HIPAA? What HIPAA?

1.6.25

Click to skip ahead: In Killing Confidentiality, an Indiana OBGYN is fighting back against the state’s reporting mandate. In the States, news from Missouri, South Carolina, Massachusetts, Idaho, New York and more. No More Limits looks at just how popular abortion rights are without restrictions. In Care Denied, another woman was refused miscarriage treatment at a Catholic hospital in California. In Abortion ‘Tourism,’ conservatives’ latest term to diminish abortion patients. In the Nation, some quick hits. Finally, kicking off Legislation Watch for 2025.

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Killing Confidentiality

Love to see it: An Indiana OBGYN is suing over the state’s abortion reporting mandate—a Republican attack on privacy that I’ve been flagging for nearly a year.

The suit from OBGYN Dr. Christina Scifres notes that if she adhered to Indiana’s abortion reporting law, she’d actually be violating a new HIPAA policy.

The new ‘Reproductive Health Care Privacy Rule’ prohibits health care providers from disclosing any patient data that could be used to investigate or impose liability on someone for their reproductive health decisions. Breaking the rule could expose Scifres to civil or criminal liability. But if she doesn’t submit terminated pregnancy reports (TPR) in Indiana, Scifres would be at risk of “being charged with a misdemeanor, losing her medical license, and facing civil monetary penalties.”

And so the state, the suit argues, is putting doctors in “the untenable position of deciding whether they must violate state law or federal law when it comes to reporting on the lawful abortions they provide.”

But that’s not all! If you’ve been reading Abortion, Every Day for a while, you know that Indiana Attorney General Todd Rokita has been trying to make women’s abortion reports into public records (like birth and death certificates). He also wants to bring back individual abortion reports instead of aggregate reports—even though the state health department has made clear that those individual reports could be reverse engineered to identify patients.

Why go through all this? Well, so that anti-abortion activists can scour those records for reasons to target providers and patients.

That’s right, despite years of claiming that abortion data collection is just about ‘protecting’ women, Rokita and his cronies admitted the real goal is enabling extremists to punish women and doctors.

That’s important for Scifres’ suit; if the real purpose of TPRs is to find information that Rokita can use to prosecute someone, it most definitely violates that federal law.

I’ll have more on this case in the coming days, but just remember that this is all part of a broader attack on patients’ privacy. You can read the full suit here, and read more about what’s happening with abortion reporting and data below:

Killing Confidentiality

In the States

Remember the South Carolina bill that could punish abortion patients with the death penalty? I sure do! Well, the Republican legislator behind the bill spoke to a local television station last week in an attempt to quell the controversy.

State Rep. Rob Harris told a reporter that claims he wants to give women the death penalty are “the farthest thing from the truth.” In an explanation that didn’t actually contradict the fact that his bill would punish abortion as a homicide, Harris said police would simply follow already-established homicide laws and that an abortion patient’s fate would be decided by trial.

Apparently because it’s not Harris himself who would be doling out the punishment—but a jury—we’re supposed to believe it means the Republican lawmaker isn’t interested in targeting women.

Harris also said that his law wouldn’t punish a “natural miscarriage,” which begs the question: What is an ‘unnatural’ miscarriage? What happens if a woman didn’t get prenatal care and had a stillbirth? Is that a homicide? What if she drank alcohol, lifted something heavy, or ran a marathon? Could any of those be used to argue she ‘caused’ a miscarriage? After all, it’s happened before.

Meanwhile, abortions are still unavailable in Missouri, even though voters passed pro-choice ballot measure Amendment 3, and despite a judge’s ruling that the state’s ban is unenforceable. That’s because Judge Jerri Zhang left other serious restrictions in place—including onerous licensing mandates, aka TRAP laws. Those restrictions allow the state to withhold licenses from abortion clinics. From Emily Wales, CEO of Planned Parenthood of Great Plains:

“We want care to be treated normally. We want it regulated like normal health care. This is a way to treat abortion providers unfairly and really to limit access for Missourians.”

