On Wednesday, the U.S. Department of Health Human Services (HHS) issued guidance to approximately 60,000 retail pharmacies stating that as recipients of federal financial assistance, they are obligated to supply prescribed medications for reproductive health care. Pharmacies could risk violating civil rights law if they refuse to fill prescriptions for medication used in abortions. This comes after the Supreme Court overturned Roe v. Wade and Planned Parenthood v. Casey in the case Dobbs v. Jackson Women’s Health Organization.
The four-page guidance outlines several different scenarios where a pregnant woman would need to obtain “ comprehensive reproductive health care services” from a pharmacy. Some examples include obtaining birth control, such as Plan B, the birth control ring, the pill or the patch.
In addition, the guidance explains that pharmacies must fill prescriptions of mifepristone and misoprostol, the two medications used to terminate a pregnancy through a medication abortion. The former cuts off progesterone from allowing the pregnancy to grow while the latter expels the pregnancy from the woman’s body.
In the guidance, the HHS wrote that these medications are used for miscarriages and stomach ulcers. It also noted that some antibiotics are used ahead of a surgical abortion and others are used to stop an ectopic pregnancy. Refusal to fill these prescriptions, the HHS notes, is discrimination based on sex or disability.
– An individual experiences an early pregnancy loss (first-trimester miscarriage) and their health care provider prescribes pretreatment with mifepristone followed by treatment with misoprostol to assist with the passing of the miscarriage. If a pharmacy refuses to fill the individual’s prescription—including medications needed to manage a miscarriage or complications from pregnancy loss, because these medications can also be used to terminate a pregnancy—the pharmacy may be discriminating on the basis of sex.
– An individual experiences severe and chronic stomach ulcers, such that their condition meets the definition of a disability under civil rights laws. Their gastroenterologist prescribes misoprostol to decrease risk of serious complications associated with ulcers. If the pharmacy refuses to fill the individual’s prescription or does not stock misoprostol because of its alternate uses, it may be discriminating on the basis of disability.
– An individual presents to a hospital emergency department with chills, fever, and vaginal bleeding. The treating physician diagnoses a miscarriage complicated by a uterine infection (known medically as a septic abortion) and orders an antibiotic. If the hospital pharmacy refuses to provide the antibiotic required for treatment because of concern that subsequent care may include uterine evacuation (via medical or surgical abortion), the pharmacy may be discriminating on the basis of sex.
– An individual who has been undergoing fertility treatments receives a positive pregnancy test. After the individual expresses concern with symptoms associated with an ectopic pregnancy, their medical provider performs an ultrasound to determine where the pregnancy is developing. The ultrasound indicates the fertilized egg is growing in a fallopian tube. The medical provider orders methotrexate to halt the pregnancy. If a pharmacy refuses to fill the prescription because it will halt the growing of cells and end the pregnancy, it may be discriminating on the basis of sex.
– An individual with rheumatoid arthritis, such that their condition meets the definition of a disability under civil rights laws, is prescribed methotrexate by their physician’s assistant as a standard immunosuppressive treatment. If the pharmacy refuses to fill the individual’s prescription or does not stock methotrexate because of its alternate uses, it may be discriminating on the basis of disability
– An individual presents a prescription for an emergency contraceptive at their local pharmacy after a sexual assault to prevent pregnancy. If the pharmacy otherwise provides contraceptives (e.g., external and internal condoms) but refuses to fill the emergency contraceptive prescription because it can prevent ovulation or block fertilization, the pharmacy may be discriminating of the basis of sex.
– An individual’s health care provider sends the individual’s prescription for hormonal contraception (e.g., oral contraceptive pill, emergency contraception, a patch placed on the skin, a contraceptive ring, or any other FDA-approved contraceptive product) to a pharmacy. If the pharmacy otherwise provides contraceptives (e.g., external and internal condoms) but refuses to fill a certain type of contraceptive because it may prevent a pregnancy, the pharmacy may be discriminating on the basis of sex.
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In a press release, HHS Secretary Xavier Becerra said that “we are are committed to ensuring that everyone can access health care, free of discrimination,” and that “includes access to prescription medications for reproductive health and other types of care.”
In the release, the Department boasted about all the ways it is working on a pro-abortion agenda. This includes funneling $3 million to fund training and assistance to a network of Title X family planning providers and meeting with pro-abortion governors and state attorneys general to discuss state-by-state abortion access.
I reported this month how the HHS unveiled a new website, ReproductiveRights.gov, which directs women, including minors, to resources to obtain an abortion. For those under 18, the website AbortionFinder.org directs them to a separate website to help them obtain a judicial bypass to get an abortion without parental notification and consent. It directs women to get their abortions funded through the National Network of Abortion Funds.
This week, the Department of Justice launched a Reproductive Rights Task Force to work on issues to protect access to abortion.
“The Court abandoned 50 years of precedent and took away the constitutional right to abortion, preventing women all over the country from being able to make critical decisions about our bodies, our health, and our futures,” Assistant Attorney General Vanita Gupta said in a statement provided by the DOJ. “The Justice Department is committed to protecting access to reproductive services.”
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