Ohio legislature passes ban on abortion via telehealth
The Ohio state legislature passed a bill this past week that would ban using telemedicine to provide abortions. Regarding the bill's implications, if Republican Gov. Mike DeWine signs the bill into law, as he is expected to do, Ohio will become the 20th state that requires a prescribing clinician to be in the presence of a patient when providing abortion medication.
Impact on Access and Communities
Advocates have noted that abortion restrictions, such as the ban on telehealth, disproportionately affect communities of color, low-income people and others who are already reeling from the effects of the COVID-19 pandemic. Highlighting the timing of this decision, NARAL Pro Choice Ohio’s Jaime Miracle stated: "In the middle of a pandemic, when we are encouraging people to stay home and not travel, to pass a bill limiting access to telemedicine and further limiting access to abortion takes a whole new level."
Medication safety and regulatory context
From a medical perspective, mifepristone, in combination with misoprostol, is FDA-approved for abortions up to 10 weeks' gestation. Studies have shown that although mifepristone's safety record is superior to that of penicillin, it is more heavily restricted than opioids such as fentanyl. The following table summarizes the data regarding medication abortion regulations mentioned in the draft:
| Metric | Details from Material |
|---|---|
| FDA Approval | Up to 10 weeks' gestation |
| Safety Comparison | Superior to that of penicillin |
| Restriction Level | More heavily restricted than opioids such as fentanyl |
| State Requirement | Ohio would become the 20th state to require in-person clinician presence |
Federal Legal Background
The bill's passage came the week after a federal judge declined to reinstate rules requiring patients seeking a medication abortion to visit a clinic or doctor's office in person during the pandemic. In his ruling, U.S. District Judge for the District of Maryland Theodore Chuang noted that his July preliminary injunction relaxing the in-person requirements is not an open-ended one; rather, it is slated to end 30 days after the end of the public health emergency declared by U.S. Secretary of Health and Human Services Alex Azar.
In October, the U.S. Supreme Court had sent the case back to Chuang to consider the Trump administration's request to "dissolve, modify, or stay the injunction, including on the ground that relevant circumstances have changed." However, wrote Chuang, "at the present time, the conditions across the United States are universally critical, such that there is no basis to exclude certain states or regions based on favorable conditions in those locations."
The Larger Trend in Healthcare IT
Reproductive health has posed an interesting challenge in the age of increasing reliance on telemedicine, with apps such as Nurx and Pandia Health rising to fill the gap for patients who rely on birth control. And when it comes to abortion, providers told Healthcare IT News in July that they had already shifted much of their practice – such as counseling – over to telehealth in the interest of patient safety.
The ruling this summer meant that many patients won't have to come into the office at all. In Illinois, for example, Dr. Colleen McNicholas explained that "now we can mail you your medication and help keep you safe" from potentially contracting the coronavirus.