Biden administration says pharmacies can’t turn away people who have a prescription for a drug that may end a pregnancy

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The US Health and Human Services Department (HHS) Office for Civil Rights sent guidance to more than 60,000 pharmacies around the country to remind the pharmacies that under federal civil rights law, pregnancy discrimination is a form of sex discrimination and that is illegal.

“We are committed to ensuring that everyone can access health care, free of discrimination,” said HHS Secretary Xavier Becerra in a news release Wednesday. “This includes access to prescription medications for reproductive health and other types of care.”

The federal law applies to any pharmacy that receives federal financial assistance, including through Medicare and Medicaid payments.

A senior HHS official said Wednesday that its Office for Civil Rights has received a lot of questions and possible complaints in the wake of the US Supreme Court’s decision to end a woman’s constitutional right to an abortion. The official could not quantify the number of calls or emails received.

The guidance gives several examples to define what this kind of discrimination might look like but did not specifically address medication abortion. Examples included if a person had a prescription for an emergency contraceptive to prevent them from becoming pregnant after they have been sexually assaulted or if a pharmacy sells other contraceptives like condoms but refuses to fill a person’s prescription for emergency contraception, these may be discrimination on the basis of sex.

Another potential case could be if a pharmacy refuses to stock or fill a prescription for methotrexate, a drug that reduces pain and swelling in people with rheumatoid arthritis but could also potentially terminate a pregnancy, it may be discriminating on the basis of disability.

One more example was if an individual with a bleeding disorder is scheduled for a surgical abortion and is prescribed hemoglobin to reduce the risk of bleeding during the procedure and if the pharmacy finds out why the patient is using the drug and refuses to fill it, they may be discriminating on the basis of sex.

Several professional associations have told CNN that they are aware that women have been denied medicines from pharmacies that had the potential to terminate a pregnancy, even if the prescription was for a condition that has nothing to do with pregnancy like lupus, rheumatoid arthritis, and certain skin conditions.

A spokesperson for Walgreens told CNN Wednesday that it will review the guidelines.

“Our pharmacy staff will continue to work closely with prescribers as needed, to ensure that any prescription medications are dispensed in compliance with applicable pharmacy laws and regulations,” said Fraser Engerman, the company’s senior director external relations, in an email. “We provide ongoing training and information to help our pharmacists understand the latest requirements in their area, and with these supports, the expectation is they are empowered to fill lawful, clinically appropriate prescriptions.”

HHS encouraged people who feel they have been discriminated against to call or file a complaint on the HHS website. This includes discrimination based on current pregnancy, past pregnancy, potential or intended pregnancy and medical conditions related to pregnancy or childbirth.

The US has the highest maternal mortality rate among developed nations, according to HHS, and most maternal deaths in the US are preventable.

Over the last two decades maternal mortality rates have been rising, according to the

US Centers for Disease Control and Prevention.

Just since the US Supreme Court decision June 24, more than a dozen states are in legal fights over abortion bans and other laws that strictly limit the procedure.

The Biden administration has also taken several steps with regard to abortion in the wake of that decision.

Last Friday, President Biden signed an executive order that is meant to protect access to medication abortion, patient privacy and emergency contraception, and to launch public education efforts.

Biden directed Becerra to submit a report on actions his department is taking to ensure reproductive health care access. HHS will take action to expand access to emergency contraception and long-acting reversible contraception like intrauterine devices.

Attorney General Merrick Garland has also issued a statement saying states cannot ban mifepristone, a medication used to end early pregnancy that has FDA approval.

On Monday, the Biden administration said that federal law preempts state abortion bans when emergency care is needed and that the federal government can penalize institutions or providers that fail to 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 outside a woman’s uterus — and complications of miscarriages. Stabilizing treatment could include abortion.

On Tuesday, the US Justice Department announced a task force aimed at identifying ways to protect reproductive rights following Supreme Court decision that struck down the federal right to abortion.

July 14, 2022 at 12:43AM

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