Nebraska senators to debate gender-affirming care, abortion limits for final time Friday

LINCOLN — A bill that has stirred session-long turmoil in the Nebraska Legislature and now includes two contentious issues — abortion and transgender health care — will see its final chapter of floor debate Friday.

State lawmakers are slated to debate and vote on Legislative Bill 574 in its final round. If it once again gets 33 votes to end an opposing filibuster, it will go to Gov. Jim Pillen’s desk, where it’s expected to be signed into law.

According to an amendment adopted Tuesday, the bill would ban gender-affirming surgeries for individuals under 19, and impose restrictions on puberty blockers and hormone therapy for the same age group based on the direction of the state’s chief medical officer. It also will ban abortions beyond 12 weeks based on gestational age, likely affecting a relatively small share of the state’s abortions.

Each round of prior debate on the bill has spurred high emotions and sometimes outright chaos. Opponents have launched an ongoing filibuster that has slowed almost every bill on the floor to protest the legislation, and recently several lawmakers have promised to continue filibustering during next year’s 60-day session if the bill passes.

Before the amendment, LB 574 would have completely banned puberty blockers, hormone therapy and surgeries for people under 19, but did not include any abortion restrictions.

Supporters framed the amendment as a compromise, but opponents don’t see it that way — especially with this week’s addition of abortion restrictions, which revived an effort that was previously thought dead for the year.

Last month, lawmakers blocked the advancement of LB 626, which would have banned abortions at around six weeks of pregnancy, once embryonic activity could be detected via ultrasound. The bill fell one vote shy of the 33 needed for a filibuster-ending cloture motion.

Usually when that happens, it means a bill is dead for the session. Instead, the abortion issue came back through the amendment to LB 574. And the proposal was enough to sway a lawmaker — State Sen. Merv Riepe of Ralston — who had helped scuttle the previous abortion bill.

Riepe had proposed his own amendment to LB 626, which would have banned abortions at 12 weeks post fertilization and included an exception for fetal anomalies. No vote was held on his amendment, but it had been panned by senators who wanted more restrictions on abortion. Tuesday, however, many of those same lawmakers backed the amendment to LB 574.

The 12-week ban included in LB 574 is more restrictive than Riepe’s amendment, as it doesn’t include an exception for fetal anomalies and it is based on gestational age. Gestational age measures a pregnancy based on the woman’s last menstrual period, whereas fertilization refers to the moment the egg is fertilized. The difference between the two could amount to several weeks. Multiple opponents thus referred to the proposal as a 10-week abortion ban.

However, the LB 574 bill would allow more abortion access in Nebraska than if the six-week abortion ban had passed. According to 2021 statistics from the state Department of Health and Human Services, about 85% of Nebraska’s abortions happen beyond the six-week mark, while only about 13% occur after 12 weeks of gestation.

In terms of transgender health care, the amendment is somewhat less restrictive than LB 574 originally intended. It includes a grandfather clause for people already receiving gender-affirming care. It also calls for the state’s chief medical officer to regulate puberty blockers and hormone therapy, while maintaining the ban on gender-affirming surgeries.

Because the chief medical officer is appointed by the governor, who supports LB 574, opponents have argued this was a thinly veiled attempt to maintain the full ban of the original bill. In February, Pillen chose ear, nose and throat physician Timothy Tesmer to serve in the position.

If the bill passes, Tesmer would follow a set of guidelines as to how to regulate the medication, including setting a minimum number of “gender-identity-focused therapeutic hours” a patient must undergo to receive it, and a minimum waiting period between a medical practitioner receiving the patient’s consent and prescribing the treatment.

Opponents have maintained that LB 574, as amended, will be harmful to women, doctors and trans youth.

“You do literally have blood on your hands if you vote for this,” said Sen. Machaela Cavanaugh of Omaha.