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Just days after the Biden Administration advised providers that abortions are protected under the federal Emergency Medical Treatment and Labor Act, the Department of Health and Human Services has released guidance saying that as recipients of federal financial assistance – including Medicare and Medicaid payments – pharmacies are obligated to provide reproductive healthcare services without discrimination.
The administration said this week that pharmacies are prohibited under law from discriminating based on race, color, national origin, sex, age and disability in their programs and activities. This includes supplying prescribed medications; making determinations regarding the suitability of prescribed medications for a patient; and advising a patient about prescribed medications and how to take them.
HHS framed the guidance as a step forward in its attempt to protect reproductive healthcare.
Under Section 1557 of the Affordable Care Act, recipients of federal financial assistance cannot exclude an individual from participation in their programs and activities based on race, sex, national origin, age or disability, and cannot deny them the benefits of such programs.
Under federal civil rights law, pregnancy discrimination includes discrimination based on current pregnancy, past pregnancy, potential or intended pregnancy, and medical conditions related to pregnancy or childbirth.
WHAT'S THE IMPACT?
The guidance comes in light of the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, which effectively overturned the Roe v. Wade precedent that had protected abortion access for 49 years.
Since the Supreme Court decision, HHS and the administration have taken a number of actions meant to ensure access to reproductive healthcare. It launched the ReproductiveRights.gov public awareness website, which includes a know-your-rights patient fact sheet, and convened a meeting with health insurers and sent them a letter, calling on the industry to commit to meeting their obligations to provide coverage for contraceptive services at no cost as required by the Affordable Care Act.
The agency also issued guidance to patients and providers that addresses the extent to which federal law and regulations protect individuals' private medical information when it comes to seeking abortion and other forms of reproductive healthcare, as well as when it comes to using health information apps on smartphones.
On top of that, HHS announced nearly $3 million in new funding to bolster training and technical assistance for the nationwide network of Title X family planning providers; and met with Michigan Governor Gretchen Whitmer, Oregon Governor Kate Brown, and Maine Governor Janet Mills and state attorneys general to discuss state-specific concerns.
Just this week, the agency issued guidance on the Emergency Medical Treatment and Active Labor Act (EMTALA), reaffirming that it protects providers when offering legally mandated, life- or health-saving abortion services in emergency situations.
THE LARGER TREND
The Supreme Court ruling striking down Roe v. Wade has implications for health insurance coverage, according to healthinsurance.org.
The ruling that unwinds close to 50 years of a woman's right to an abortion now leaves that decision to individual states. An estimated half of them already have abortion restrictions in place or are expected to implement restrictions.
"With Roe v. Wade overturned, abortion access will vary more sharply from one state to another," said Louise Norris, an analyst with healthinsurance.org, said in a statement. "State-level variations were already the norm for health insurance coverage of abortion, particularly for health plans purchased by individuals and small groups. States that will now ban abortions were generally the same states that already prohibited abortion coverage on health plans purchased in the exchange or even on all private state-regulated health plans."
For the time being, she said, most health plans in all states will continue to provide coverage for FDA-approved female contraception, including sterilization, long-acting contraception (such as IUDs and implants) and emergency contraception.
Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com