See how three decades of restrictions impact Virginians and their access to safe and legal abortion in Virginia and what we are doing to stop it.
In Virginia, before 1973, abortion was a crime. Unlike other states, Virginia did not take abortion out of the criminal code and instead created exemptions under which abortion can be legally performed. Abortion still remains in the criminal code. Among restrictions on abortion that continued until the passage of the Reproductive Health Protection act in 2020, was a requirement that only physicians be able to perform abortion care. This had become outdated well before 2020, as nurse practitioners and otehr advanced medical practitioners were able to perform care substantially similar to early abortion care in the miscarriage context and administer medication largely similar and with more risks than the medication used for medication abortion.
In 2001, the Virginia General Assembly passed legislation requiring physicians to offer patients government-written materials concerning abortion and pictures of fetuses every two weeks during gestation. Some images were from ultrasounds while others were idealized depictions. Such materials and counseling must be provided at least 24 hours before the abortion procedure. The law was clearly designed to discourage a patient from pursuing an abortion.
A study from Rutgers University found that over 41% of the statements about pregnancy in the first trimester in the government-written materials are medically inaccurate.
The legislation, House Bill 2570, was sponsored by 15 Delegates, including future Virginia Governor Robert McDonnell and passed by a vote of 65 to 35. Its companion Senate Bill 1211 passed by a vote of 24 to 15. It was signed into law by Governor Jim Gilmore and became effective on July 1, 2001.
In 2010, the Virginia General Assembly voted to expand its ban on state abortion coverage for Medicaid-eligible patients, prohibiting coverage even when a patient’s health is at risk. Thirty-three states and the District of Columbia prohibit state coverage of abortion services for Medicaid-eligible patients. Governor Robert McDonnell proposed the prohibition as an amendment to the biennial budget. The amendment was approved by the House of Delegates 64-30 and by the State Senate 20-19. Today, Virginia’s Medicaid funds still cannot be used to cover an abortion except as exempted in the Hyde Amended; public funds in Virgnia can be used to fund abortions where the pregnancy resulted from rape or incest or when a fetus has incapacitating physical or mental deficiency as certified by a physician.
Sources: 12 Va. Admin. Code § 30-50-105(E); 12 Va. Admin. Code § 30-50-140(F); 12 Va. Admin. Code § 30-50-100(D); HB 30, 2010; Guttmacher Institute, State Policies in Brief, “State Funding of Abortion Under Medicaid.”
The Virginia General Assembly passed Targeted Restrictions on Abortion Providers (TRAP) law in 2011. The restrictions required first-trimester abortion providers to meet the same regulations as hospitals. Regulations drafted by the Virginia Board of Health and enacted in 2012 required existing abortion providers to adhere to the design and construction standards for building new hospitals, including specific requirements around the width of hallways, parking spaces, and the style of sink handles. Never before have these design standards been retroactively applied to any other health facility. The American College of Obstetricians and Gynecologists and the American Medical Association opposed the TRAP regulations approved by the Virginia Board of Health.
When the clinic-shutdown law passed the General Assembly in 2011, there were 21 first-trimester abortion providers in Virginia. Today there are 16.14. The Reproductive Health Protection Act repealed both the TRAP law and the associated regulations in 2020.
Senate Bill 924, sponsored by Senator Ryan McDougle (R – Mechanicsville), was amended by the House of Delegates to include language from Delegate Kathy Byron (R – Lynchburg) regulating abortion providers. It passed the House 63-34 and the Senate 20-20, with the tie vote broken by Lieutenant Governor Bill Bolling.
Senate Bill 924, sponsored by Senator Ryan McDougle (R – Mechanicsville) was amended by the House of Delegates to include language from Delegate Kathy Byron (R – Lynchburg) regulating abortion providers. It passed the House 63-34 and the Senate 20-20, with the tie vote broken by Lieutenant Governor Bill Bolling.
Sources: Va. Code Ann. § 32.1-127; SB924, 2011; Virginia Department of Health; Letter from Stephen H. Bendheim, Chair, Virginia Section of the American Congress of Obstetricians and Gynecologists, Holly S. Puritz, Vice-chair, and Christian A. Chisholm, Secretary-Treasurer to Karen Remley, Commissioner of Health, regarding proposed regulations on abortion facilities, September 14, 2011; American Public Health Association, Opposition to Requirement for Hospital Admitting Privileges and Transfer Agreements for Abortion Providers, Policy Statement, May 2012.
In 2012, the General Assembly and Governor Robert McDonnell passed a law requiring a patient having an abortion to undergo an ultrasound in a separate appointment at least 24 hours before her procedure and for them to be asked to see it. The medical professional performing the ultrasound must certify in writing whether the patient chose to see the image. Additionally, a copy of the picture and written certification kept in the patient’s medical records at the facility for seven years.
The American College of Obstetricians and Gynecologists and the American Medical Association oppose the mandatory ultrasound requirement.
“Intrusive legislation sets a dangerous precedent that would allow government and/or other third parties to mandate what tests, procedures or medicines must be provided to patients. If these efforts are not stopped, patients and our health care system will lose.”
WAH, R. OF THE AMERICAN MEDICAL ASSOCIATION. (2012, MAY 28). LETTER TO THE EDITOR, USA TODAY.
The mandatory ultrasound law also requires the Virginia Department of Health to maintain a public list of low or no-cost ultrasound providers. In practice, this list is composed solely of anti-abortion groups known as “crisis pregnancy centers” or “CPCs.” These groups are not licensed to provide medical care or regulated by any state agencies. A 2013 report found many Virginia CPCs provide patients with medically-inaccurate information about abortion and birth control. Some CPCs even indicated they would not offer a patient with a copy of their ultrasound image if they wanted to use it to fulfill the mandatory ultrasound law and have an abortion.
In 2020, this law was partially repealed. The law still includes a rewuirement that physicians get informed consent before an abortion is performed; however, the mandatory ultrasound requirement and the requirement that specific information including government written materials be provided were repealed.
Under the Federal Patient Protection and Affordable Care Act, Americans can purchase individual health insurance policies in state-specific online marketplaces, or exchanges. In 2013, Governor Robert McDonnell attached an amendment to House Bill 1900 prohibiting any policy sold in Virginia’s health exchange from covering abortion, even if purchased with private dollars. If you buy an exchange or marketplace policy and want abortion coverage, you would need to purchase a separate abortion rider. Before Governor McDonnell’s amendment, most insurance policies in the private market included abortion coverage.
House Bill 1900 was sponsored by Delegate Tom Rush (R-Fairfax). The House of Delegates voted 55-37, and the State Senate voted 20-19 to approve Governor McDonnell’s amendment banning abortion coverage.
In 2020, Virginia established a state health insurance exchange as opposed to using the one set up by the federal government; however, the prohibition on abortion coverage remains.
Those restrictions include: