HHS sends letter to governors on reproductive rights, including abortion

HHS Secretary Xavier Becerra

Photo: Alex Wong/Getty Images

The U.S. Department of Health and Human Services has taken action to strengthen access to reproductive healthcare the day after trigger laws went into effect in three states to ban abortions. 

On Friday, HHS Secretary Xavier Becerra and the Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure announced they had issued a letter to U.S. governors inviting them to work with the CMS and apply for a Medicaid 1115 waiver to provide increased access to care for women from states where they may be denied access to reproductive medical care. 

States interested in developing approaches that use federal funding are encouraged to engage with the CMS, Brooks-LaSure said. This includes applying for Section 1115 demonstration authority to expand access to care for women traveling from a state that has restricted or prohibited abortion.

Current or proposed state abortion restriction laws do not negate providers' responsibilities to comply with federal laws protecting access to emergency healthcare, the letter said. 

WHY THIS MATTERS

HHS issued the letter to states the day after trigger bans for abortion took effect in Tennessee, Texas and Idaho. These states join eight other states that have outlawed abortion since the Supreme Court overturned Roe v. Wade in June, according to The Guardian. Trigger laws took effect either immediately following the overturn of Roe or 30 days after the Supreme Court's transmission of its judgment, which took place on July 26, the report said.

A fourth state, North Dakota, had its trigger ban blocked Thursday by a judge who is weighing an abortion clinic's legal challenge on grounds that it violates the state constitution, according to AP.

The letter comes just days after a federal court granted a preliminary injunction restraining and enjoining the State of Idaho from enforcing Idaho's anti-abortion law in situations where an abortion is a necessary stabilizing treatment for an emergency medical condition. 

Earlier this month, the U.S. government filed a lawsuit alleging that Idaho's anti-abortion law, which went into effect this week, directly conflicts with the federal Emergency Medical Treatment and Labor Act (EMTALA). 

THE LARGER TREND

HHS said Friday it had also issued a report and plan of action in response to the Dobbs v. Jackson Women's Health Organization Supreme Court decision. 

The "Secretary's Report: Health Care Under Attack: An Action Plan to Protect and Strengthen Reproductive Care" reiterates former guidance for hospitals and other providers in reaffirming EMTALA. The Act protects providers when offering legally mandated, life- or health-saving abortion services as stabilizing care for emergency medical conditions, HHS said.

HHS also launched the ReproductiveRights.gov public awareness website and a Know-Your-Rights patient fact sheet to help patients and providers.

The actions support President Biden's Executive Order 14076, Protecting Access to Reproductive Health Care, and Executive Order 14079,  Securing Access to Reproductive Health Care, HHS said.

In July, HHS issued a proposed rule to strengthen regulations interpreting the nondiscrimination provision of the Affordable Care Act and said it would reinforce that discrimination on the basis of sex, including discrimination on the basis of pregnancy or related conditions, is prohibited.

HHS issued guidance to roughly 60,000 U.S. retail pharmacies, clarifying their obligations under federal civil rights laws. It also issued guidance that clarifies to patients and providers the extent to which federal law and regulations protect individuals' private medical information when seeking abortion and other forms of reproductive healthcare, as well as when using apps on smartphones.

In June, with the Departments of the Treasury and Labor, HHS convened a meeting with health insurers and sent them a letter, calling on the industry to commit to meeting their obligations to provide contraceptives as required by the ACA. Later, in response to this conversation, the departments issued guidance to clarify protections for birth control coverage under the ACA. Under the ACA, most private health plans are required to provide birth control and family planning counseling at no additional cost.

ON THE RECORD

"Since the Supreme Court's decision in Dobbs, we have seen the gut-wrenching stories of women suffering and not getting the care they need because of newly enacted laws that restrict abortion care," said HHS Secretary Becerra. "We have also seen state legislatures try to mislead women by saying they're protecting patients while also making it a crime to provide abortion care. At my request and at President Biden's direction, HHS has been and will continue to take concrete action, like today's invitation to states, that will protect women's access to reproductive care, including abortion."

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