Montana LR-131, Medical Care Requirements for Born-Alive Infants Measure (2022)

Montana LR-131
Election date November 8, 2022
Topic Abortion and Healthcare
Status d Defeated
Type State statute	Origin State legislature

Montana LR-131, the Medical Care Requirements for Born-Alive Infants Measure, was on the ballot in Montana as a legislatively referred state statute on November 8, 2022. The ballot measure was defeated.

A "yes" vote supported this ballot measure to: state that infants born alive at any stage of development are legal persons;  require medical care to be provided to infants born alive after an induced labor, cesarean section, attempted abortion, or another method; and establish a $50,000 fine and/or 20 years in prison as the maximum penalty for violating the law.

A "no" vote opposed this ballot measure to: state that infants born alive at any stage of development are legal persons; require medical care to be provided to infants born alive after an induced labor, cesarean section, attempted abortion, or another method; and establish a $50,000 fine and/or 20 years in prison as the maximum penalty for violating the law.

Additional information on abortion-related ballot measures

In 2022, there were six ballot measures addressing abortion — the most on record for a single year. Measures were approved in California, Michigan, and Vermont. Measures were defeated in Kansas, Kentucky, and Montana.

• You can find a list of 2022's certified and proposed measures here: 2022 abortion-related ballot measures.

• Information on abortion-related ballot measures since 1970 is available here: History of abortion ballot measures.

Election results

Montana LR-131
Result		Votes	Percentage
Yes		213,001	47.45%
No		235,904	52.55%

Results are officially certified.

Source

Aftermath

The Montana State Legislature passed House Bill 625, which was signed by Governor Greg Gianforte (R) on May 3, 2023. HB 625 is similar to LR-131. The bill provided that infants born alive following an attempted abortion are "legal person[s] for all purposes under the laws of this state and is entitled to all protections under these laws" and are " entitled to the same protections under the law that would arise for any newborn infant or for any person who comes to a medical facility or other facility for screening or treatment or otherwise becomes a patient in the facility's care."

The bill included a provision stating that nothing in the law shall prevent an infant's parents or guardian from refusing medical care or treatment if it is not necessary to save the infant's life, if the care or treatment has a potential risk to the infant's health or life that outweighs the benefits of treatment, or that will do no more than temporarily extend life if death is imminent.

Under HB 625, a healthcare provider who violates the law would be subject to a $1,000 fine and up to a five-year prison sentence. Healthcare providers aware of violations under the law are required to report violations to law enforcement.

In the Senate, the bill was approved by a vote of 30-18. Among Senate Republicans, 29 were in favor and three were opposed. Among Senate Democrats, one was in favor and 15 were opposed. In the House, the bill was approved by a vote of 67-30 with Republicans in favor and Democrats opposed.

Overview

What would the measure have done?

See also: Measure design

The measure would have required medical care to be provided to infants born alive by classifying a born-alive infant as "a legal person for all purposes under the laws of the state ... entitled to the protections of the laws, including the right to appropriate and reasonable medical care and treatment." The law would have required infants born alive after an induced labor, a cesarean section, an attempted abortion, or another method to receive medical care. Under the law, a healthcare provider who "purposely, knowingly, or negligently violates" this requirement by not providing care would have been convicted of a felony with a maximum sentence of a $50,000 fine and/or 20 years in prison. Healthcare providers aware of violations of the proposed law would have been required to report violations to law enforcement. The law would have taken effect on January 1, 2023.

At the time of the election, Montana law stated that a person commits an offense if they "purposely, knowingly, or negligently cause the death of a premature infant born alive, if the infant is viable." The maximum punishment for negligent homicide was time in prison not to exceed 20 years and a fine not to exceed $50,000. The maximum punishment for deliberate homicide was the death penalty, life imprisonment, or prison time not to exceed 100 years.

Do other states have similar laws?

See also: Medical care requirements for born-alive infants across the country

At the time of the election, 18 states had laws that required healthcare providers to provide reasonable care to preserve the life of an infant born alive after an attempted abortion; required either hospitalization of the born-alive infant or a second attending physician; and enforced criminal and civil penalties for healthcare providers who did not comply with the state law.

Additionally, the United States Congress passed House Resolution 2175 (HR 2175), known as the "Born-Alive Infants Protection Act," in 2002, which extended legal protection to an infant born alive after any stage of development or attempted abortion.

