This past month, a new law in Texas went into effect requiring physicians to examine patients in person before providing abortion medication and banning the delivery of such medications by mail.  

Abortion via telemedicine was already prohibited in the state, as reported by NPR. But violating the new law, SB 4, is considered a state jail felony – meaning providers who are convicted could face between 180 days and two years in prison, and a fine of up to $10,000.

The new law notes that patients who use telemedicine for abortions are not criminally liable although some states have prosecuted individuals under other laws after they obtained abortion medication online.   

WHY IT MATTERS  

The new law bans physicians from providing abortions past 49 days' gestation – similar to Texas' SB 8, passed earlier this year, which restricts abortions beyond approximately the six-week mark in pregnancy.  

As advocates and researchers have pointed out, many individuals do not realize they're pregnant until after six weeks.   

The Food and Drug Administration has also approved abortion medications for up to 10 weeks' gestation.   

Additionally, despite revised regulations from the agency that enable abortion via telehealth nationwide, legal experts told local outlets that state laws overrule the new policy.  

"The federal policy permits these drugs to be mailed, but doesn't require states to allow them to be mailed," said legal expert Josh Blackman of the South Texas College of Law Houston to the Fort Worth Star-Telegram. "The status quo will remain the same in Texas."   

Meanwhile, other experts said that Texas may face difficulty in enacting laws that reach beyond the state. "Mail is regulated by the federal government," said lawyer David Coale to ABC affiliate KVUE. "So, from the minute it goes in the mail to when it gets to the mailbox, that's a matter of federal law. Now, once you open the mailbox and take it out … an issue of state law comes up."   

Eighteen other states also require in-person provision of abortion medication.  

THE LARGER TREND  

In general, telehealth policies during the pandemic have been shaped in part by state laws, in lieu of permanent action from Congress.  

For instance, a June 2021 study from the Commonwealth Fund found that nearly two dozen states had altered telemedicine laws during the COVID-19 pandemic.

Although the vast majority (with a few exceptions) had moved to expand telehealth access, most had also pursued change via administrative action – meaning the solutions may not be permanent after the public health emergency.  

ON THE RECORD  

"We can't lose sight that despite the FDA's decision, state laws – including in Texas – still ban access to medication abortion through telehealth or by mail, and will prevent patients from getting the healthcare they need," Sen. Patty Murray, D-Washington, said in a statement this past December.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.