The Appropriations Committee had Round 2 of a hearing Thursday on moving Title X funding language into state law rather than allowing it in the state budget bill, as Gov. Pete Ricketts wants.
Appropriations Chairman John Stinner offered an amendment to a bill (LB481), introduced by Lincoln Sen. Kate Bolz, that replicates language put into last year's budget bill by Ricketts. If enacted, the law would expire in two years.
Bolz also submitted an amendment to her bill that would have the Department of Health and Human Services administer the federal Title X program in accordance with federal regulations. Those regulations were finalized earlier this month.
Stinner said that last year, on what was supposed to be debate on budget priorities, senators spent 16 hours instead talking about the Title X family planning language in the budget document. Ricketts put the language in the budget again this year, and the committee took it out and put it into a separate bill.
He wanted this session's budget debate to be on the issues of Medicaid expansion, higher education, property taxes, K-12 school funding and tax incentive programs, he said.
"We need to have a robust and comprehensive discussion about our budget, our fiscal posture as we move forward, and what's important to us, what are our priorities," he said. "That budget sets our priorities."
Last year's compromise on Ricketts' provision allowed family planning clinics to refer patients for abortions only in emergency situations, in which a physician determined a pregnancy would cause death or serious impairment of a woman's physical function. It allowed most Title X clinics to continue providing essential reproductive services to low-income men and women.
But Planned Parenthood got none of the Title X funding.
With the compromise, neutral, factual, nondirective information about prenatal care, delivery and pregnancy termination would not constitute a referral for abortion.
The Ricketts provision called for legal, physical and financial separation between a federally qualified clinic and an affiliated clinic. The new federal regulation says a Title X recipient must have objective integrity and independence, but does not call specifically for legal, physical and financial separation.
Lincoln Sen. Anna Wishart said last year opponents of the Title X budget provision feared it would lead to fewer people accessing important family planning services because Planned Parenthood of the Heartland was one of the main providers of the services.
At the hearing, she offered a federal Title X report that showed an 8 percent decrease in total unduplicated family planning users in 2018. In Nebraska, there were 2,281 fewer female users than in 2017, and 85 fewer male users.
The decrease, the report said, is likely due to Planned Parenthood of the Heartland and the Fred LeRoy Health & Wellness Center of the Ponca Tribe of Nebraska no longer being Title X recipients.
The number of pap tests and clinical breast exams decreased. And there was a 12 percent decrease in the number of uninsured users.
Bo Botelho, chief operating officer of the state Department of Health and Human Services, said the department wanted the Title X language kept in the budget bill.
He said there was no indication people who had gone to Planned Parenthood before hadn't continued to go there.
Stinner asked Botelho if the Ricketts administration wanted the Legislature to spend hours again talking about the Title X provision, rather than the budget.
"The intent language on a social issue in a budget … is inflammatory," Stinner said. "And if you don't understand that, you didn't watch last year's proceedings. … I'm taking it out of the budget discussion. … If the administration doesn't understand that, I'm sorry."
The committee will discuss the bill and decide whether to forward it to the full Legislature and which amendments, if any, would be attached.