Who supported and opposed the measure?

See also: Support and Opposition

The measure was sponsored in the state legislature by State Representative Matt Regier (R). Rep. Regier said, "We need to make it abundantly clear that here in Montana the protection of all life is available. ... I believe this decision should be made by not just us here at the capitol but by [the voters] back home. This is a defining issue that goes directly to who we are, and I believe Montanas should have the final say." Supporters also included the Charlotte Lozier Institute, Montana Family Foundation, and Pro-Life Helena.

Representative Kathy Kelker (D), who voted against the measure, said, "This one size fits all legislated standard of care not only interferes with medical practice, but denies physicians the ability to provide care that is necessary, compassionate, and appropriate to an individual woman's circumstances." The Montana Medical Association, ACLU of Montana, Montanas for Choice, and Planned Parenthood of Montana opposed the measure.

How did the measure get on the ballot?

See also: Path to the ballot

The measure was a legislatively referred state statute placed on the ballot by a vote of the Montana State Legislature.

The measure was introduced as House Bill 167 (HB 167) on January 14, 2021, in the Montana House of Representatives by Rep. Matt Regier (R). The House passed the measure in a vote of 68-32. All 67 Republicans voted in favor of it, and all but one Democrat, Rep. Dave Fern, voted against it. On February 26, 2021, the Senate passed an amended version in a vote of 30-20. The vote was largely along party lines, except for Senator Jeffrey Welborn, who was the sole Republican to vote against the measure. On April 22, 2021, the state House concurred with the amended version in a vote of 66-34. The vote was also along party lines, except for Rep. Edward Buttrey, who was the sole Republican to vote against the measure.

A similar law was proposed in 2019 that if passed and signed by the governor would not have gone before voters. After passing the House by a vote of 54-43 and the Senate by a vote of 32-18, Governor Steve Bullock (D) vetoed the law, and the state legislature did not have enough votes to overcome the two-thirds vote requirement.

Measure design

See also: Text of measure

LR-131 would have enacted a law stating that an infant born alive "is a legal person for all purposes under the laws of the state and is entitled to the protections of the laws, including the right to appropriate and reasonable medical care and treatment." The law would have required infants born alive after an induced labor, a cesarean section, an attempted abortion, or another method to receive medical care. Under the measure, a healthcare provider who was found guilty of violating this provision could have been charged with a felony and received a maximum sentence of a $50,000 fine and/or 20 years in prison. Healthcare providers would have been required to report violations of the law to law enforcement. The law would have taken effect on January 1, 2023.

LR-131 would have defined "born alive" as "the complete expulsion or extraction from the mother of a human infant, at any stage of development, who, after expulsion or extraction, breathes, has a beating heart, or has definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, induced abortion, or another method."

LR-131 was also known as the "Born-Alive Infant Protection Act."

Text of measure

Ballot question

The ballot question was as follows:

“

An act adopting the born-alive infant protection act; providing that infants born alive, including infants born alive after an abortion, are legal persons; requiring health care providers to take necessary actions to preserve the life of a born-alive infant; providing a penalty; providing that the proposed act be submitted to the qualified electors of Montana; and providing an effective date. [ ] YES on Legislative Referendum [ ] NO on Legislative Referendum

”

Full text

The full text of the measure can be read below:

Readability score

See also: Ballot measure readability scores, 2022

Using the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) formulas, Ballotpedia scored the readability of the ballot title for this measure. Readability scores are designed to indicate the reading difficulty of text. The Flesch-Kincaid formulas account for the number of words, syllables, and sentences in a text; they do not account for the difficulty of the ideas in the text. The state legislature wrote the ballot language for this measure.

The FKGL for the ballot title is grade level 11, and the FRE is 41. The word count for the ballot title is 62.

Support

Supporters

Officials

• Gov. Greg Gianforte (R)
• State Rep. Matt Regier (R)
• State Rep. Lola Sheldon-Galloway (R)

Organizations

• Americans United for Life
• Charlotte Lozier Institute
• Montana Family Foundation
• Pro-Life Helena

Arguments

• State Rep. Matt Regier (R): "We need to make it abundantly clear that here in Montana the protection of all life is available. ... I believe this decision should be made by not just us here at the capitol but by [the voters] back home. This is a defining issue that goes directly to who we are, and I believe Montanas should have the final say."

