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Lawmaker proposes new medication abortion requirements, documentation in Nebraska • Nebraska Examiner

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Lawmaker proposes new medication abortion requirements, documentation in Nebraska • Nebraska Examiner


LINCOLN — A pregnant woman seeking a medication abortion in Nebraska would be required under a new bill to attend an in-person appointment with her physician before receiving the drugs and a follow-up appointment after to document any “adverse events.”

Legislative Bill 512, by State Sen. Rick Holdcroft of Bellevue, has proposed the Chemical Abortion Safety Protocol Act. It would apply to any “abortion-inducing drug” that has the specific intent of terminating a pregnancy.

State Sen. Rick Holdcroft of Bellevue. July 31, 2024. (Zach Wendling/Nebraska Examiner)

Other drugs, medications or substances that can be known to cause an abortion but are provided for other medical reasons, such as chemotherapy meds, would be excluded.

“The purpose of the bill [is] just to try and ensure we’re providing good health care for our women who are receiving abortions,” Holdcroft told reporters after introducing LB 512.

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Some reproductive health doctors for Nebraska women said the proposed restrictions appear aimed at making it harder to get a medication abortion in the state.

New requirements and documentation

State law already prohibits telemedicine for receiving abortion medications, but Holdcroft said his goal is to prevent physicians from flying into Nebraska just to prescribe the drug, then leave.

LB 512 would add additional steps before a physician could give a woman an abortion-inducing drug in the state:

  • Independently verify the woman is pregnant.
  • Determine whether the woman has an ectopic pregnancy.
  • Document the gestational age and location of the pregnancy.
  • Determine the woman’s blood type and, if the woman is Rh negative, offer to administer Rh immunoglobulin to prevent Rh incompatibility, complications or miscarriage in future pregnancies.
State Sens. Lou Ann Linehan, Julie Slama and Joni Albrecht join Gov. Jim Pillen at a news conference pressing passage of a bill to outlaw abortion after an ultrasound detects embryonic cardiac activity. (Aaron Sanderford/Nebraska Examiner)

The physician also would need to schedule an in-person follow-up visit with the woman who received the drug between three and 14 days after it is given. The physician would need to confirm the woman’s pregnancy is completely terminated and document any adverse events

An “adverse event” could include shock, heavy or prolonged bleeding, hemorrhage, aspiration or allergic response, infection, sepsis, pelvic inflammatory disease or missed ectopic pregnancy.

That report would need to be sent to the Nebraska Department of Health and Human Services, similar to current reports for non-medication abortions in the state.

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A woman who receives an attempted or successful medication abortion could not be held liable under the new law.

‘Effectively a total ban’

Dr. Elizabeth Constance, a reproductive endocrinologist in Omaha, said the bill doesn’t ban major drugs like mifepristone or misoprostol, the most common two-drug regimen for a medication abortion. 

“But I do think it puts so many onerous and non-standard of care restrictions on their use that it will effectively be a total ban on medication abortions,” Constance said in a text. “Effective ban if not an outright one.”

Dr. Elizabeth Constance speaks at a rally
Dr. Elizabeth Constance speaks at a rally in the Nebraska State Capitol. Feb. 8, 2023. (Zach Wendling/Nebraska Examiner)

Constance said the bill doesn’t explicitly include an exception for the targeted drugs to be used in miscarriage management, which they often are.

She said that could complicate access to care, including in emergencies, as the drugs are more highly regulated. That includes misoprostol, routinely used to treat postpartum hemorrhage.

Mifepristone is also used to treat endometriosis, fibroids or hyperglycemia associated with Cushing’s syndrome. Misoprostol can also be used to treat ulcers. Both medications can be used to induce labor.

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Dr. Emily Patel, a maternal-fetal medicine specialist in Omaha, said other medications can be obtained without someone ever seeing a physician but are more dangerous, such as certain over-the-counter pain relievers or erectile-dysfunction meds that could be bought online.

