New York Passes Bill to Shield Abortion Providers Sending Pills to States With Bans

The New York legislature on Tuesday finalized a bill that would provide legal protection for New York doctors who prescribe and send abortion drugs to patients in states where abortion is illegal.

The measure, along with similar new laws in several other Democratic-controlled states, will allow more patients in abortion-restricting states to conceive at home without traveling to states where abortions are legal. can be terminated, potentially greatly expanding access to medical abortion.

The New York bill is now in the hands of Governor Kathy Hochul, who has indicated that she supports the idea of ​​such a shield law. The bill would allow New York courts to prosecute, sue, or otherwise penalize New York health care providers who provide telemedicine abortions to patients in a state that prohibits abortion. And the authorities have stipulated that they will not cooperate. Conforms to New York law. After passing the Senate by a 39-22 vote last month, the bill passed the state legislature by a 99-45 vote on Tuesday night.

Since the Supreme Court overruled abortion rights nationwide last year, legislation known as the Telemedicine Abortion Protection Act has been enacted in Massachusetts, Colorado, Vermont and Washington. But the New York bill is expected to have a noticeable impact. Several health care providers in New York state have said they plan to send abortion pills to patients in all restricted states, and while a few have spoken out publicly, there are no protection laws. Other states have not so far.

“As soon as the governor signs the bill, we will be mailing the drugs,” said Dr. Linda Prine, a New York State physician and co-founder of the Abortion and Abortion Hotline, which answers patient questions about medical abortion. . “This is the first time we can do anything to fight back,” she added.

Dr. Prine said she and at least three other doctors plan to mail the pills to patients in all states where it is restricted or banned. New York telemedicine service Juniper Midwives also said it wants to use the shield method to mail pills to patients in states where abortion is prohibited.

“That’s definitely something we want to explore and achieve,” said Jillian Balovic, a midwife and co-founder of Juniper.

Abortion is now outlawed in most of the 14 states. But most bans punish those who facilitate abortions, not those who take abortion drugs.

Currently, more than half of abortions in the United States are performed medically using two drugs, mifepristone and misoprostol. Data show the process is safe and effective.

Anti-abortion advocates are challenging the Food and Drug Administration’s 23-year-old approval of mifepristone in a lawsuit expected to be decided by the Supreme Court, seeking to push mifepristone off the market. The lawsuit also challenges a 2021 FDA decision to allow patients to receive prescription drugs by mail.

Since the reversal of Roe v. Wade, tens of thousands of patients have taken abortion drugs in states with bans or severe restrictions. Many people traveled to states where abortion was legal and got the pills from a doctor’s office or at a state address where the pills were mailed. However, many patients cannot afford the cost of travel and time.

“The protection of telemedicine options and providers of telemedicine abortion services will be of tremendous help to people here in Mississippi and in other restricted states,” says Mississippi Reproductive said Michelle Colón, executive director of SHERo Mississippi, an organization focused on supporting the rights of children. colour. “This expands the access we desperately need.”

Other patients receive their tablets by mail from abroad, either prescribed by doctors abroad through telemedicine services in Europe or ordered directly from online pharmacies in India and elsewhere. By the time the tablets arrive, often after 2-3 weeks, the patient may be past the 12th week of pregnancy threshold. Endorsed by the World Health Organization To use medical abortion. Mailing the pills from within the United States, as doctors working under the Shield Act do, cuts delivery times to days.

The Telemedicine Shield Act does not guarantee full legal protection for healthcare providers. Under the law, New York would refuse to extradite a doctor like Dr. Prine to a proscribed state if it issued an arrest warrant. But if she traveled there or to another state that agreed to her extradition, she could face criminal charges.

“Texas could prosecute them for murder,” said former Texas Attorney General, banning abortions after six weeks of pregnancy and asking private citizens to seek a $10,000 cash sentence per abortion. Jonathan Mitchell, the drafter of the 2021 Texas law whose enforcement will be delegated, said. .

“Under Texas law, killing a fetus through illegal abortion is no different than killing an infant, except that the mother cannot be prosecuted (or sued) for fetal death,” Mitchell said in an email. Stated.

Only about 10 health care providers in shield-law states are known to have started sending pills to patients in abortion-restricting states because of the significant risk. These providers are working cautiously.

“Most of the people who have used the Shield Act so far have only stepped into states that don’t have as many lawsuits, but I think we need to start applying it to everyone,” he said. A doctor in Hudson Valley, New York, who plans to send pills under the new shield method, spoke on condition of anonymity because of the risks involved.

Other abortion providers are interested in using the shield method if they can send prescriptions to pharmacies who will mail the drugs to them rather than stocking and shipping them themselves. If California enacts a telemedicine abortion shield bill, that option could become available in the coming months. passed it State Senate last month. Honeybee Health, an online pharmacy based in California, hopes to use the law to deliver to all 50 states, said Jessica Knowhavandi, co-founder and president of Honeybee.

“We look forward to the passage of the California Shield Act,” she said.

As providers test state telemedicine shield laws, many legal issues could arise, including potential civil lawsuits and challenges to providers’ medical licenses for unauthorized medical practice.

“It doesn’t matter if the provider can challenge it in court,” said Rachel Lebouchet, dean of Temple Law School. written I support shield law. “It’s a matter of when.”

Attorneys on each side of the issue say the shield law undermines the basic premise of interstate cooperation. Instead of approving an arrest warrant or court order in one state, another state effectively interferes with the enforcement of that state’s laws.

A law protecting telemedicine abortion would also disrupt the usual model of telemedicine law and policy “that is premised on providing care where the patient is,” Lebouchet said.

For example, when treating a patient in Texas, a New York doctor usually first obtains a Texas medical license. If a doctor practiced without a doctor, New York would normally help Texas initiate disciplinary proceedings through the medical board. Without a shield law, out-of-state rulings could affect New York’s medical license.

Additionally, in some cases, the U.S. Constitution requires each state to enforce the civil judgments of other states.New York abortion workers could be sued In Texas, for example, families of abortion patients have filed claims for damages for fetuses and wrongful death of fetuses. If the plaintiff wins, the Constitution’s full trust and credit clause could oblige New York to comply with the damages claim.

“It’s clear that in other states, citizens can still sue doctors who practice illegal medicine,” said the Alliance to Defend Liberty, a conservative Christian law group calling for the removal of anti-abortion plaintiffs. Senior Counsel Dennis Haar said. Lawsuit Against FDA Gets Mifepristone From Market “They can sue to protect against bad behavior by people who are committing crimes.”

Arranging malpractice insurance can also be difficult. However, New York’s Shield bill states that insurance companies cannot fire or penalize health care providers who provide abortions under New York law.

To date, there are no known instances of prosecution, lawsuit, or other lawsuit against health care providers operating under the Telemedicine Abortion Protection Act. Dr. Prine and others said they were prepared to be guinea pigs, but they were also taking steps to protect themselves.

Most health care providers using shield laws say they avoid traveling to states where abortion is prohibited. Dr. Prine said he would also make sure to avoid connecting flights at airports where restrictions are in place.