SACRAMENTO – Giving California women more access to abortion, Gov. Jerry Brown signed a bill Wednesday that allows nurse practitioners and certain other non-physicians to perform the procedure during the first trimester of pregnancy.
The governor acted on 32 bills in all, approving measures that will cap drug costs for cancer patients, expand the number of people on CalFresh, the state's food stamp program, and promote breastfeeding.
Assemblywoman Toni Atkins (D-San Diego) introduced the abortion measure because of concern that not enough physicians perform abortions, especially in rural areas, to meet the needs of women seeking to terminate a pregnancy.
"Timely access to reproductive health services is critical to women's health," Atkins said in a statement. "AB 154 will ensure that no woman has to travel excessively long distances or wait for long periods in order to obtain an early abortion."
Neither Brown nor his staff would comment on his acceptance of the bill, which extends the authority to perform abortions by vacuum aspiration to nurse practitioners, certified nurse-midwives and physicians' assistants.
The measure requires the non-physicians to complete specified training and comply with standardized medical protocols for the non-surgical procedure.
Opponents of abortion said the new law will subject women to a lower level of medical care.
"It's very disappointing, particularly from a women's health standpoint," said Wynette Sills, executive director of the Coalition for Women and Children, a group that opposes abortion rights. Brown "has put the profits of the abortion industry above the health and well-being of women and children."
A January study by UC San Francisco that involved 8,000 abortions performed by non-physicians found that their complication rates were statistically about the same as for those performed by doctors.
The opponents included the California Catholic Conference and the Traditional Values Coalition. Brian Johnston, executive director of the California Pro-Life Council, said his group and others were weighing a referendum or other legal challenge to the measure.
The bill's supporters included the California Medical Assn., the California Women's Health Alliance and the Planned Parenthood Advocacy Project of Los Angeles County.
Forty-seven nurse practitioners and other non-doctors have already been trained to provide abortion when the new law takes effect Jan. 1.
The governor also signed legislation Wednesday that requires health insurers to cover prescribed, orally administered anti-cancer medications and to limit the patient's total cost to no more than $200 per 30-day supply. The law will apply to insurance policies issued in 2015 or later.
"This provides good value for patients of modest means," Brown wrote in a rare signing message for AB 219, by Assemblyman Henry T. Perea (D-Fresno).
Currently, insured cancer patients face costs as high as $4,000 a month for chemotherapy pills, state officials say.
The California Chamber of Commerce, America's Health Insurance Plans and Assn. of California Life and Health Insurance Companies opposed the bill, saying it threatened to limit treatment options.
Another bill that Brown approved requires hospitals that have a perinatal unit to adopt programs to promote successful breastfeeding. Sen. Kevin De León (D-Los Angeles) introduced that bill, SB 402.
In addition, Brown signed a measure aimed at expanding the number of people in CalFresh, the state's food stamp program.
There are 1.3 million Medi-Cal beneficiaries who participate in CalFresh, but the food program has a lower income limit for eligibility than the healthcare program.
By making the income requirements the same, an estimated 227,000 more people will be eligible for the food aid, according to the group California Food Policy Advocates. The bill, AB 191, was introduced by Assemblyman Raul Bocanegra (D-Los Angeles).
As the Oct. 13 deadline for the governor to act on bills approaches, Brown is wielding his veto pen more frequently. He rejected seven bills Wednesday on topics including public school health centers and elder abuse.
Brown vetoed AB 50, by Assemblyman Richard Pan (D-Sacramento), which would have expanded coverage of pregnancy services for those on public health insurance.
"While I support this policy, I cannot support this bill," Brown wrote.
But he said he was directing his administration to come up with a more complete proposal to expand state pregnancy coverage in his next budget, to be unveiled in January.
Brown also vetoed AB 888 by Assemblyman Roger Dickinson (D-Sacramento), which would have allowed the state Bar to bring civil penalties against people practicing law illegally.
And the governor rejected a bill that would require notaries to report elder abuse, saying they "generally have no more than fleeting contact with individuals who request their services." That bill is AB 477 by Assemblyman Ed Chau (D-Monterey Park).
patrick.mcgreevy@latimes.com
anthony.york@latimes.com
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