The passage of a major bill in Texas threatens the national safety net that has allowed tens of thousands of Americans to get around abortion bans.
House Bill 7 targets health care providers in states like California, New York and Massachusetts who have, since the fall of Roe v. Wade, used telehealth to prescribe abortion pills. Interacting with patients virtually, those providers never leave their home states, which have laws explicitly protecting them from out-of-state prosecution. Those protections hold even if the patient is located in a state with a ban, like Texas. Only eight states — California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington — have those protections in place for health providers.
HB 7 gives anti-abortion activists a new tool that heightens the risk for medical professionals. It says any private citizen can bring a civil lawsuit, with a minimum payout of $100,000, against anyone who makes medication abortion available to a Texan. That includes prescribing, mailing and distributing pills. The bill’s authors have also said it would allow suits against drug manufacturers.
The Texas bill is yet to be signed by the state’s Republican Gov. Greg Abbott and would not take effect until the first week of December. But if it successfully lowers the number of abortions done in Texas, it’s likely to inspire similar legislation in other states with bans.
“We need to be thinking about this as a blueprint,” said Jessica Waters, a legal scholar at American University who specializes in reproductive rights. “Texas is taking this unprecedented action. It’s the first of its type to really target out-of-state abortion providers, and I think we will see more states do this.”
Some experts and shield law providers told The 19th that the bill could stop some abortion pills from being mailed to Texas. The legal risks to shield law providers mean that relatively few health professionals offer telehealth abortions to people in states like Texas — amplifying the possible consequences if any decide to stop.
“There probably will be some shield providers who stop sending pills into Texas because of the law, because they’re taking great personal risk to do so,” said Elisa Wells, who runs the website Plan C, a clearinghouse of telehealth abortion options.
Already, the election of President Donald Trump has deterred some health providers from offering telehealth abortions to people living under bans, said Rebecca Nall, who runs the website INeedanA, a comprehensive database of abortion providers.
Some policy analysts argued that if HB 7 drives out just a few more health providers, it could seriously limit who in Texas can get abortions.
“Even if it’s just a small impact on the availability of care or availability of medication abortion in the state, it can have a really big impact,” said Kimya Forouzan, who tracks state policy for the Guttmacher Institute, which supports abortion rights.
A week before the bill’s passage, one California-based telehealth provider told The 19th that the recent onslaught of lawsuits against providers has left her increasingly unsure of how long she will be able to continue offering abortions to people in other states. She declined to speak further after HB 7 passed.
“Every day it feels like it’s very tenuous,” said the doctor, who asked that her name be withheld because of the risk of incurring a lawsuit. “It feels like things are ramping up.”
Debra Lynch, a nurse who runs the shield law practice called Her Safe Harbor, said she is now in regular communication with other health professionals who worry HB 7 will make it too dangerous to continue offering telehealth abortions to Texans, despite the protections of their state laws.
“We’re hearing from other providers that have large on-the-ground practices: Is it worth it for them to continue to take this risk by providing a telehealth service, if it’s going to pose a risk to their on-ground practice?” she said. “They’re concerned. If they continue to do the telehealth abortion, is that going to, through civil action, pose a big threat to their ability to maintain their in-person clinics?”
Still, several shield law providers said that they intend to continue offering telehealth abortions to Texans, even after the new legislation takes effect.
“We’re talking with lawyers and other stakeholders, but right now we don’t anticipate changing anything about our practice,” said Dr. Angel Foster, who runs the Massachusetts Medication Abortion Project. “We believe our shield law protects us from these civil lawsuits.”
Health providers are only one component of the telehealth abortion ecosystem, and it’s not yet clear how others, such as drug distributors or pharmaceutical manufacturers, will react to the threat of new financial penalties. Both Danco and GenBioPro, the two main U.S. manufacturers of one of the key drugs used in medication abortions, declined to comment on how they intend to respond to HB 7.
