ANCHORAGE, Alaska — The Alaska Supreme Court is considering whether to overturn a lower court ruling that removed restrictions on the kind of providers who can perform abortions in the state.

A Superior Court judge last year struck down a law that required abortions to be performed only by a doctor licensed by the State Medical Board. The ruling came after Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana, Kentucky sued the state in 2019.

Advanced practice clinicians — including physician assistants and nurse practitioners — have been allowed to provide medication abortion in Alaska since 2021, when Superior Court Judge Josie Garton granted a Planned Parenthood request while the underlying case was ongoing.

The lower court order allowed Planned Parenthood to begin providing abortions every day of the week, instead of just one day a week, according to Planned Parenthood, which operates clinics in Anchorage and Fairbanks.

According to statistics collected by the state, the number of abortions provided in Alaska has remained fairly steady since the order was issued, after declining steadily in the previous decade. However, in the same time period, the percent of abortions performed using medication, rather than more invasive procedures, has increased.

The Alaska Constitution has been interpreted to protect abortion access. But the administration of Gov. Mike Dunleavy has repeatedly sought to limit access to the procedure and to punish the court system for its defense of abortion access.

The struck law that the Dunleavy administration seeks to revive dates back to 1970, when Alaska first sought to regulate abortion access.

“The specific animating concern was what is often referred to as back-alley abortions,” Supreme Court Justice Jennifer Henderson said during the Wednesday hearing.

An attorney for the Dunleavy administration argued in court that allowing only doctors — and not physician assistants or nurses — to perform abortions does not significantly limit access to the procedure.

Some of the Supreme Court judges appeared to question that during oral arguments held Wednesday.

“The real world in Alaska is — health care is already a challenge,” said Judge Aimee Oravec. “If, say, in a generic state that has a high population with a great road system and a grid, this law wouldn’t be a substantial burden because there’s lots of providers, lots of options, lots of appointments, but in Alaska we uniquely have a challenging health care provision — even if it’s an inconvenience somewhere else, wouldn’t that incremental challenge result in a substantial burden here?”

Many residents of rural Alaska must travel to seek abortions in Anchorage, Fairbanks or outside of Alaska.

Laura Wolff, the attorney representing the state, argued that Planned Parenthood had not sufficiently proved that patients seeking abortions in Alaska had been denied access to them because of the limit on who could perform them.

Camila Vega, an attorney representing Planned Parenthood, said the limit on who could perform an abortion violated Alaskans’ rights regardless of whether specific patients had been denied an abortion because of it.

“Contrary to what the state has represented, it is not Planned Parenthood’s burden to show that there is some minimum number threshold of patients that have been prevented from accessing abortion in order to show that this law infringes Alaska’s equal protection and privacy rights,” said Vega.

Rebecca Gibron, chief executive of Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana, Kentucky, said in a statement that Alaska’s “vast geography and severe health care shortages already make it difficult for people in Alaska to access timely, essential care.”

“Qualified clinicians are ready and able to provide abortion services safely. The State’s efforts to block them only deepen long-standing inequities and unnecessarily endanger patients,” Gibron said.

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