Understanding the Pennsylvania Fetal Remains Management Bill

Question: Have Pennsylvania lawmakers voted to “fine” women who miscarry?

A: No. But a bill proposes to force health care providers to bury or cremate fetal remains, regardless when or how the pregnancy ends. Experts say such requirements could translate into additional costs for women or their insurers.


“PA legislature fines women for miscarriage”

Is this a true statement?


Recent legislation in Pennsylvania Advanced by Republican state lawmakers on a committee would demand that miscarriages or abortions treated in health facilities be treated as fetal deaths and followed by burial or cremation, regardless of the duration of pregnancy.

The question is probably moot: Democratic Governor Tom Wolf said in a declaration the same day he “will veto any anti-choice legislation that lands on my desk.

But viral social media posts criticizing the bill, HB 118, has prompted some readers to question whether lawmakers voted in favor of “fined” women who suffer a miscarriage.

A reader asked us about a Tweet of May 25 by a candidate for the US Senate in Pennsylvania, Democrat Val Arkoosh, who says: “Members of the PA Legislative Assembly today voted to fine women who have miscarried and require them to complete this form. It is traumatic for women who are going through incredible loss. Incredible. ”The tweet included a copy of the state’s request for a“ fetal death certificate ”and has been shared over 9,000 times.

A similar post was shared the next day in a Facebook post which has amassed more than 48,000 shares.

It reads: “The Pennsylvania state legislature today voted in favor of a bill from Republican state legislator Frank Ryan that would essentially fine women who miscarry, force them to seek a “Fetal death certificate” (and to pay an application fee), then would require a burial or cremation of the remains (for which the woman would also have to pay) – regardless of where the pregnancy occurs miscarriage.

The bill in question does not technically impose a “fine” on women for miscarriage. The new requirements – and fines for non-compliance – would be tied to healthcare facilities, such as clinics or hospitals.

That said, experts say the costs of these requirements, if adopted, would likely pass on to patients who miscarry or have an abortion, or their insurers.

HB 118

A little background: The bill is similar to laws enacted in some other states. A group called Americans United for Life provides states with model legislation for the “Law on the Dignity of Unborn Children”. In Indiana, such a law was enacted under the government of the day. Mike Pence in 2016 and Survived a challenge before the Supreme Court of the United States in 2019.

The Pennsylvania version was originally past by the State House of Representatives in 2019 – then known as HB 1890 – but blocked in the State Senate. Reintroduced this year as HB 118, it past the House Health Committee on May 25 along party lines and will now move to the full House for consideration.

The sponsor of the bill, Republican Representative Frank Ryan, argues the bill would provide parents with “the right to claim their child’s remains for proper cremation or burial at their own expense.

The bill effectively codifies this option – but it also states that healthcare facilities must “[c]remate or enter fetal remains ”if the parents choose not to have their own burial.

The Pennsylvania Civil Liberties Union, which opposes the law, retorts that nothing in the current state law prohibits parents from choosing an optional burial. The group also argues that the bill’s definition of “fetal remains” would result in all medical tissue, from the moment of conception, being treated as fetuses – and adding an additional burden to clinics and women. seeking an abortion.

The term fetus is defined in the medical community as the stage beginning at the end of the 10th week after a woman’s last menstrual period. Before that, it is an embryo.

Pennsylvania law currently defines “fetal death” as “the expulsion or extraction of its mother from a product of conception after sixteen (16) weeks of gestation, which shows no evidence of life after such expulsion or extraction”. The vast majority of abortions in Pennsylvania take place before 16 weeks, according to state data from 2019, and more than half before eight weeks gestation.

HB 118 proposes an alternate definition of “fetal death”, removing the 16 week timeframe and defining it simply as “the expulsion or extraction of its mother from a product of conception that shows no evidence of life afterward. expulsion or extraction “. It defines “fetal remains” as “the fetus expelled or extracted in the event of fetal death”.

Cost assessment of the invoice

The bill would require health care providers to arrange for the burial or cremation of all fetal remains. He notes that “if a parent of the unborn child chooses a location for the final disposition of fetal remains other than a location that is customary and customary for a health facility, the parent will be responsible for the costs associated with the final disposition. fetal remains.

