Medicaid Abortion Payment Amendments

5
26B-3-114
76-7-301
0
Medicaid Abortion Payment Amendments
2026 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Nicholeen P. Peck
Senate Sponsor:
LONG TITLE
General Description:
This bill changes the standards for determining which medical providers may qualify as an
eligible Medicaid provider.
Highlighted Provisions:
This bill:
prohibits certain abortion providers from qualifying as an eligible Medicaid provider.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26B-3-114
, as last amended by Laws of Utah 2024, Chapter 240
76-7-301
, as last amended by Laws of Utah 2024, Chapter 313
Be it enacted by the Legislature of the state of Utah:
Section 1. Section
26B-3-114
is amended to read:
26B-3-114
. Department standards for eligibility under Medicaid -- Funds for
abortions.
(1)
(a)
The department
may
shall
develop standards and administer policies relating to
eligibility under the Medicaid program if the standards and policies comply with
Section
26B-3-108
.
(b)
Except as provided in Subsection
(1)(c)
, under the standards established in
accordance with Subsection
(1)(a)
, a provider or a provider's affiliate may not be an
eligible Medicaid provider if the provider or the provider's affiliate:
(i)
performs an elective abortion, as that term is defined in Section
76-7-301
; and
(ii)
has an annual revenue of $500,000,000.
(c)
The restriction described in Subsection
(1)(b)
does not apply to a hospital.
(b)
(2)
An applicant receiving Medicaid assistance may be limited to particular types of
care or services or to payment of part or all costs of care determined to be medically
necessary.
(2)
(3)
The department may not provide any funds for medical, hospital, or other medical
expenditures or medical services to otherwise eligible persons where the purpose of the
assistance is to perform an abortion, unless the life of the mother would be endangered if
an abortion were not performed.
(3)
(4)
Any employee of the department who authorizes payment for an abortion contrary
to the provisions of this section is guilty of a class B misdemeanor and subject to
forfeiture of office.
(4)
(5)
Any person or organization that, under the guise of other medical treatment,
provides an abortion under auspices of the Medicaid program is guilty of a third degree
felony and subject to forfeiture of license to practice medicine or authority to provide
medical services and treatment.
Section 2. Section
76-7-301
is amended to read:
76-7-301
. Definitions.
As used in this part:
(1)
(a)
"Abortion" means the act, by a physician, of using an instrument, or prescribing a
drug, with the intent to cause the death of an unborn child of a woman known to be
pregnant, except as permitted under this part.
(b)
"Abortion" does not include:
(i)
removal of a dead unborn child;
(ii)
removal of an ectopic pregnancy; or
(iii)
the killing or attempted killing of an unborn child without the consent of the
pregnant woman, unless:
(A)
the killing or attempted killing is done through a medical procedure carried
out by a physician or through a substance used under the direction of a
physician; and
(B)
the physician is unable to obtain the consent due to a medical emergency.
(2)
"Abortion clinic" means the same as that term is defined in Section
26B-2-201
.
(3)
"Abuse" means the same as that term is defined in Section
80-1-102
.
(4)
"Department" means the Department of Health and Human Services.
(5)
"Down syndrome" means a genetic condition associated with an extra chromosome 21,
in whole or in part, or an effective trisomy for chromosome 21.
(6)
"Elective abortion" means an abortion other than:
(a)
removal of a dead fetus;
(b)
removal of an ectopic pregnancy;
(c)
an abortion that is necessary to avert the death of a woman;
(d)
an abortion that is necessary to avert a serious physical risk of substantial impairment
of a major bodily function of a woman;
(e)
an abortion of a fetus that has a defect that is uniformly diagnosable and uniformly
lethal; or
(f)
an abortion where the woman is pregnant as a result of rape or incest.
(6)
(7)
"Gestational age" means the age of an unborn child as calculated from the first day
of the last menstrual period of the pregnant woman.
(7)
(8)
"Hospital" means:
(a)
a general hospital licensed by the department according to Title 26B, Chapter 2, Part
2, Health Care Facility Licensing and Inspection; and
(b)
a clinic or other medical facility to the extent that such clinic or other medical facility
is certified by the department as providing equipment and personnel sufficient in
quantity and quality to provide the same degree of safety to the pregnant woman and
the unborn child as would be provided for the particular medical procedures
undertaken by a general hospital licensed by the department.
(8)
(9)
"Information module" means the pregnancy termination information module
prepared by the department.
(9)
(10)
"Medical emergency" means a life threatening physical condition aggravated by,
caused by, or arising from a pregnancy that places the pregnant woman at risk of death,
or poses a serious risk of substantial impairment of a major bodily function, unless the
abortion is performed or induced.
(10)
(11)
"Minor" means an individual who is:
(a)
under 18 years old;
(b)
unmarried; and
(c)
not emancipated.
(11)
(12)
(a)
"Partial birth abortion" means an abortion in which the person performing
the abortion:
(i)
deliberately and intentionally vaginally delivers a living fetus until, in the case of a
head first presentation, the entire fetal head is outside the body of the mother, or,
in the case of breech presentation, any part of the fetal trunk past the navel is
outside the body of the mother, for the purpose of performing an overt act that the
person knows will kill the partially delivered living fetus; and
(ii)
performs the overt act, other than completion of delivery, that kills the partially
living fetus.
(b)
"Partial birth abortion" does not include the dilation and evacuation procedure
involving dismemberment prior to removal, the suction curettage procedure, or the
suction aspiration procedure for abortion.
(12)
(13)
"Perinatal hospice" means comprehensive support to the mother and her family
from the time of the diagnosis of a lethal fetal anomaly, through the time of the child's
birth, and through the postpartum period, that:
(a)
focuses on alleviating fear and ensuring that the woman and her family experience
the life and death of a child in a comfortable and supportive environment; and
(b)
may include counseling or medical care by:
(i)
maternal-fetal medical specialists;
(ii)
obstetricians;
(iii)
neonatologists;
(iv)
anesthesia specialists;
(v)
psychiatrists, psychologists, or other mental health providers;
(vi)
clergy;
(vii)
social workers; or
(viii)
specialty nurses.
(13)
(14)
"Physician" means:
(a)
a medical doctor licensed to practice medicine and surgery under Title 58, Chapter 67,
Utah Medical Practice Act;
(b)
an osteopathic physician licensed to practice osteopathic medicine under Title 58,
Chapter 68, Utah Osteopathic Medical Practice Act; or
(c)
a physician employed by the federal government who has qualifications similar to an
individual described in Subsection
(13)(a)
or
(b)
(14)(a) or (b)
.
(14)
(15)
(a)
"Severe brain abnormality" means a malformation or defect that causes an
individual to live in a mentally vegetative state.
(b)
"Severe brain abnormality" does not include:
(i)
Down syndrome;
(ii)
spina bifida;
(iii)
cerebral palsy; or
(iv)
any other malformation, defect, or condition that does not cause an individual to
live in a mentally vegetative state.
Section 3.
Effective Date.
This bill takes effect on
May 6, 2026
.
1-12-26 3:08 PM