Overall, Utah lawmakers want to promote the use of telemedicine in the state. But a new piece of legislation seeking to modernize various telehealth rules in the state also has another goal that has catapulted the bill into a debate: prohibit the use of telemedicine to prescribe medication to induce an abortion.

Introduced by Republican Representative Ken Ivory, the amendment bill HB 154 mainly works to clarify definitions surrounding reimbursement models for physicians providing telehealth services, but the end of the bill specifically states practitioners “may not issue a prescription through electronic prescribing for a drug or treatment to cause an abortion, except in cases of rape, incest or if the life of the mother would be endangered without an abortion.”  

The bill moved from the House Public Utilities, Energy, and Technology Standing Committee and is onto the full House, where it is expected to pass in the majority Republican legislature. If passed, Utah would be the 20th state in the country that requires a doctor to be physically present when prescribing abortion-inducing medication.

The amendment is similar to bills that have recently been struck down in other states. Idaho recently stopped banning the use of telemedicine to provide abortion-inducing medication following the settlement of a lawsuit filed by Planned Parenthood, and that organization also won a similar lawsuit in Iowa in 2015 when the state Supreme Court ruled a 2013 rule preventing doctors from administering abortion-inducing medication via telehealth was unconstitutional.

The medication-inducing process – which is referred to as “medical abortion” (as opposed to surgical procedure), and must be done earlier in the pregnancy – consists of two medications. First taken is progesterone-blocking mifepristone, followed a couple days later by misoprostol. At the latest study, medical abortions accounted for about 22 percent of all abortions in the United States. The American College of Obstetricians and Gynecologists has supported the use of telemedicine to prescribe and counsel women who wish to choose this process.

“Medical abortion can be provided safely and effectively via telemedicine with a high level of patient satisfaction; moreover, the model appears to improve access to early abortion in areas that lack a physician health care provider,” the association writes. “Despite the medical evidence, several states have passed legislation that bans the use of telemedicine to provide abortion.”

While Ivory has reportedly said the provision was added to protect the health and safety of women, Democratic opponents of the bill said it would place undue restrictions on women who live in rural areas, which many in Utah do. According to the research organization Guttmacher Institute, which tracks reproductive issues, clinics providing abortion services in Utah have been on the decline since 2011, and 62 percent of women live outside a county with such a clinic.

Moreover, they took issue with the fact that a discussion of women’s reproductive health did not belong in the House Public Utilities, Energy and Technology Committee.

“It’s a health bill. Yes, it involves telehealth, but under that analysis all the health bills could be over here because we would be talking about technology in all of them,” Utah Public Radio reported Democratic Representative Patrice Arent as saying. “All of the hospitals I know have computers, for example.”