That said, “the legislation is aimed at disincentivizing online pharmacies and manufacturers from sending medications into the state altogether,” said Nimra Chowdhry, senior state legislative counsel for the Center for Reproductive Rights.
John Seago, the head of the anti-abortion group Texas Right to Life, said in a statement that he believes HB 7 can offer a blueprint for other states seeking to block telehealth abortions. The largest state to ban abortion, Texas has for more than a decade served as a testing ground for restrictive policies that, when effective, have been copied around the country. Texas was also the first state to outlaw most abortions, enacting a six-week ban in 2021 — months before the Supreme Court’s decision to overturn Roe.
Despite sustained pressure from national abortion opponents, the White House has not taken action to block telehealth abortions. If this law is effective at doing so — a key goal for abortion opponents, who remain frustrated over the large swath of patients still able to access care — similar legislation is likely to emerge in conservative-led statehouses across the country.
“It certainly is a shot across the bow, to be very public and loud about taking on shield laws and ending mailed medication abortion in the state of Texas,” said Rachel Rebouché, a professor of law at the University of Texas Austin. “I’m not sure it changes what’s happening yet — and that’s what I think we’re all waiting to see.”
Abortion opponents across the country have been focused on finding a way to stop telehealth abortions. Dr. Margaret Carpenter, a New York-based physician, is a defendant in criminal and separate civil lawsuits put forth by the Louisiana and Texas attorneys general. Two Texas individuals — both represented by the anti-abortion lawyer Jonathan Mitchell, who helped craft HB 7 — have also filed wrongful death suits against out-of-state health care providers. One suit targets California-based Dr. Remy Coeytaux, and the other is against the telehealth organization Aid Access.
Lawmakers from states with shield laws have suggested that they will defend organizations and individuals making telehealth abortions available to Texans.
A spokesperson for California Attorney General Rob Bonta said that state’s chief law enforcement officer “stands ready to enforce California’s robust laws that protect patients, providers, and those assisting in abortion access.” This week, New York Attorney General Letitia James intervened in a Texas-based lawsuit that argues the Empire State’s shield law is unconstitutional.
Texas lawmakers are divided on whether their new bill passes constitutional muster, with several state Democrats arguing that its provisions could violate the U.S. and state constitutions. And abortion opponents disagree on how successful it will be in stopping telehealth abortions.
Seago said in a statement that the bill is “the most effective Pro-Life defense against out-of-state companies and activists that send abortion pills to Texas.” But another anti-abortion activist, Texans for Life head Kyleen Wright, called it “vastly oversold” in its ability to halt telehealth. She pointed out that Texas law already offers a mechanism to sue people who help residents get abortions — the six-week abortion ban that took effect in 2021 — but that nobody has used that law’s civil suit offering to try to block telehealth.
In Texas, women like Raquel are grappling with what the end of telehealth would mean. The mother of two living near Houston discovered last fall that she was pregnant, despite using contraception. She feared for her life — the last time she had given birth, her postpartum depression had been so powerful that she had required hospitalization.
“I never want to be back in that situation where I wanted to end my life because of how I felt — I couldn’t do that to my children, I couldn’t do it to my husband, I couldn’t do it to my family in general,” she said. “It was life or death.”
Raquel, who asked to be referred to by her middle name because few people know about her abortion, ordered medication from Aid Access. Beyond talking with someone at the organization, Raquel discussed her decision with her doctor and her therapist. Her husband, whose job often requires months of travel at once, took time off from work to stay home with her during the abortion.
But even without a telehealth option, she said, she would have found a way to end her pregnancy: driving 15 hours to Colorado, or finding a way to Mexico for care. She expressed anger about the state’s effort to eliminate that path — and fear about what it could mean for other people in situations like hers.
“It pisses me off because it’s really nobody’s business but your own,” she said. “And it’s sad because now these women — and potentially me — we have to go through twice as much to receive care if that’s what we so choose to do. And that’s just not right. It’s not fair, and we’re going backwards in time.”
Great Job Shefali Luthra & the Team @ The 19th Source link for sharing this story.
