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Federal officials on Wednesday warned pharmacies to comply with civil rights law amid reports of pharmacists turning away women seeking to fill prescriptions for abortion drugs and other treatments following the Supreme Court’s overturning decision Roe v. Wade.
“As our nation faces another significant health care crisis, this guide aims to remind the approximately 60,000 retail pharmacies in the United States of the unique role that pharmacies play in providing access to comprehensive reproductive health services ,” according to Department of Health and Human Services guidelines.
Officials pointed to recent news and court documents detailing how pharmacists in states including Louisiana and Texas have refused to fill prescriptions for medical abortion, citing the Supreme Court ruling on Rowe and new state abortion restrictions take effect.
In the guidance issued Wednesday, officials cited federal civil rights laws, including provisions in the Affordable Care Act, which they say prohibit pharmacists from making their own decisions about the suitability of a prescribed drug for patients, as well as other situations they believe would represent discrimination of patients. For example, a woman who has suffered a miscarriage may be prescribed drugs such as mifepristone and misoprostol, and health officials have warned pharmacists not to refuse to fill these prescriptions.
“The Department is committed to improving maternal health — including for survivors of miscarriage — and vigorous enforcement of our civil rights laws is one way we plan to do that,” the guidance said. “Discrimination against pregnant people on the basis of their pregnancy or related conditions … is a form of sex discrimination.”
But the guidelines do not guarantee universal access to abortion drugs or represent new policy, focusing instead on the health department’s role in enforcing existing civil rights law. Health care providers who do not comply risk losing federal funding and incur financial penalties, officials have warned.
A senior health department official told reporters at a briefing that the decision to alert pharmacies was part of the government’s wider response to the abortion ruling.
“HHS is committed to ensuring that everyone has access to health care without discrimination,” the official said. “We believe today’s guidance helps take a step in that direction to provide assurances to patients, providers, and pharmacists and pharmacies that federal law can help protect that access to care.”
The official, who spoke on condition of anonymity under guidelines set by the administration, also said people who believe they have faced discrimination when seeking to fill prescriptions for abortion drugs can file formal complaints with the Office of Civil federal health agency rights.
The abortion ruling’s fallout has trapped patients seeking treatment for unrelated medical needs, according to cases cited by federal officials. For example, methotrexate is a drug commonly used to treat rheumatoid arthritis, but the drug is restricted in some states because it has been used off-label to cause miscarriages and terminate ectopic pregnancies, leading some pharmacists to refuse the drug to women lately weeks.
President Biden and his deputies have struggled to respond to last month’s abortion ruling, repeatedly touting other provisions they say should ensure access to reproductive health services. Administration officials earlier this week reminded doctors that under federal law they must terminate a pregnancy if it is necessary to stabilize a patient in a medical emergency.
Wednesday’s move was denounced as a federal overreach by Roger Severino, who led the health department’s civil rights division during the Trump administration and said it was appropriate for pharmacists to screen patients before filling prescriptions.
“It is an outrageous violation of our civil rights laws to say that abortion should be assisted by doctors and pharmacists in our nation,” Severino said.
Other experts praised the administration’s move and said it showed the strength of Section 1557 of the Affordable Care Act, a provision that prohibits discrimination in health care and was targeted under the Trump administration but was repeatedly cited by Biden officials on Wednesday when they pharmacies warned.
“The new guidance underscores the importance of civil rights protections like Section 1557 to ensure women and pregnant people have access to the care they need,” said Katie Keith, who serves as director of the Health Policy and Legal Initiative at the O’Neill Institute at Georgetown University Law Center.
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