Tennessee’s GOP-dominant Senate gave final approval Wednesday to legislation that would add a narrow exemption to one of the strictest abortion bans in the United States, with it now heading to Gov. Bill Lee’s desk for his approval.
The Senate passed the bill on a 26-1 vote, with several of the chamber’s Democratic lawmakers voting “present” rather than picking a side.
The bill’s passage comes after weeks of drastically reworking the proposal in order to gain enough support from the General Assembly’s Republican supermajority, as well as the state’s powerful anti-abortion lobby, which had warned lawmakers would likely face political retribution if they advanced a bill without the group’s endorsement.
Under the bill, doctors would be allowed to use “reasonable medical judgment” when determining an abortion is necessary to prevent the death of a pregnant patient or to spare her from the irreversible, severe impairment of a major bodily function. Some doctors argue that is a harsher legal standard than before.
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Currently, Tennessee has no explicit exemptions under it’s so-called “trigger law,” which wasn’t allowed to go into effect until after the U.S. Supreme Court overturned the constitutional right to abortion. Instead the law includes an “affirmative defense” for doctors, meaning the burden is on the physician to prove that an abortion was medically necessary — instead of requiring the state to prove the opposite.
The bill headed to Gov. Lee’s desk removes the affirmative defense for doctors and adds in language that doctors may provide abortion services for ectopic pregnancies and miscarriages. However, it does not keep the previous version’s inclusion of “medically futile pregnancies” and lethal fetal anomalies as approved reasons for physicians to provide an abortion. Instead, it allows doctors to use “reasonable medical judgment” to determine if an abortion is necessary.
Lee, a Republican, has not publicly commented on whether he supports the legislation. He has previously defended the state’s current law and has said it does not need to be changed.

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