Pregnancy and state policies.States have a variety of policies on pregnancy-related issues. Seven subjects are examined in these charts: (1) substance by pregnant women, (2) infertility infertility, inability to conceive or carry a child to delivery. The term is usually limited to situations where the couple has had intercourse regularly for one year without using birth control. insurance coverage, (3) Medicaid Medicaid, national health insurance program in the United States for low-income persons; established in 1965 with passage of the Social Security Amendments and now run by the Centers for Medicare and Medicaid Services. family planning family planning Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. waivers, (4) minors' access to prenatal care prenatal care, n the health care provided the mother and fetus before childbirth. , (5) "safe surrender To give up, return, or yield. The word surrender presupposes the possession or ownership of the thing that is to be returned or given up. It indicates a transfer of title as well as possession, but it does not express or in any way suggest the transaction of a sale " of infants Persons who are under the age of legal majority—at Common Law, 21 years, now generally 18 years. According to the sense in which this term is used, it may denote the age of the person, the contractual disabilities that non-age entails, or his or her status with regard to , (6) human cloning Although genes are recognized as influencing behavior and cognition, "genetically identical" does not mean altogether identical; identical twins, despite being natural human clones with near identical DNA, are separate people, with separate experiences and not altogether , and (7) gay and lesbian lesbian /les·bi·an/ (lez´be-an) 1. pertaining to homosexuality between women. 2. a female homosexual. les·bi·an n. A woman whose sexual orientation is to other women. adoption. All charts were compiled by Kate n. 1. (Zool.) The brambling finch. Bowen Bow·en , Catherine Drinker 1897-1973. American writer of semifictional biographies, such as The Lion and the Throne (1957), a life of Sir Edward Coke. , SIECUS SIECUS Sexuality Information and Education Council of the United States public policy associate.
CHART 1
SUBSTANCE ABUSE DURING PREGNANCY
Substance abuse during pregnancy can cause harm to both the mother and
the fetus. Legislators have attempted to curb this problem with a
variety of approaches. There are currently 34 states with policies
relating to substance abuse by pregnant women. The consequences for
women range from reporting and testing by health care professionals (the
results of which are often used in child welfare proceedings) to
termination of parental rights or forced rehabilitation. If a state is
not listed, there is no relevant law.
Terminates Civil Reporting Health Care
Parental Rights Commitment Required Professionals
Authorized Must Test
AZ X
AR
CA
CO
CT
FL X
GA
IL X X
IN X
IA X X
KS
KY
LA
MD X
MA X
MI X
MN X X X X
MO
NV X
NE
NY
NC
OH X
OK
OR
PA
RI X
SC * X
SD X X
TX X
UT X
VA X X
WI X X
WA
Priority Access to
Treatment Create or Fund
Treatment
AZ X
AR X
CA X
CO X
CT X
FL X
GA X
IL X
IN
IA
KS X
KY X
LA X
MD X
MA
MI
MN X
MO X X
NV
NE X
NY X
NC X
OH X
OK X
OR X
PA X
RI
SC *
SD
TX X
UT
VA X
WI X
WA X
* South Carolina's Supreme Court held that the state's criminal child
endangerment statute includes "maternal acts endangering or likely to
endanger the life, comfort, or health of a viable fetus." Thus,
substance abuse by pregnant women is a criminal act in South Carolina.
CHART 2
INFERTILITY INSURANCE LAWS
Whether or not infertility treatments are covered by insurance depends
on where individuals live and where they have their insurance plans.
Some states have enacted laws that require insurers to either offer or
cover some infertility treatment or testing A mandate to offer requires
insurance companies to make available for purchase a plan that offers
coverage of infertility treatment. An employer is not required, however,
to pay for the coverage. A mandate to cover requires insurance companies
to provide coverage for infertility treatments in every policy they
offer. Of the 14 states with mandates relating to insurance coverage for
infertility, four require that potential parents be married. There are
many additional variations among the state laws. If a state is not
listed, there is no relevant law. There are exemptions and requirements
not listed here.
Mandate to Cover Mandate to Offer Must Be Married and
Spouse's Spern Used
AZ X X
CA X
CT X
HI X X
IL X
MD X X
MA X
MT X
NJ X
NY *
OH X
RI X
TX X X
WV X
* New York mandates that insurance companies cover the "diagnosis and
treatment of correctable medical conditions." Thus, insurers must cover
treatment of any correctable condition even if the only result of the
condition is infertility. The law does not, however, require coverage
for reversal of sterilization or for procedures intended to produce
pregnancy.
