned Roe v. Wade, the 1973 decision that established abortion as a constitutional right, allowing an abortion ban to immediately take effect in Kentucky. It includes exceptions only for rare and life-threatening situations.
Lawmakers of both parties and organizations have attempted to loosen or undo Kentucky’s abortion bans, to no avail.
In 2022, Kentucky voters defeated the anti-abortion Amendment 2, which would have specified there’s no right to an abortion in Kentucky’s Constitution.
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