It should be noted that the proposal does not address miscarriages that occur at home.

Tanya Swamp, a law professor at Wake Forest University specializing in human remains law, told us in an email that the bill would therefore only apply “to fetal deaths when a healthcare facility is involved. “.

And while the bill technically doesn’t say anything about the requirements for fetal death certificates, state law in force indicates that these certificates must be “deposited before the issuance of a burial permit or any other disposition of the body or fetal remains”. (Currently death certificates are obligatory for fetal deaths after 16 weeks of gestation.)

Therefore, Marsh said, the bill would trigger the requirement for a fetal death certificate.

In one June 3 radio segment, Ryan – the sponsor of the bill – claimed “that he does not require a death certificate” and that “my bill does not change this requirement for a fetal death certificate.” In fact, we are going to make an amendment to the bill that says that no death certificate is required.

A representative for Ryan, Donna Pinkham, told us in an email that Ryan will amend the bill in the coming days to clarify the issue of the certificate.

A fetal death certificate in Pennsylvania costs $ 20 and is paid when requesting a certificate. It is to be completed by “the person responsible for the burial or removal of the body or fetal remains from the registration district”, although “[p]personal information concerning the deceased or fetal death is provided by the person best informed of the facts.

Under the legislation, the “additional documentation requirements (i.e. death certificate and transit permit) as well as the requirement that fetal remains be buried or cremated will be more costly than current practices, ”Marsh said. It is “correct to say that the bill does not require parents to pay these fees unless they choose to take possession of the remains themselves, but it is probably reasonable to assume that the increase a fee will be passed on to the patient (unless the insurance chooses it up).

Alina salganicoff, assenior vice president and ddirector of women’s health policy at the Kaiser Family Foundation, told us in a telephone interview that any additional activity that requires more staff, patient time or documentation “will increase the cost and these costs are generally borne by the patient or the payer ”, ie the insurer.

Such legislation would be ‘iinflating the cost of abortion – and those costs are usually borne by people who abort and pay out of pocket, ”she said.

It is unclear exactly how much the costs would be affected by the introduction of such requirements in Pennsylvania. Costs are affected by a variety of factors, such as the specific company handling the burial or cremation.

In Indiana, Planned Parenthood officials estimated in 2019 that requirements – including hiring a funeral home or cremation service – could add hundreds of dollars to expenses, Associated Press reported. Although Planned Parenthood has said it will seek to absorb costs or raise funds to avoid charging patients more.

We reached out to Planned parenthood which represents Indiana to ask if he could provide estimates for any cost changes as a result of that state’s law, as a benchmark, but did not receive a response.

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Abortion statistics 2019. “Pennsylvania Department of Health. December 2020.

ACLU-PA Opposition to HB 118 PN 86 Maison Santé 2021-05-21. “American Civil Liberties Union of Pennsylvania. Accessed June 3, 2021.

Davies, Tom. “Fetal Indiana remains the law could increase abortion costs. “Associated Press. May 29, 2019.

Pennsylvania General Assembly. “Bill n ° 1890. “(as posted on Sep 26, 2019)

Pennsylvania General Assembly. “Bill n ° 118. “(as introduced on January 11, 2021)

Governor Wolf issues statement on anti-choice bill. “Press Release, Office of the Governor of Pennsylvania. May 25, 2021.

Last sound. “Office of Pennsylvania State Representative Frank Ryan. Accessed June 4, 2021.

Marsh, Tanya. Professor of Law, Wake Forest University. Send an email to FactCheck.org. June 2, 2021.

Order a fetal death certificate. “Pennsylvania Department of Health. Accessed June 3, 2021.

Pinkham, Donna. Spokesperson, Pennsylvania House GOP. Send an email to FactCheck.org. June 4, 2021.

Salganicoff, Alina. Senior Vice President and Director of Women’s Health Policy, Kaiser Family Foundation. Telephone interview with FactCheck.org. June 3, 2021.

Civil Status Act 1953. Pennsylvania Public Law 304, No. 66. June 29, 1953.

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