Patel said the characterization that physicians are flown in to provide abortions is “overblown,” though some physicians do travel to provide general care, like she does to Hastings or Fremont.

‘Pretty slipshod operation’

Holdcroft said he didn’t know whether mifepristone could be used for other medical purposes but that his intent isn’t to ban medication abortions, just to tighten up the medical care.

He said if his bill needs amendments, he’s willing to look into any needed changes, but he thinks LB 512 has support for an issue that isn’t “that far a stretch.”

“I just want to make sure we’re providing safe procedures, and that’s not what we’re seeing,” Holdcroft said. “We’re seeing a pretty slipshod operation, in my opinion.”

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Dr. Emily Patel. (Courtesy of Emily Patel)

Patel said the assumption patients aren’t receiving standard-of-practice care is “blatantly false.” 

“It is not standard practice to have mandated follow ups,” Patel said in a text, “nor is it standard to have to report how we practice medicine to the state.”

LB 512 was among 96 legislative bills or constitutional amendments introduced Tuesday, including:

  • LB 443, by State Sen. Brad von Gillern of Omaha, would outlaw “unlawful squatting,” defined as the intent to claim ownership of someone’s land or property by refusing to leave.
  • LB 457, by State Sen. Eliot Bostar of Lincoln, would require school districts and licensed child care facilities to design policies to prevent and respond to serious allergic reactions — anaphylaxis or anaphylactic shock. It would also limit the cost that an insured individual must pay for a two-pack of medically necessary epinephrine injectors to up to $60, regardless of the type of brand.
  • LB 463, by State Sen. Beau Ballard of Lincoln, would require school districts to develop a cardiac emergency response plan and place automated external defibrillators on school grounds. The bill would create up to $1.5 million in grants to fund the plans.
  • LB 475, by State Sen. Merv Riepe of Ralston, would classify tianeptine — known as “gas station heroin” — as a controlled substance in Nebraska. The drug had previously been used to treat depression in dozens of countries, and even though it is illegal to market or sell the drug, it is not on the list of federally controlled substances.
  • LB 500, by State Sen. Wendy DeBoer of Omaha, would create a 21-member School Financing Review Commission for an in-depth review of how K-12 schools are funded in the state.
  • LB 513, by State Sen. Carolyn Bosn of Lincoln, would increase the salaries of justices on the Nebraska Supreme Court by 4% each on July 1, 2025, and July 1, 2026. They would rise from $225,055.35 currently to $243,419.87 next year.
  • LB 523, by State Sen. Margo Juarez of Omaha, would create a stipend program for student teachers, who could apply for stipends at $4,000 per student-teaching semester. Most student teachers are not currently paid by their districts.
  • Legislative Resolution 22CA, by State Sen. George Dungan of Lincoln, would enshrine a right to a clean and healthy natural environment and that political subdivisions serve as trustees of Nebraska’s natural resources in the Nebraska Constitution.
  • LR 25CA, by State Sen. Ben Hansen of Blair, would amend the Nebraska Constitution so lawmakers are paid the state’s minimum wage, which will rise from $13.50 to $15 next year, before annual cost-of-living increases. Lawmakers would also receive health insurance. Senators currently receive a $12,000 salary, as set in the Constitution. The proposal does not set a floor or ceiling for how much lawmakers would be paid.

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Gov. Jim Pillen calls for budget cuts, hiring freeze in new memo

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Gov. Jim Pillen calls for budget cuts, hiring freeze in new memo


Nebraska Gov. Jim Pillen on Wednesday announced measures to further cut state spending, including a cut in state agency spending and a hiring freeze on most positions.

Pillen said in a news release that the measures are necessary after the state paid out $307 million more in state tax refunds than anticipated in fiscal year 2026, which ended June 30. Tax receipts have come in below projections in March, April and May, leading to a current expected deficit of $172 million.

That’s after lawmakers closed a $646 million budget hole in their most recent legislative session.

The governor has previously sought to cut spending to provide more property tax relief to Nebraska residents and had called for additional cuts during the current fiscal year.