Opposition

Compassion for Montana Families: No on LR-131 led the campaign in opposition to LR-131.

Opponents

Organizations

• ACLU of Montana
• Human Rights Campaign PAC
• Montana Medical Association
• Montanans for Choice
• Planned Parenthood of Montana

Arguments

• State Rep. Kathy Kelker (D): "This one size fits all legislated standard of care not only interferes with medical practice, but denies physicians the ability to provide care that is necessary, compassionate, and appropriate to an individual woman's circumstances."
• Greg Dorrington of Montana Medical Association: "When the Legislature adopts code that mandates specific processes or procedures be taken in the course of medical treatment, it infringes upon the physician’s medical judgement."
• Nancy Maxson and Nancy Leifer, co- presidents of the League of Women Voters Missoula: "LR 131 is unnecessary. Montana law already recognizes the responsibility of medical providers to care for viable infants outside of the womb. In an environment where doctors and nurses are already quitting and retiring early because of intolerable conditions in the current health care model, LR 131 would only aggravate those conditions."

Campaign finance

See also: Campaign finance requirements for Montana ballot measures

The campaign finance information on this page reflects the most recently scheduled reports processed by Ballotpedia, which covered through November 25, 2022.

Ballotpedia identified two committees registered in opposition to LR-131: Compassion for Montana Families: No on LR-131 and Montanans Against LR-131. Together they reported over $1 million in contributions. Ballotpedia did not locate a campaign in support of the ballot measure.

	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
Support	$0.00	$0.00	$0.00	$0.00	$0.00
Oppose	$1,000,202.68	$64,326.62	$1,064,529.30	$720,974.89	$785,301.51

Opposition

The following table includes contribution and expenditure totals for the committee in opposition to the ballot measure.

Committees in opposition to LR-131
Committee	Cash Contributions	In-Kind Contributions	Total Contributions	Cash Expenditures	Total Expenditures
Compassion for Montana Families: No on LR-131	$987,903.00	$59,016.62	$1,046,919.62	$716,925.84	$775,942.46
Montanans Against LR-131	$12,299.68	$5,310.00	$17,609.68	$4,049.05	$9,359.05
Total	$1,000,202.68	$64,326.62	$1,064,529.30	$720,974.89	$785,301.51

Donors

The following table shows the top donors to the committee registered in opposition to the ballot measure.

Donor	Cash Contributions	In-Kind Contributions	Total Contributions
Families United for Freedom	$275,000.00	$0.00	$275,000.00
PPAMT-ICLR131	$220,000.00	$0.00	$220,000.00
Blue Mountain Clinic	$101,500.00	$46,189.44	$147,689.44
New Venture Fund	$70,000.00	$0.00	$70,000.00
Montana Women Vote	$60,000.00	$0.00	$60,000.00

Methodology

To read Ballotpedia's methodology for covering ballot measure campaign finance information, click here.

Media editorials

See also: 2022 ballot measure media endorsements

Ballotpedia identified the following media editorial boards as taking positions on the measure.

Ballotpedia lists the positions of media editorial boards that support or oppose ballot measures. This does not include opinion pieces from individuals or groups that do not represent the official position of a newspaper or media outlet. Ballotpedia includes editorials from newspapers and outlets based on circulation and readership, political coverage within a state, and length of publication. You can share media editorial board endorsements with us at editor@ballotpedia.org.

Support

You can share campaign information or arguments, along with source links for this information, at editor@ballotpedia.org

Opposition

• Daily Inter Lake Editorial Board: "But LR-131 represents governmental overreach and interference far beyond simple redundancy in law. ... Vote 'no' on the Born Alive question to protect all Montanans’ right to privacy and to keep the government out of your deeply personal health-care decisions."

Background

History of abortion on the ballot

See also: History of abortion ballot measures

Since the 1970s, abortion-related policies have been a topic for statewide ballot measures across the U.S.

The most recent vote on an abortion-related ballot measure was Ohio Issue 1, which voters approved. Issue 1 provided a state constitutional right to "make and carry out one’s own reproductive decisions," including decisions about abortion, contraception, and other reproductive matters.

