Lawmakers send revamped maternal health bill to governor’s desk

Lawmakers send revamped maternal health bill to governor’s desk March 13, 2025

House Majority Whip Jason Nemes, R-Middletown, speaks on the updated version of House Bill 90 on the House floor on Thursday. The bill would regulate freestanding birthing centers, clarify Kentucky’s abortion law and allow for perinatal palliative careA high-res version is available here.

FRANKFORT — House Bill 90 has undergone a metamorphosis throughout the legislative process, but the lawmakers behind the legislation hope it will provide better maternal health outcomes across Kentucky.

HB 90 began as only a bill to establish a regulatory framework for freestanding birthing centers and remove the certificate of need requirement for centers with no more than four beds, House Majority Whip Jason Nemes, R-Middletown, said.

Those provisions remain, but as the bill advanced off the House floor on Thursday, lawmakers also voted to provide clarifying language to Kentucky’s abortion law and make perinatal palliative care available in Kentucky hospitals.

Doctors have communicated to the legislature that the current abortion ban law is confusing, which is putting pregnant women in potentially deadly situations, Nemes, who is the primary sponsor of HB 90, said.

“This is a problem that is real and present, and we need to solve it,” he said.

The clarifications to Kentucky’s abortion law in HB 90 will ensure pregnant women experiencing a miscarriage, ectopic pregnancy, molar pregnancy or other life-threatening complications can receive care, Nemes added.

Rep. Nancy Tate, R-Brandenburg, Rep. Kimberly Poore Moser, R-Taylor Mill, Dr. Jeffery Goldberg with the Kentucky Chapter of the American College of Obstetricians and Gynecologists, and pro-life advocates worked with Nemes on the legislation, he said.

Nemes said the bill is not an exception to the abortion law, but a clarification.

“There are no additional abortion exceptions or exceptions to abortions in this bill,” he said. “It’s a clarification of what it means when a pregnant woman is presenting and her life is in jeopardy.”

HB 90 also includes language from House Bill 414 on perinatal palliative care, Nemes said. Tate has filed perinatal palliative care legislation in the past and is the primary sponsor of this year’s HB 414.

The bill would require hospitals, birthing centers and other obstetric care centers to offer perinatal palliative care to women who receive a prenatal diagnosis that their baby may die before or after birth or at the diagnosis of a potentially deadly or life-altering fetal abnormality.

Tate said the care would be optional and would serve as a source of support for a mother and a family going through a difficult time.

“Perinatal palliative care is to ensure when a woman has a less than perfect pregnancy … that the woman and her family will have the spiritual, emotional, financial and medical attention they need,” Tate said.

Several lawmakers raised concerns about the clarifying language on abortions during a nearly hour-long debate on HB 90 on the House floor. Several members said the language is confusing, lacks proper medical terminology and doesn’t go far enough to ensure care and protect physicians from criminal liability.

Rep. Lisa Willner, D-Louisville, said she appreciates the intent of the language and the collaboration behind the bill, but finds the language concerning. She asked Nemes if he intends to keep working on the issue.

“Dr. Goldberg … was one of maybe the most ambiguous testifiers I’ve ever heard in committee. He said multiple times, ‘This is very imperfect. This needs lots of work,’” Willner said. “… Do you agree this is going to be an ongoing conversation, and we may be able to get to a safer, from my perspective, place, or is this the end of the conversation?”

Nemes said while he believes Goldberg’s testimony was clear, he agrees the legislation is not perfect.

“We are committed to having those continued conversations,” Nemes said.

Rep. Rachel Roarx, D-Louisville, said she was proud to vote for the freestanding birthing center bill when it came to the House floor for a vote the first time. She said while the language in the new HB 90 “is not medically accurate,” she would vote “yes” on the legislation.

“I do intend to vote yes today because if it does grant a pregnant individual the opportunity to have life-saving care, then we need to do that,” Roarx said.

HB 90 advanced off the House floor by a 74-17 vote, and the Senate voted 29-0 with five pass votes on the legislation earlier Thursday.

“I don’t want to mislead anybody. Kentucky is a pro-life state, and it will stay as such,” Nemes said. “But if we have to do things to continue to improve the lives of pregnant women in danger and to help doctors, we are committed to doing that.”

HB 90 is now headed to the governor’s desk for his signature or veto. He can also allow the bill to become law without his signature.

West said the DEI prohibitions do not include the Americans with Disabilities Act, the Individuals with Disabilities Education Act, the federal Age Discrimination in Employment Act, sex-based dormitory restrictions and athletic eligibility, accommodations for religion, the federal Civil Rights Act of 1964, Title IX and others.

Lawmakers debated the bill for nearly two hours, recounting personal stories and, at times, discussing the history of race and slavery in America.

Senate Democratic Floor Leader Gerald A. Neal, D-Louisville, was among several who spoke in opposition to the bill, and recalled how he marched with civil rights leader Martin Luther King Jr. He said he wanted to put the past and present in context.

“What I’m saying is, even today you hear the language, there’s nothing systemic. There’s nothing structural. Everything we do is systemic. Every time we do a policy we’re setting up some type of system, a framework, guidelines, context,” he said. “And we enforce it. And guess what, what we don’t do, enhances or allows for those unofficial behaviors to take shape, which are manifest today. We all know it. Racism is wide and deep.”

Senate Minority Whip David Yates, D-Louisville, also spoke against the measure. He read from an e-mailed letter from four Roman Catholic bishops of Kentucky. It stated that “those who are in positions of power or who have benefitted from a system of inequalities have a moral responsibility to address injustice.”

Speaking in favor of the measure was Sen. Donald Douglas, R-Nicholasville, who argued that the legislation is about establishing “a fair playing field for all.” He said the goals of DEI begin in the home with parental support.

“Let us consider strengthening our homes first. Let us consider teaching our children the self-respect, the self-motivation and the self-accomplishment and monitoring their independent thought, their personal responsibility and their accountability for their own personal decisions,” he said.

The bill now heads back to the House. If lawmakers concur with the final version of the bill, it will next head to the governor’s desk.

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https://apps.legislature.ky.gov/publicservices/pio/release.html#HB90-031325