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“I am pleased with the progress we have made, but I’m not satisfied,” Pillen said in a news release.

Accompanying the release was a memo Pillen sent to state agencies, boards and commissions in which he called on them to “exercise additional fiscal restraint.”

Among the measures outlined in the memo:

  • A freeze on creating any new positions or filling any vacancies without approval from the state budget office. The freeze does not apply to law enforcement or corrections positions.
  • A 5% reduction in budgets for all state agencies.
  • All agencies, boards and commissions must provide monthly cash flow projections.
  • Agency leaders are directed to “concentrate” on eliminating redundant processes, services regulation and aid programs.
  • Agency leaders are directed to reduce their agencies’ physical footprint and “consolidate teams and services.”

All state entities are required to submit their plans for reducing spending by the end of the month.

The memo also said agencies should “prepare for downward adjustments to appropriations” not only in the current fiscal year but also in the 2028 and 2029 fiscal years.



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Supreme Court will hear Nebraska’s fight over access to Colorado’s South Platte River

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Supreme Court will hear Nebraska’s fight over access to Colorado’s South Platte River


The U.S. Supreme Court has agreed to hear Nebraska’s lawsuit against Colorado over a proposed canal that would take water out of the South Platte River in Colorado and send it to a reservoir in Nebraska.

Nebraska claims Colorado is deliberately obstructing efforts to build the ditch, known as the Perkins Canal, even though everyone agrees Nebraska has the right to do so. The canal is necessary, Nebraska says, because Colorado isn’t sending enough water into Nebraska.

The Perkins Canal would divert water from the South Platte River near Ovid to a storage site somewhere in Nebraska. The South Platte River Compact, ratified by both states and Congress in 1923, requires Colorado to guarantee a flow in the river of 120 cubic feet per second at a water gauge near the state line during the irrigation season. The compact also authorizes Nebraska to build the canal and grants the right to use the power of eminent domain to acquire land on which to build it. Initial work was done on the canal more than a century ago, but the project was abandoned as unfeasible.

Nebraska resurrected the idea in late 2021, citing fears that urban development along Colorado’s Interstate 25 corridor and plans to expand water storage were causing Colorado to violate the terms of the 1923 compact. 

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The idea that Nebraska might actually build the canal has water users in the lower reaches of the river worried that doing so would disrupt the water augmentation process that underpins much of the crop irrigation along the South Platte, especially between Fort Morgan and the Colorado-Nebraska state line. It is designed to help Colorado meet the terms of the 1923 compact. 

Colorado land owners have resisted Nebraska’s efforts to buy land in the Julesburg area so the canal can be built. Colorado Attorney General Phil Weiser and Gov. Jared Polis, while recognizing Nebraska’s right to build the canal, have nevertheless sworn to do all they can to protect Coloradans’ property and water rights. Seeing such rhetoric as subverting Nebraska’s right to build, Nebraska sued Colorado in the Supreme Court in July 2025, alleging that Colorado is obstructing Nebraska’s efforts to go ahead with the Perkins project. Nebraska also attacked Colorado’s water augmentation system, saying it doesn’t work.

To understand augmentation, it’s important to know that Colorado operates on the prior appropriation doctrine, meaning the oldest (senior) water right holders get their water first. During dry periods, senior users may place a “call” on a stream, forcing junior users to stop taking water to ensure the senior rights are fulfilled. When someone pumps water out of a river basin, it eventually pulls water out of nearby streams and rivers, which can illegally shortchange senior surface-right holders. In that case, the junior wells would have to be shut down until senior rights were satisfied

To avoid such shutdowns, called “curtailment,” Colorado devised a system called augmentation in which the water that is pumped during the irrigation season must be replaced during the winter months so it flows back through the aquifer into the river in the following irrigation season. Some augmentation is done simply by buying water rights from upstream users, increasing the amount of water in the river. The system is highly complex and requires detailed accounting of river flows.

In a prepared statement issued last week, after the high court agreed to hear the case, Colorado Attorney General Phil Weiser said Colorado is in compliance with the compact.