In 2022, there were six ballot measures addressing abortion — the most on record for a single year. Measures were approved in California, Michigan, and Vermont. Measures were defeated in Kansas, Kentucky, and Montana.

From 1970 to November 2023, there were 54 abortion-related ballot measures, and 43 (80%) of these had the support of organizations that described themselves as pro-life. Voters approved 11 (26%) and rejected 32 (74%) of these 43 ballot measures. The other 11 abortion-related ballot measures had the support of organizations that described themselves as pro-choice or pro-reproductive rights. Voters approved eight (73%) and rejected three (27%).

Before Roe v. Wade in 1973, three abortion-related measures were on the ballot in Michigan, North Dakota, and Washington, and each was designed to allow abortion in its respective state.

Senate Bill 315 (2021)

Senate Bill 315 (SB 315) was the exact same law as LR-131; however, if it had passed, it would have become law upon the governor's signature. It would have not been submitted to voters. SB 315 also contained a provision that would have voided LR-131 if SB 315 had passed.

SB 315 was introduced on February 22, 2021, by Sen. David Howard (R). SB 315 passed the Senate on March 2, 2021, by a vote of 30-19. It was transferred to the House but died in Standing Committee when the state legislature adjourned on April 29, 2021.

2019 veto of the Montana Born Alive Infant Protection Act

During the 2019 legislative session, the Montana State Legislature passed the Montana Born-Alive Infant Protection Act (Senate Bill 354), which would have been enacted once signed by the governor. Unlike LR-131, the 2019 law was not a legislatively referred state statute. The law would have required that viable infants born alive after an attempted abortion must receive "medically appropriate and reasonable medical treatment." The Senate passed the bill by a margin of 32-18, and the House passed the bill by a margin of 54-43. Both votes were largely along party lines with Republicans favoring the law and Democrats opposing the law.

Governor Steve Bullock (D) vetoed the bill on May 8, 2019. He said, "The situation SB 354 purportedly seeks to address is a medical practice that does not exist. This bill does nothing more than politicize decisions that are deeply personal and medically complex. I believe women, families and health care providers are best able to make these difficult medical decisions without political interference that is meant only to inflame and cause division."

Montana requires a two-thirds (66.67%) vote to overturn a veto. The Senate was two votes short of the 34 vote threshold, and the House needed 12 more votes to meet the 67 vote threshold.

Before the 2020 election, Montana had a divided government with a Republican majority in both chambers of the state legislature and a Democratic governor. At the 2020 election, Montana voters elected Governor Greg Gianforte (R) making Montana a Republican state government trifecta.

Montana law protecting premature infants born alive

At the time of the election, Montana Code Annotated § 50-20-108 stated that a person commits an offense if they "purposely, knowingly, or negligently cause the death of a premature infant born alive, if the infant is viable." State law defined viability as, "the ability of a fetus to live outside the mother's womb, albeit with artificial aid."

Born Alive Infants Protection Act of 2002

In 2002, the United States Congress passed House Resolution 2175 (HR 2175), known as the "Born-Alive Infants Protection Act of 2002." The law extended legal protection to an infant born alive after any stage of development or attempted abortion. The law defined "born alive" as "a member of the species homo sapiens ... after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut."

The bill passed the House by voice vote, meaning there is no tally of the vote recorded, and it passed the Senate by unanimous consent, which also means there is no recorded tally of the vote. It was signed into law on August 5, 2002.

Medical care requirements for born-alive infants across the country

Montana LR-131 was the first ballot measure to appear on a statewide ballot proposing medical care requirements for born-alive infants. States that provide medical care requirements have adopted them via state legislatures. As of June 2021, 18 states had laws with the following three provisions related to infants born alive after an attempted abortion:

• required healthcare providers to provide reasonable care to preserve the life of an infant born alive after an attempted abortion;
• required either hospitalization of the born-alive infant or a second attending physician; and
• enforced criminal and civil penalties for healthcare providers who did not comply with the state law.

The 18 states with the three provisions providing protections for born-alive infants are shaded dark below:

Status of abortion in Montana

As of June 2021, Montana was one of 10 states, according to The Guttmacher Institute, that provided a state constitutional right to abortion based on court rulings.

