Tennessee governor signs narrow abortion exemption bill

Gov. Bill Lee speaks during an interview with the media at Ridgedale Baptist Church in Chattanooga, Tenn., where Lee signed the Forever Homes Act, Monday, April 24, 2023. (Olivia Ross/Chattanooga Times Free Press via AP)

Gov. Bill Lee speaks during an interview with the media at Ridgedale Baptist Church in Chattanooga, Tenn., where Lee signed the Forever Homes Act, Monday, April 24, 2023. (Olivia Ross/Chattanooga Times Free Press via AP)

NASHVILLE, Tenn. (AP) — Tennessee’s abortion ban, known as one of the strictest in the United States, will now include an extremely narrow exemption under legislation signed into law by Republican Gov. Bill Lee on Friday.

Lee signed off on the bill after repeatedly arguing that the state didn’t need to tweak its abortion ban even as medical experts, with the support of a growing group of Republican lawmakers, warned the statutes failed to protect doctors and pregnant patients. The law goes into effect immediately, carving a narrow option for doctors to use their “reasonable medical” judgment in deciding whether providing the procedure can save the life of the pregnant patient or prevent major injury.

However, even under the new exemption, Democratic lawmakers, reproductive rights activists and health care officials have warned that what Republican leaders came up still didn’t go far enough.

Last year, Tennessee’s so-called trigger law was finally allowed to go into effect due to the U.S. Supreme Court overturning the constitutional right to abortion over the summer. The state law not only banned all abortions, but also included an “affirmative defense” for doctors, meaning that the burden was on the physician to prove that an abortion was medically necessary — instead of requiring the state to prove the opposite.

Under the law that Lee enacted, doctors will now be allowed to use “reasonable medical judgment” when determining an abortion is necessary to prevent the death of a pregnant patient or to prevent irreversible, severe impairment of a major bodily function. It then adds in language that doctors may provide abortion services for ectopic pregnancies and miscarriages. There is no exception for rape and incest.

Legislatures across the country have been pulling in opposite directions on the issue. In over a dozen other states, abortion is banned at all stages of pregnancy, with courts blocking enforcement of total bans in four more states. The majority of those bans were adopted in anticipation of Roe being overturned, and most do not have exceptions for rape or incest.

Overall, the final version that was able to clear Tennessee’s GOP-dominant Statehouse was much more narrow than what backers initially proposed. The original bill would have allowed doctors to provide abortion services for “medically futile pregnancies,” as well as lethal fetal anomalies. Also, it would have allowed doctors to provide abortions based on their “good-faith judgement” — which experts say allows more flexibility than the harsher standard of “reasonable medical judgment.”

The significant changes were made after the state’s powerful anti-abortion lobby, Tennessee Right to Life, warned that lawmakers would likely face political retribution if they advanced a bill without the group’s endorsement. The group played a major role in advancing the state’s trigger law in 2019, when access to abortion was still constitutionally protected in the U.S.

Lee and others had argued that they believed patients were protected under the trigger law and that no doctor had faced felony charges since it had gone into effect.

After the signing the exemption into law, Lee’s office said in a statement that the governor was “happy to work with the General Assembly to provide even greater clarity in Tennessee law to protect mothers and children.”

Maternal health will benefit from the exemption, but it still falls short, said a statement from the Tennessee Medical Association, a nonprofit health advocacy group representing physicians.

“For example, TMA is disappointed that the bill does not exempt addressing fatal fetal anomalies from the criminal statute as the sponsors set out to accomplish,” the group said. “Also, we do not believe the legal standard by which doctors are judged when addressing life and health concerns of the mother provide the level of protection needed for doctors and patients.”