Update, May 8, 3:23 pm Eastern: After debate in the house Wednesday afternoon, HB 693 was referred back to committee for reworking. RH Reality Check will keep you updated on the bill’s movement.
Between 2003 and 2011, the teen pregnancy rate in North Carolina fell 28 percent, outpacing the rest of the country when it comes to teen pregnancy prevention. But that trend may quickly reverse if a new bill, HB 693, passes, requiring previously unseen levels of parental consent for minors accessing health care related to pregnancy prevention, sexually transmitted infection (STI) treatment, mental health, and chemical dependency.
The decade-long decline in unplanned teen pregnancy rates in the state brought North Carolina into the national spotlight as a state that’s leading the way on curbing teen pregnancies. The National Campaign to Prevent Teen and Unplanned Pregnancy directly attributed the decline to an increased use of contraception, with Chief Program Officer Bill Albert telling the News Observer in January, “Something is working, because we’ve seen such dramatic declines.”
Whatever is “working,” it isn’t making some legislators in North Carolina happy. HB 693 adds the following subsection to the state’s existing parental notification law, which currently exempts the diagnosis of STIs and pregnancy and the treatment of STIs, chemical dependency issues, and emotional health issues, but not abortion.
Except as prohibited by federal law, unless a parent or legal guardian or legal custodian of an unemancipated minor is present with the unemancipated minor and gives consent, no health care provider duly licensed in the State of North Carolina, or agent thereof, shall provide health care services for the prevention, diagnosis, and treatment of (i) sexually transmitted diseases, including Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome, (ii) abuse of controlled substances or alcohol, (iii) mental illness, or (iv) pregnancy unless the health care provider or agent thereof, or another health care provider or agent thereof, first obtains the written consent of the minor and the notarized written consent of any one of the following:(1) A parent with custody of the minor.
(2) The legal guardian or legal custodian of the minor.
(3) A parent with whom the minor is living.
(4) A grandparent with whom the minor has been living for at least six months immediately preceding the date of the minor’s written consent.
Under the expanded legislation a minor would not be able to have an abortion without parental permission, but also would not be able to confirm a pregnancy or receive prenatal care to assist with a healthy pregnancy. The language puts minors at risk by forcing them to avoid treatments in order to keep their own conditions private from potentially dangerous parental involvement, and it endangers fetal health by adding roadblocks to a confirmation of a pregnancy and making a relationship with a parent or guardian a prerequisite for receiving proper care.
The original version of the bill from March only included physicians, but the bill was revised on May 7 to include any “health care provider duly licensed in the State of North Carolina, or agent thereof.” This shows the legislature’s eagerness to cut off all health-care to teens, regardless of the harm it will cause them, in favor of legislating the parent-child relationship. The fact that the house moved straight from committee to a full floor vote in just one day makes it clear that legislators are concerned that open debate or a period for public feedback would show how unpopular the idea is with state voters.
They’re right to be concerned. According to polling conducted by Adolescent Pregnancy Prevention Campaign of North Carolina (APPCNC) in January, 83 percent of respondents called the North Carolina Minor’s Right to Consent law “important,” and 77 percent agreed that “I want my teen to abstain from sex, but I also think he or she needs information on birth control.”
“They are trying to fast-track this bill because they know that parents and medical providers are not going to support such overreaching legislation,” Paige Johnson, vice president of public affairs for Planned Parenthood of Central North Carolina, told RH Reality Check. Tuesday’s committee hearing occurred just after the any-licensed-health-care-provider change was made in the bill, emphasizing a legislature eager to push through the most extreme bill possible as quickly as it can before anyone can raise any objections.
A rush job like this one is likely to leave many citizens and providers confused about what is or isn’t allowed in the state, especially around teen reproductive health. Committee testimony confirmed that under the new restrictions, a teen who brought a notarized consent form to a doctor to obtain birth control pills would probably then be required to take the same or another notarized consent to the pharmacy to get the medication itself, despite the doctor already approving the prescription.
Even more confusing would be the rules surrounding emergency contraception or teen pregnancy tests. A nurse practitioner would be unable to offer a pregnancy test to a 16-year-old, or provide her with emergency contraception if she walked into a clinic, unless her guardian accompanied her or she brought in notarized consent. But would that extend to purchasing an over-the-counter pregnancy test at a grocery store, or buying Plan B at the pharmacy? A phone call and email in to state Rep. Tom Murry (R-Wake), pharmacist and leader for numerous health-care bills in the assembly, asking for clarity around these issues wasn’t returned prior to publication.
A bill like this would not have been seen in the state just a few years ago, according to Johnson. “North Carolina has always been a leader in public health. We have worked to expand access to health care. We were a leader in this until 2011 when the Republicans took over.” Instead, the state is continuing to offer confusing, misleading, or dangerous bills to restrict rights at the expense of public health. And now they’re rushing them through as quickly as possible in the hopes that the public won’t notice.