In Armstrong v. State (1999), the Montana Supreme Court held that Section 10 of Article II of the Montana Constitution provided women with a right to procreative autonomy, including an abortion before fetal viability. Section 10 read, "The right of individual privacy is essential to the well-being of a free society and shall not be infringed without the showing of a compelling state interest." The provision was included as part of the 1972 Montana Constitution.

Path to the ballot

See also: Legislatively-referred state statutes in Montana

In Montana, a simple majority is required in both chambers of the state legislature to place a legislatively referred state statute on the ballot.

The measure was introduced as House Bill 167 (HB 167) on January 14, 2021, in the Montana House of Representatives. On January 26, 2021, the state House passed the measure in a vote of 68-32. All 67 Republicans voted in favor of it, and all but one Democrat representative voted against it. It was sent to the Montana State Senate on January 26. On February 26, 2021, the state Senate passed an amended version in a vote of 30-20. The vote was largely along party lines, except for Senator Jeffrey Welborn, who was the sole Republican to vote against the measure. On April 22, 2021, the state House concurred with the amended version in a vote of 66-34. The vote was also along party lines, except for Rep. Edward Buttrey, who was the sole Republican to vote against the measure. The vote totals below are for the final version of the bill.

Vote in the Montana State Senate February 26, 2021
Requirement: Simple majority vote of those voting in each chamber
Number of yes votes required: 26  a
	Yes	No	Not voting
Total	30	20	0
Total percent	60.0%	40.0%	0.0%
Democrat	0	19	0
Republican	30	1	0

Vote in the Montana House of Representatives April 22, 2021
Requirement: Simple majority vote of those voting in each chamber
Number of yes votes required: 51  a
	Yes	No	Not voting
Total	66	34	0
Total percent	66.00%	34.00%	0.00%
Democrat	0	33	0
Republican	66	1	0

How to cast a vote

See also: Voting in Montana

Click "Show" to learn more about voter registration, identification requirements, and poll times in Montana.

How to cast a vote in Montana

Poll times In Montana, polling place hours vary throughout the state. Most polling places open at 7:00 a.m. and close at 8:00 p.m., although some polling places may open as late as 12:00 p.m. An individual who is in line at the time polls close must be allowed to vote. Registration Check your voter registration status here. To register to vote in Montana, each applicant must be a citizen of the United States, a resident of Montana for at least 30 days prior to the election, and at least 18 years old by the day of the election. People serving a felony sentence in a penal institution and those who have been declared by a court to be of unsound mind are not eligible to vote. Citizens can register to vote in person by completing a registration application at their county election office. They can register by mailing the application to their county election administrator or submitting it when applying for or renewing a driver’s license or state ID. Citizens may also register to vote at their county election offices, certain designated locations, or at their designated polling location on Election Day. Automatic registration Montana does not practice automatic voter registration. Online registration See also: Online voter registration Montana does not permit online voter registration. Same-day registration Montana allows same-day voter registration. Residency requirements In order to register to vote in Montana, applicants must have lived in the state for at least 30 days prior to the election. Verification of citizenship See also: Laws permitting noncitizens to vote in the United States Montana does not require proof of citizenship for voter registration. Verifying your registration The site My Voter Page, run by the Montana secretary of state’s office, allows residents to check their voter registration status online. Voter ID requirements Montana requires voters to present identification while voting. Montana's voter identification requirements are outlined in Section 13-13-114 of Montana Code, as amended when SB 169 was signed into law on April 19, 2021. The law states, "Before an elector is permitted to receive a ballot or vote, the elector shall present to an election judge one of the following forms of identification showing the elector's name:" “ (i) Montana driver's license, Montana state identification card issued pursuant to 61-12-501, military identification card, tribal photo identification card., United States passport, or Montana concealed carry permit; or (ii) (A) a current utility bill, bank statement, paycheck, government check, or other government document that shows the elector's name and current address; and (B) photo identification that shows the elector's name, including but not limited to a school district or postsecondary education photo identification. ” On March 27, 2024, the Montana Supreme Court ruled that the portion of SB 169 that precluded the use of student ID for voter identification was unconstitutional. See here for more.

See also

2022 measures

• 2022 ballot measures
• Healthcare on the ballot
• Abortion on the ballot
• 2022 legislative sessions

Montana

• Montana ballot measures
• Montana ballot measure laws

News and analysis

• Ballot measure lawsuits
• Ballot measure readability
• Ballot measure polls

External links

• Full text