The U.S. Department of Health and Human Services’ Office of Civil Rights sent guidance to more than 60,000 pharmacies across the country with a reminder that under federal civil rights law, discrimination on the basis of pregnancy is a form of sex discrimination and this is illegal.
“We are committed to ensuring that everyone has access to health care, without discrimination,” HHS Secretary Xavier Becerra said in a press release on Wednesday. “This includes access to prescription drugs for reproductive health and other types of care.”
Federal law applies to any pharmacy that receives federal financial assistance, even through Medicare and Medicaid payments.
A senior HHS official said Wednesday that the Office of Civil Rights has received many questions and possible complaints following the U.S. Supreme Court’s decision to end the constitutional right to abortion. The official was unable to quantify the number of calls or emails received.
The guide provides several examples to define what this type of discrimination might look like, but it did not specifically address abortion with medication. Examples included a person who had a prescription for an emergency contraceptive to prevent them from becoming pregnant after being sexually assaulted, as well as a pharmacy that sold other contraceptives as condoms but refused to fill a prescription for contraceptives. emergency. These can be sex discrimination.
Another potential case could be if a pharmacy refuses to store or fill a prescription for methotrexate, a drug that reduces pain and swelling in people with rheumatoid arthritis, but that could also terminate the pregnancy. This can be discriminatory on the grounds of disability.
One more example was someone with a clotting disorder who is scheduled for a surgical abortion and is prescribed hemoglobin to reduce the risk of bleeding during the procedure. If the pharmacy finds out why the person is using the drug and refuses to fill the prescription, they may be discriminating on the basis of sex.
Several professional associations have told CNN that they are aware that women have been denied medications from pharmacies that had the potential to terminate the pregnancy, even if the prescription was for a disease that has nothing to do with pregnancy such as lupus, rheumatoid arthritis and certain skin. conditions.
A Walgreens spokesman said Wednesday it will review the guidelines.
“Our pharmacy staff will continue to work closely with prescribers as needed, to ensure that all prescription drugs are dispensed in accordance with applicable pharmacy laws and regulations,” said Fraser Engerman, senior director of external relations, in an email. “We offer ongoing training and information to help our pharmacists understand the latest requirements in their area, and with these supports, the expectation is that they have the power to fill legal and clinically appropriate prescriptions.”
CVS said it will also evaluate the guidelines.
The company said that before a pharmacist fills a prescription for the drugs methotrexate or misoprostol, “we instruct our pharmacists to validate that the intended indication is not to terminate the pregnancy.”
“Our top priority is to ensure safe and timely access to medicines for our patients and we understand the important role that pharmacies play in supporting women’s health care,” wrote Amy Thibault, senior director or external communications of CVS, in an email. “We encourage providers to include their diagnosis in the prescriptions they write to help ensure patients have quick and easy access to medications.”
HHS encouraged people who feel they have been discriminated against to call or file a complaint on the agency’s website. This includes discrimination based on current pregnancy, past pregnancy, potential or expected pregnancy, and medical conditions related to pregnancy or childbirth.
The United States has the highest maternal mortality rate among developed nations, according to HHS, and most maternal deaths in the U.S. can be prevented.
Over the past two decades, maternal mortality rates have been rising, according to the U.S. Centers for Disease Control and Prevention. Since the Supreme Court ruling on June 24 alone, more than a dozen states have been in legal fights over the ban on abortion and other laws that strictly limit the procedure.
The Biden administration has also taken several measures regarding abortion as a result of this decision.
On Friday, President Biden signed an executive order to protect access to medical abortion, patient privacy and emergency contraception, and to launch public education efforts.
Biden ordered Becerra to send a report on the actions his department is taking to ensure access to reproductive health care. HHS will take steps to expand access to emergency contraception and long-acting reversible contraception such as intrauterine devices.
Attorney General Merrick Garland has also issued a statement saying states cannot ban mifepristone, a drug used to end early pregnancy that has FDA approval.
On Monday, the Biden administration said federal law avoids state bans on abortion when emergency care is needed and that the federal government can penalize institutions or providers that do not provide abortions as needed to treat medical emergencies. .
The administration said examples of emergency medical conditions include, but are not limited to, ectopic pregnancy, when the fertilized egg grows out of a woman’s uterus, and complications from miscarriages. Stabilizing treatment could include abortion.
On Tuesday, the U.S. Department of Justice announced a working group to identify ways to protect reproductive rights.