Alaska Supreme Court is weighing a case that could decide who can provide abortion care in the state

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JUNEAU, Alaska (AP) — The Alaska Supreme Court is weighing a case that is expected to determine who can provide abortion care in the state.

The court heard arguments Wednesday in a 2019 case challenging the constitutionality of a law that states only a doctor licensed by the State Medical Board can perform an abortion in Alaska.

The law, dating to the 1970s, was struck down as unconstitutional by Superior Court judge Josie Garton last year, a victory for the group that brought the challenge, Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana, Kentucky. The state appealed Garton's ruling.

Planned Parenthood has argued there is no medical justification for the restriction and that it unfairly burdens those seeking an abortion by limiting the pool of those qualified to provide care. In 2021, Garton granted the group’s request to allow advanced practice clinicians — health care workers, such as nurse practitioners and physician assistants — to provide medication abortion pending her decision in the underlying case. They have continued to do so and since the 2024 ruling also have been able to provide procedural abortions, Planned Parenthood says.

Advanced practice clinicians routinely provide care similar in risk and complexity to that of providing abortion services, and in 25 states can provide medication abortion, attorneys for Planned Parenthood said in court documents. Planned Parenthood's advanced practice clinicians seek to provide abortion care in just the first trimester, the attorneys said.

Since Garton's 2021 decision, advanced practice clinicians have been providing “nearly all” medication abortions in Alaska, and Planned Parenthood clinics in the state have been able to offer medication abortion each day they've been open, the attorneys wrote. Before that, doctors hired by Planned Parenthood on a per diem basis — at the clinics on limited days — were able to offer medication abortions perhaps once or twice a week at each clinic, they wrote.

A vital statistics report released by the state this year shows that the total number of abortions in Alaska has been fairly consistent — 1,229 in 2021, 1,247 in 2022, 1,222 in 2023 and 1,224 last year. The report says that could include cases where medication was provided to manage a miscarriage, but without providing a number. It also says reasons for ending pregnancies are not reported to the state.

The U.S. Supreme Court in 2022 overturned a federal right to abortion, leaving it up to each state to regulate.

Access to health care has been a longstanding concern in Alaska, with travel — sometimes covering hundreds of miles — required for many residents. Compounding that are ongoing challenges to recruit and keep medical providers.

Most Alaska communities are not connected to the state’s main road system, and health care in many small communities is often limited, requiring residents to fly to larger cities, such as Anchorage or Seattle, for more options or for specialized care. Roundtrip flights can easily cost hundreds of dollars. In remote communities, fog or poor weather can cause flight delays.

Planned Parenthood has two clinics in Alaska, in Anchorage and Fairbanks. It closed its clinic in Juneau last year.

The Alaska Supreme Court has long interpreted the right to privacy in the state’s constitution as encompassing abortion rights.

But attorneys for the state argued in court filings that Planned Parenthood did not show that the law at the center of the legal challenge had “inhibited women in Alaska from exercising their right to choose an abortion.” Planned Parenthood could have hired more doctors but chose not to, wrote the attorneys, including Laura Wolff, an assistant attorney general.

“Even if an occasional patient were prevented from getting an abortion, the physician-only law is not unconstitutional as applied to all women who are not significantly affected by the law because the law has a plainly legitimate sweep,” the filing states.

Wolff and Camila Vega, an attorney representing Planned Parenthood, argued their respective sides in court Wednesday. The court did not indicate when it might rule.