CHART 3
MEDICAID FAMILY PLANNING WAIVERS
The federal government requires every state to cover pregnancy-related
care and family planning services through Medicaid for 60 days
postpartum to women with incomes at or below 133 percent of the federal
policy level. Most states usually cut off Medicaid eligibility to people
with incomes under that level. Since 1993, some states have expanded
Medicaid eligibility for family planning services to women who would
otherwise lose coverage because of their income levels by applying for
"waivers" of federal policy from the federal government. These waivers
allow states to either continue coverage for postpartum women for longer
than the requisite 60 days or to grant coverage to women, regardless of
whether they are postpartum, based on a percentage of the federal policy
level. The result of these waivers is to extend family planning services
through Medicaid to women who would otherwise not be eligible because
their income levels are above their state's Medicaid eligibility
ceiling. If a state is not listed, there is no relevant policy.
Grant Coverage
Based on Income
Extend for Women (income ceiling as Extend for Women
Losing Medicaid percentage of Losing Medicaid
Post-partum federal poverty for Any Reason
(amount of time) level) (amount of time)
AL * approved (2 years) approved (133%)
AZ approved (2 years)
AR approved (133%)
CA approved (200%)
CO pending approval (150%)
DE approved (2 years)
FL approved (2 years)
GA pending approval
MD approved (5 years)
MS
MO approved (2 years)
NM approved (185%)
NY approved (22 months) pending approval (200%)
NC pending approval (185%)
OK pending approval (185%)
OR approved (185%)
RI approved (2 years)
SC approved (185%)
VA pending approval
WA approved (200%)
WI pending approval (185%)
* Mobile County Only.
CHART 4
MINORS' ACCESS TO PRENATAL CARE
Whether a minor can consent to confidential prenatal care varies from
state to state, but the trend over the last 30 years has been to allow
minors greater authority to consent to their own health care. Among the
states that have policies or laws regarding minors' access to prenatal
care, there are variations in the age at which a minor can consent (with
some states requiring only that a minor is "mature" enough to understand
the treatment), whether physicians can inform the minor's parents about
the care, and whether the policy is for prenatal care or for medical
care in general. If a listed state has no information in the chart, that
state allows minors to consent to prenatal care at any age. If a state
is not listed, there is no relevant policy.
Age, If Any, Physician May Medical Care
Minor Must Be Inform Parents in General
AL
AK
AR
CA
DE 12 x
DC
FL
GA
HI 14 x
ID
IL * x
KS "mature"
KY x
MD x
MA
MI x
MN x
MS
MO x
MT x
NV "mature" x
NH "mature" x
NJ x
NM
NY
NC
OK x
OR 15 x x
PA
SC 16 x
TN
TX x
UT
VA
WA 12 x
* Illinois allows a minor to consent if her health requires it, if she
is a parent, or if she is referred by a specified professional. Idaho
bases its policy on the interpretation of state law by the attorney
general's office. Washington State bases its policy on a state supreme
court decision holding that minors have the same constitutional rights
as adults.
CHART 5
SAFE SURRENDER LAWS
"Safe surrender" laws provide safe and legal places for parents to give
up unwanted newborns. These laws are intended to dissuade parents from
abandoning their newborns in unsafe places where they are likely to die.
Variations in the laws include: limits on the infant's age; authorized
people or places to which parents can relinquish the children; anonymous
surrenders; required medical information; checks to see if a child is
reported missing; identification bracelets to facilitate later attempts
at reclamation; and surrender of the child by people other than the
parent. If a state is not listed, there is no relevant law.
