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California could OK abortions by solo nurse practitioners

A bill announced Thursday in the California Legislature would let some nurse practitioners perform abortions without the supervision of a doctor.

SACRAMENTO, Calif. — A bill announced Thursday in the California Legislature would let some nurse practitioners perform abortions without the supervision of a doctor — part of a plan to prepare for a potential influx of patients from other states if the U.S. Supreme Court allows states to ban or severely restrict the procedure.

State Senate leader Toni Atkins, a Democrat from San Diego, said the goal is to increase the number of health care workers in California who can perform abortions ahead of a potential Supreme Court ruling this summer.

“As states like Texas and others start to restrict further abortion, it just makes sense that women are going to find other places to go. California will be one of those states,” she said.

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Nurse practitioners are not doctors, but they have advanced degrees and can provide a number of treatments. In 2013, California passed a law allowing nurse practitioners, certified nurse midwives and physician assistants to perform abortions during the first trimester of pregnancy — but only if they completed special training and were under the supervision of a doctor.

Atkins' bill would change the law by letting nurse practitioners with the required training perform first trimester abortions without a doctor's supervision. California has about 30,000 nurse practitioners. But it's unclear how many more of them would be allowed to perform abortions if this bill becomes law.

The U.S. Supreme Court now has a conservative majority after former President Donald Trump made three appointments during his term. Many conservative-led states have responded by passing new abortion restrictions, hoping the court will uphold them.

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Texas has a law that bans nearly all abortions in the state, but it is only enforceable by civil lawsuits. Abortion rights groups have sued to block that law, but the U.S. Supreme Court has allowed the law to remain in effect while the case is pending.

Last year, the court heard arguments over whether to uphold a Mississippi law that bans most abortions after 15 weeks of pregnancy. The court likely won't make a decision on that case until June. But during a hearing on the case, a majority of justices indicated they were likely to uphold the law and could even overturn Roe v. Wade, the court's 1973 ruling that banned states from outlawing abortion.

If the court overturns or significantly weakens the Roe ruling, multiple states would likely act quickly to ban or severely limit access to abortion.

But California, led by Democrats who support abortion rights, would do the opposite by passing laws to increase access to abortion. That could include helping women who live in states where abortion is banned or severely limited travel to California for care.

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A proposal filed last month would potentially use taxpayer money to help women from other states get to California by paying for things like travel, lodging, child care and food. Atkins said the government couldn't pay for everyone, saying the bill would create a fund that would also accept private donations.

“You will see a bill that tries to set up a framework for where we can do that and take private dollars,” Atkins said.

Jonathan Keller, president and CEO of the California Family Council, called Atkins' bill “a tragic example of the legislators putting abortion numbers above abortion safety and putting ideology above patients."

“We are essentially treating abortion like no other health care service,” he said. “We're not flying people from poor states to California to get heart transplants.”

A 2013 study led by the University of California-San Francisco concluded first trimester abortions are “just as safe when performed by trained nurse practitioners, physician assistance and certified nurse midwives as when conducted by physicians.”

“When we're within our areas of training, we are absolutely qualified to provide the care that we do,” said Patti Gurney, president of the California Association for Nurse Practitioners.

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