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The court’s decision, he wrote, “merely opens the door for Nebraska to bring its claims against Colorado. Nebraska’s burden to prove those claims is incredibly high and we will vigorously defend Colorado’s full entitlements under the compact.”

Perkins Canal needed because Colorado is harming Nebraska

But Nebraska officials insist water augmentation isn’t doing what it was supposed to do. In its 55-page complaint to the U.S. Supreme Court, Nebraska calls the augmentation system illegal and a violation of the river compact.

“Colorado’s water administration system, including its augmentation plans, have harmed and will continue to harm Nebraska,” the lawsuit reads. “For example, many augmentation projects … allow junior well owners to pump water out of priority during the irrigation season, provided they pump or divert additional water during the non-irrigation season and apply it to recharge ponds. This method assumes that water will percolate back into the water table and make its way to the South Platte River in time to make whole downstream senior users.”

Kent Miller is general manager of the Twin Platte Natural Resources District, which includes most of the South Platte River in Nebraska. He’s said he’s watched the river since 1972 and is skeptical that augmentation even works.

“Those plans have not been working, and I base that on the fact that the Western Irrigation District rarely receives what it’s supposed to receive,” Miller said. 

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In May, U.S. Solicitor General John Sauer filed an amicus brief with the high court recommending that the court allow the suit to go ahead, but with conditions. 

In its lawsuit, Nebraska addresses augmentation because of its complexity and insists that any mechanism Colorado uses to comply with the compact should be simple. In his amicus brief, Sauer recommended tossing the argument.

“Nebraska reads Article VIII (of the compact) as mandating that compliance mechanisms be ‘simple,’ and it alleges that Colorado has violated that requirement,” Sauer wrote. “But Article VIII imposes no such requirement; it merely authorizes Colorado officials to enforce the Compact without action by the Colorado legislature. Because Nebraska’s Article VIII claim is facially meritless, it should not be permitted to proceed further.”

Sauer further recommended disallowing arguments that Colorado is obstructing Nebraska’s efforts to build the canal, saying Nebraska offers no evidence of such obstruction.

In signaling its acceptance of the lawsuit on Monday, the Supreme Court said it wants to hear all of Nebraska’s complaints and let the justices judge for themselves whether parts of it lack merit. Colorado originally had 30 days to respond to the court’s action but, on July 2, requested a 60-day extension.

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Nebraska Rep. Mike Flood faces frustrated constituents at second town hall of year

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Nebraska Rep. Mike Flood faces frustrated constituents at second town hall of year


Some Nebraskans arrived early with signs outside U.S. Rep. Mike Flood’s second town hall of the year, hoping to press the congressman on issues ranging from food assistance to the conflict in the Middle East.

Rhonda Mays said she brought a sign to show Flood what some constituents think and to encourage others heading inside to speak up. “People walking by that plan on going in there need a reminder to speak out, to ask the right question, and don’t just go to listen but to actually challenge the representative,” Mays said.

Flood said Nebraskans are able to treat each other with respect while also having tough conversations.

During the hourlong event, attendees asked about a range of topics, including multiple questions about SNAP benefits. Some Nebraskans said there is a large population facing food insecurity. Flood responded, “I understand your concerns with SNAP I work often with the foodbanks and with Nebraskans that need assistance. I appreciate the question and I will double back with some of my sources when I get a chance this week, but I have not heard anything about that from any of my sources.”

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The crowd became particularly rowdy during discussion of the conflict in the Middle East. Flood said, “We have no greater ally in the middle east than Israel. We have no greater ally than Israel.”

Asked about the outcry after the town hall, Flood reiterated his position, saying, “Isreal was attacked by Hamas; a terrorist organization and horrific things were done to Israelis. At the same time Hezbollah working to do the same on the northern border and then you have the Houthis. Israel has the right to defend itself and we would as well if we were put in that situation.”

Flood holds three town halls a year. It was not known where his third town hall will be.

The town hall was held in Bellevue.



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