Topline
Retail pharmacies must fill prescriptions for drugs that can terminate pregnancies under federal civil rights law, the Department of Health and Human Services said Wednesday afternoon, as state-level abortion bans leave some patients unable to access key medication—including drugs that aren’t necessarily abortion-related.
A Publix pharmacy manager retrieves a bottle of antibiotics from the shelf on August 7, 2007 in ... [+]
Key Facts
The guidance from HHS’s civil rights office says any pharmacy that refuses to fill prescriptions for drugs that can end pregnancies may be discriminating on the basis of disability or sex, which includes pregnancy-related discrimination.
HHS offered a few examples of possible discrimination, like refusing to fill mifepristone, which is commonly used for medication abortions but also are prescribed to patients who have had a miscarriage, withholding a rheumatoid arthritis patient’s prescription to methotrexate because it can also induce miscarriages, and declining to fill drug prescriptions that were issued in connection to surgical abortions.
The agency also said pharmacies can’t refuse to fill prescriptions for birth control or emergency contraception because they could prevent pregnancies.
What We Don’t Know
HHS did not explain how—or whether—it plans to enforce this policy, or how pharmacists should contend with conflicting state laws. An unnamed federal official told several news outlets patients can file discrimination complaints with HHS.
Key Background
After the Supreme Court overturned Roe v. Wade last month, several states enacted near-total bans on abortion, including medication abortions, which advocates hope will remain more accessible since patients can receive the pills through the mail from other states. But state-level curbs on abortion medication are legally contentious. The Department of Justice says states can’t ban the abortion drug mifepristone because they disagree with the Food and Drug Administration’s decision to approve it, an argument also made by mifepristone’s manufacturer in a lawsuit against the state of Mississippi, but it’s unclear how the courts will rule on the issue or whether the federal government will take legal action. State laws have also created uncertainty about drugs that aren’t always used for abortion-related care. Some people with autoimmune conditions have reported difficulty getting methotrexate because of its alternate use to terminate pregnancies, and a Texas doctor told Slate some pharmacists are wary of filling prescriptions for misoprostol—which is used for stomach ulcers but is also prescribed alongside mifepristone for medication abortions—due to state laws.
Tangent
This is the second time this week HHS has issued guidance to healthcare providers grappling with state-level abortion bans. On Monday, the agency said federal law requires hospitals to offer abortions in life-threatening and emergency situations regardless of state law.
Further Reading