Limit on Authorized Personnel Anonymous Medical
Infant's Age or Places Information
Requested
AL 72 hrs. EMS
AZ 72 hrs. adoption, church, EMS, X
hospital
AR 30 days hospital, police X
CA 72 hrs. hospital, "other
designated place"
CO 72 hrs. EMS, hospital
CT 30 days hospital X
DE 14 days hospital X X
FL 3 days EMS, hospital X
ID 30 Days EMS, hospital, 911 X
IL 72 hrs. EMS, hospital
IN 45 days EMS
IA 14 days clinic, hispital X
KS 45 days clinic, EMS
LA 30 days clinic, CPC, EMS, X
hospital, police
MI 72 hrs. EMS, hospital, police X
MN 72 hrs. hospital X
MS 72 hrs. adoption, hospital
MT 30 days EMS, hospital, police X
NV 30 days clinic, EMS, hospital,
police
NJ 30 days hospital, police X X
NM 90 days clinic, hospital X
NY 5 days "appropriate" person
or location
NC 7 days clinic, EMS, X
hospital, police
ND 1 year hospital X
OH 72 hrs. EMS, hospital, police
OK 7 days clinic, EMS, X
hospital, police
OR 30 days clinic, EMS,
hospital, police
RI 30 days clinic, EMS, X
hospital, police
SC 30 days hospital X X
SD 60 days adoption, clinic,
EMS, police
TN 72 hrs. clinic, hospital
TX 30 days EMS X
UT 72 hrs. hospital X X
WV 30 days clinic, hospital
WI 72 hrs. EMS, hospital,
police, 911
Check if ID Others
Child Is Bracelet May
Missing Surrender
AL
AZ X
AR
CA X X X
CO
CT X X
DE X X X
FL X
ID X
IL
IN
IA X
KS
LA
MI X
MN X X
MS
MT X
NV X
NJ X
NM X X
NY
NC X
ND X X
OH X X
OK X
OR X
RI X
SC X X
SD
TN X X
TX X
UT X
WV X
WI X
AUTHORIZED PERSONNEL OR PLACES
911 = Allows a parent to use 911 and give infant to responding
personnel; Adoption = Licensed adoption agency; Clinic = Health care
clinic; CPC = Crisis pregnancy center; EMS = Emergency Medical Services
or fire station; Police = Police station
CHART 6
HUMAN CLONING
While human cloning holds enormous promise for medical breakthroughs, it
also creates moral and ethical questions. Recently, due to the
tremendous increase in scientific knowledge and capability, the clash
between science and those who have ethical concerns about cloning has
come to a head. Some states have begun to pass laws that regulate
cloning. Human cloning comes in two forms: reproductive cloning and
therapeutic cloning. Stem cell research is a form of therapeutic
cloning. The U.S. House of Representatives voted last year to outlaw
both reproductive and therapeutic cloning, and the U.S. Senate is set to
debate the issue this spring. Only five states prohibit cloning humans,
and four of those make exceptions for research. If a state is not
listed, there is no relevant law.
Cloning of Humans Penalty Provided by Law
Prohibited
CA X license revocation; civil
penalties
LA X civil penalties
MI X civil penalties
RI X civil penalties
VA X civil penalties
Exceptions
CA
LA scientific research and
cell-based therapies
MI scientific research and
cell-based therapies
RI biomedical,
microbiological, and
agricultural research
VA research purposes
Missouri limits use of state funds for human cloning research.
CHART 7
GAY AND LESBIAN ADOPTION LAWS
Coparent adoption grants a couple joint custody of a child while
second-parent adoption refers to the process whereby one parent
maintains legal parental status (either because that parent was the
biological mother or father or because that parent adopted the child)
and the partner seeks equal parental rights. The most common method for
same-sex couples to jointly adopt children is through "second parent"
adoption. Joint adoption of an unrelated child is much less likely to be
permitted. Adoption laws for same-sex couples are unsettled and subject
to change in many states. Because of the difference among the states, it
is difficult to provide a complete and accurate legal summary. If a
state is not listed, its adoption law in this area is unclear.
Second Parent Second Parent Statute Permitting or
Adoption Permitted Adoption Permitted Case Law Prohibiting
by Lower Court by High Court Second Parent
Precedent Precedent Adoption
AK X
CA X
CO * X prohibited by case law
CT X permitted by statute
DE X
DC X
FL ** prohibited by statute
HI X
IL X
IN X
IA X
KY
MD X
MA
MI X
MN X
MS prohibited by statute
NV X
NJ X
NM X
NY X
OH
OR X
PA * X prohibited by case law
RI X
TX X
UT
VT X
WA X
WI prohibited by case law
Joint Non-Relative Individual Adoption
Adoptive by Same by Homosexuals
Sex Couples
AK permitted
CA permitted permitted
CO *
CT
DE
DC permitted
FL ** prohibited by statute prohibited by statute
HI
IL permitted permitted
IN
IA
KY prohibited
MD permitted
MA permitted permitted
MI
MN
MS prohibited prohibited
NV
NJ permitted permitted
NM
NY permitted permitted
OH permitted
OR
PA * permitted permitted
RI permitted permitted
TX
UT state-sponsored
adoptions prohibited
VT permitted permitted
WA permitted permitted
WI prohibited
* In Colorado and Pennsylvania, there is conflicting case law regarding
second-parent adoptions.
** In Florida, a federal appeals court is currently considering whether
to reverse a lower court ruling throwing out a challenge to the state's
ban on all homosexual adoptions.
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