Planned Parenthood has filed a motion asking Zhang to lift those requirements, pointing out that the rules discriminate against abortion providers. I’ll have more on this story soon; in the meantime, you can listen to a short segment from KCUR’s “Kansas City Today” on the issue below:

In better news...

A new law took effect in New York that gives people at least 20 hours of paid leave for pregnancy care—whether it’s a prenatal appointment, treatment for a miscarriage, or an abortion. Laws like this are an important acknowledgment that abortion is a vital and normal part of reproductive health care.

Folks in Idaho can now get up to six months of birth control at a time. Senate Minority Leader Melissa Wintrow, who sponsored the legislation, wrote a column highlighting why this law is so important for Idaho women. She explains, for example, that those in rural areas may need to travel hours to reach a pharmacy. Sen. Wintrow also emphasizes that the state’s abortion ban is driving OBGYNs out of Idaho—making it increasingly difficult for women to access reproductive health care:

“Access to contraceptives is an easy way to remove the barriers women face when trying to take control of their reproductive health, particularly in Idaho where the consequences of being pregnant—even when that’s what you desperately want—are life and death.”

Finally, Massachusetts Sen. Rebecca Rausch says she wants to expand abortion rights protections by getting temporary licenses for out-of-state medical students who want abortion training. As you know, abortion bans have caused huge gaps in abortion education—which is necessary for anyone training to be an OBGYN.

Students and residents in states with bans have been forced to learn on models or travel to pro-choice states on their own dime. In their end-of-year roundup, for example, NC Health News reports that North Carolina’s ban has made it difficult for residents to learn second-trimester abortions, “which can be more technically challenging.”

For more on this issue, check out my live-stream conversation with Pam Merritt, executive director of Medical Students for Choice. (To join video live-streams and other community perks in the future, make sure to upgrade your subscription!)

Quick hits:

• A look at the work of abortion funds in Maine;

• Kansas Republicans are going after gender-affirming care (again);

• Wisconsin Gov. Tony Evers is trying to find a way to stop Republicans from passing laws (like abortion bans) against voters’ wishes;

• And new data from Minnesota’s health department shows that abortion numbers in the state continue to increase—largely because of out-of-state patients.

No More Limits

We all know abortion rights are popular, but we don’t talk enough about the fact that Americans support abortion throughout pregnancy.

Consider voters’ overwhelming support for Maryland’s pro-choice amendment: The state board of elections reported that nearly 2.2 million Maryland voters supported Question 1, with only 692,000 voting against the measure. That’s 76% of voters—a level of support that a spokesperson for Planned Parenthood of Maryland says “almost rises to the level of a mandate.”

What makes this especially notable is that unlike most other pro-choice amendments in front of voters this November, Maryland’s measure did not have any limiting language about ‘viability.’ Despite concerns from mainstream abortion rights groups that policies without restrictions might alienate voters, Maryland’s amendment was actually the most popular pro-choice measure passed on election day.

In fact, the amendments in New York and Colorado—which also protected abortion rights without restrictions—were among the most popular measures this November, as well.

This aligns with what pollster PerryUndem found in late 2023: That respondents were actually 15 percentage points more likely to support a hypothetical ballot measure when it didn’t include a ‘viability’ restriction.

It’s important to keep in mind, especially as folks revisit some of the failed abortion rights measures that sought a supposed ‘middle ground,’ as well as the amendments that passed but excluded later abortion patients.

We know that pregnancy is too complicated to legislate—ever. So in 2025, let’s commit to fighting for abortion rights without restrictions or limits.

Care Denied

A second woman has come forward about being denied miscarriage treatment at a Catholic hospital in California, reminding us that pro-choice protections don’t necessarily help if you’re at a religious institution.

Back in October, we learned that Anna Nusslock was refused care after her water broke just 15 weeks into her pregnancy. Instead, Providence St. Joseph Hospital handed her a bucket and towels for the car ride to another center, “in case something happens in the car.”

