The Trump administration this week asked the U.S. Supreme Court to reverse a lower court ruling that allowed for mail-order and telemedicine abortion during the COVID-19 crisis.

U.S. Food and Drug Administration regulations require mifepristone, which is used in medication abortion, to be dispensed at a clinic, hospital or medical office. In June, U.S. District Judge for the District of Maryland Theodore Chuang blocked the requirements during the pandemic, finding them to be a "substantial obstacle." 

Mifepristone, in combination with misoprostol, is FDA-approved for abortions up to ten weeks' gestation. In 2017, a New England Journal of Medicine article argued against the FDA regulations for mifepristone, given the drug's safety record.  

WHY IT MATTERS  

Acting Solicitor General Jeffrey B. Wall applied for a stay of Chuang's injunction on Wednesday as the case makes its way through the lower courts, arguing that the regulations do not represent an undue burden.  

"The safety requirements here concern only medication abortions using Mifeprex, which is approved for use only during the first ten weeks of pregnancy. They have no effect on the availability of surgical abortions, a method that this Court has treated as safe for women," wrote Wall.  

Reproductive rights groups spoke out against the move, noting that people of color are disproportionately affected both by abortion restrictions and by the COVID-19 pandemic.  

"Black, Brown, Indigenous people and people of color are already dying/getting sick at disproportionate rates from COVID-19," said All Above All* on Twitter. "The Trump-Pence admin is trying to make this worse by asking SCOTUS to require people face unnecessary risk just to get abortion care."  

"The FDA’s in-person requirements on mifepristone subject patients to unnecessary exposure to a deadly virus, and two federal courts have already rejected the Trump administration’s argument. Forcing patients to travel to a health center to access the safe, effective medication they need especially hurts people of color and people with low-incomes, who already face more barriers to care," said Planned Parenthood Federation of America President and CEO Alexis McGill-Johnson in a statement.

THE LARGER TREND  

The COVID-19 pandemic has exacerbated many existing barriers to care, including for reproductive health services.   

"We’ve seen the undue burden and hardship these restrictions create during COVID-19, especially in communities hit hardest by the pandemic," said Skye Perryman, chief legal officer at the American College of Obstetricians and Gynecologists, a coplaintiff in the telemedicine case, to Healthcare IT News.   

In response to the July ruling, some abortion providers reportedly moved to delivering mifepristone by mail.  

Still, others faced state laws that restricted the provision of abortion via telemedicine.

And as Dr. Jacquelyn Yeh from Physicians from Reproductive Health pointed out in July, telemedicine itself involves hurdles such as broadband access and privacy concerns.  

It remains to be seen whether the Supreme Court will grant the Trump administration's request.  

ON THE RECORD  

"As COVID-19 ravages Black, Latino, Indigenous, and other communities of color across the country, the Trump administration should be aiming to keep us healthy – not moving forward with an agenda to endanger people who seek abortion," said McGill-Johnson.

Kat Jercich is senior editor of Healthcare IT News.

Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.