Becerra: Support for medication abortion, travel and privacy, but there is no 'magic bullet' to ruling 

Photo: HHS.gov

 

The federal government will do all it can to protect Americans' reproductive rights, but there is no "magic bullet" to Friday's Supreme Court ruling overturning Roe v. Wade, Health and Human Services Secretary Xavier Becerra said Tuesday.

HHS will support access to medication abortion, safe travel to states that allow abortions, and health privacy.

"There is no magic bullet," Becerra said. "But if there is something we can do, we will find it and we will do it at HHS. Indeed, that was the instruction I received from the president of the United States."

HHS has been preparing for the ruling for some time and formed a Reproductive Access Task Force, Becerra said. Yet legal questions remain about protection from criminal prosecution or access to travel vouchers.

Last Friday's ruling left abortion decisions to states. There's been legal wrangling in several states, and judges have temporarily blocked abortion bans in Louisiana and Utah, according to NPR. An estimated 13 states have trigger laws to enact bans following the Supreme Court's decision. 

In all but 20 states and the District of Columbia, abortion is banned, will soon have severe restrictions or is threatened, according to The Guardian.

Much of the question of access has centered on medication abortion, pills such as Mifepristone that can be obtained by mail, and the ability to travel to states where an abortion is legal.

President Joe Biden said after the Supreme Court's decision that the ruling does not prevent a person from traveling to another state to receive an abortion, and it does not prevent a doctor in that state from treating the person. His administration will also protect a woman's access to medications that are approved by the Food and Drug Administration. The FDA approved Mifepristone 20 years ago to end early pregnancies safely and is commonly used to treat miscarriages, he said.

Becerra said he is working with the U.S. Attorney General and the Department of Justice as they work to ensure that states may not ban medication abortions based on a disagreement with the FDA's expert judgment about the drug's safety and efficacy.

"Working to increase access to this drug is a national imperative," Becerra said.

The drugs are available for prescription, but precisely what this means is unclear as some states want to ban or severely restrict access to these medications.

"We will stay within the confines of the law," Becerra said. "They are available to be prescribed. Under what conditions, stay tuned."

It also raises privacy concerns in states that may be looking to track who is ordering the abortion pill.

Becerra said HHS and the administration will do what is necessary to protect privacy and prevent having data leaked. 

"We will enforce any violations of those rights," he said.

Also, he said, "We will make sure if a state is utilizing federal funds, that they respect the laws at the federal level. [There is] misinformation out there over what the Supreme Court did."

WHY THIS MATTERS

Since the ruling, abortion pills, or medication abortion, are becoming even more sought after, as they are less expensive and less invasive than surgical abortion, according to Dr. Darshak Sanghavi, former member of the Obama administration and currently global chief medical officer at Babylon. 

States banning medication abortion will find it is difficult to monitor the sending and receiving of pills via mail, he said. It will be difficult to track those receiving pills through the mail or traveling to a state where pills are legal to have a consultation and pick them up. 

"We are seeing medication abortion providers across the country ramp up efforts to accommodate the increase in demand from patients seeking abortion pills and the Biden administration vowing to protect the right to take medicines that have been approved by the federal government," Sanghavi said.

Nineteen states have passed laws barring the use of telemedicine for abortion, with Texas enacting a law prohibiting sending abortion pills through the mail. 

For virtual consultations, the patient must participate from a state that allows abortion, where the IP address of the computer or phone will allow the clinic to identify the patient's location, according to Sanghavi. 

States such as New York provide virtual care abortions for those neighboring states that are not able to get access to abortion pills, he said. For those able to travel to state borders or alter their IP address, they will do so, but for those unable to afford the rising costs of gas and take the time to travel, it will be extremely difficult to access these pills, he said.

THE LARGER TREND

Biden on Friday said he is directing the Department of Health and Human Services to take steps to ensure the abortion medications are available to the fullest extent possible and that politicians cannot interfere in decisions made between a woman and her doctor.  

HHS is taking several steps, including directing the department to examine its authority under the Emergency Medical Treatment and Labor Act (EMTALA) to ensure that clinical judgment of doctors and hospitals is supported in treating pregnant patients, including those experiencing pregnancy loss or complications, and reaffirming that abortion care can be appropriate to stabilize patients.

For ER physicians, this could become complicated when they are required to perform lifesaving abortions, according to Greer Donley, assistant professor at the University of Pittsburgh Law School. 

ON THE RECORD

"This is a critical moment in history," Becerra said. "How we respond will speak to how we view the rights, dignity and well-being of women everywhere. This is a moment of crisis in healthcare. We will leave no stone unturned. All options are on the table. We will do everything within the legal limit of the law to reach patients and support providers."
 

Twitter: @SusanJMorse
Email the writer: SMorse@himss.org