By the time Nusslock arrived at the second emergency room, she was “hemorrhaging and passing a blood clot the size of an apple.” She had to be rushed into emergency surgery.

Now a second woman says she was also denied care at St. Joseph. An anonymous patient filed a suit a few weeks ago detailing three separate incidents where the hospital refused to give her miscarriage treatment. In one such case, she says she had to drive for over five hours to get care in San Francisco.

Something tells me we’re going to see a lot more of these cases in the coming months.

To learn more about the role of religious hospitals in the abortion rights fight, revisit AED’s investigation below:”

The Catholic Hospital System Killing Women

To find out more about the people harmed by abortion bans, consider reading some of 2024’s best (and most wrenching) investigations: States Newsroom’s “When and Where” is a must-read, for example, as is all of ProPublica’s work on post-Roe deaths, which you can find under their series, “The Life of the Mother.” Make sure you also check out the incredible project, “Abortion in America”—which has been keeping track of all these stories and collecting some of their own.

Abortion ‘Tourism’

One of the biggest abortion rights trends since the end of Roe has been the increase in people leaving anti-choice states for care. One in five women who end their pregnancies now travel for abortions, and bans are forcing people to travel even farther distances.

While it’s terrific that so many people are still able to get the care they need despite state bans, we shouldn’t downplay how awful it is: Women are fleeing their states for basic healthcare. That’s no small thing: people have to find child care, take off of work, pay for hotels and airplanes—sometimes doing so while in the middle of a medical trauma.

Rather than own up to the fact that their policies have created a nation of medical refugees, Republicans have instead decided to make this nightmare sound like a vacation. They’re calling it ‘abortion tourism.’

I’ve been warning about this term for nearly two years, but I’m seeing it everywhere these days. Check out Pregnancy Help News, for example—the go-to publication for crisis pregnancy center workers and anti-abortion activists. They’re not only warning about abortion ‘tourism,’ but abortion ‘mini vacations,’ where women supposedly travel to destinations to end their pregnancies while having a bit of sun and fun.

We’re seeing similar talking points from Republican lawmakers. Colorado Rep. Richard Holtorf said that women were coming to the state in order to “drive up to the ski resort, go skiing for a week, and then on the way home they can get their abortion.” And Florida Gov. Ron DeSantis accused the Pentagon of promoting ‘abortion tourism’ by allowing service members to take time off if they need to leave their state for care.

The idea is to diminish just how bad the consequences of abortion bans really are. By using language like this, conservatives can paint desperate women escaping misogynist states for healthcare as shallow, fun-seeking twits.

By the way: ‘Abortion tourism’ isn’t the only term to watch out for in 2025. Later this week, I’ll send you a glossary of anti-abortion terms to keep an eye on.

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In the Nation

• The Associated Press examined how states with abortion bans often don’t have social safety programs to help families;

• Ms. magazine on how Trump’s incoming administration will force taxpayers to support crisis pregnancy centers;

• Columnist Robin Epley writes at The Sacramento Bee that infant mortality has shot up since Roe was overturned;

• Truthout has a profile of the Muslim-led reproductive justice organization, HEART (Health, Education, Advocacy, Research and Training);

• And in international news, Pope Francis’ new year remarks honed in on abortion and the idea that life starts at conception.

Legislation Watch

New year, new bills! Abortion, Every Day will be tracking abortion-related legislation in 2025—whether it’s New Hampshire’s ‘abortion trafficking’ bill, South Carolina’s legislation to make abortion punishable by the death penalty, or Tennessee’s attempt to define life at fertilization.

Don’t worry, I’ll be telling you about good news, too! Remember that Delaware, for example, has a new law going into effect that requires health insurance plans—including state-regulated and Medicaid plans—to cover abortion care.

If there’s an anti-abortion bill in your state that I should know about, please email me here.