Amid post-Roe chaos, HHS outlines nondiscrimination guidelines for pharmacies

As some hospitals and health systems flounder to care for patients after some states have banned or severely restricted abortions, the HHS instructed national retail pharmacies on July 13 to continue handing out reproductive health medication and other drugs that have been affected by abortion restrictions. 

Citing the Affordable Care Act, the agency said the nation's 60,000 pharmacies cannot discriminate against Medicare and Medicaid recipients who are pregnant, were pregnant or have the capacity for pregnancy. 

"Discrimination against pregnant people on the basis of their pregnancy or related conditions is a form of sex discrimination," the guidance says. "Such discrimination can have significant health consequences from denial of medication or treatment which can have negative health impacts on a patient."

In the wake of the overturn of Roe v. Wade, people who use a drug that's used to treat rheumatoid arthritis but has also been prescribed for cancer, methotrexate, have reported a delay in access since the medication can also induce an abortion. In response, the HHS said any pharmacy that refuses to fill prescriptions for methotrexate or doesn't stock the product can face a discrimination case since rheumatoid arthritis is listed as a disability, and therefore is protected under federal law. 

Emergency contraceptives, known by the brand name Plan B, are also protected under federal law, according to the guidance. 

The HHS added that, compared to other developed nations, the U.S. has the highest maternal mortality rate and it disproportionately affects Black and Native American women. The department said the recent Supreme Court decision will "exacerbate these inequities."

Once the Supreme Court struck down a nearly 50-year precedent with its June 24 decision, some health systems have been wary about what medical services they can provide without fear of prosecution. On July 11, the HHS clarified to healthcare providers that emergency abortions were legal in any state. 

Before the instruction, one health system with 14 hospitals across Missouri and Kansas stopped providing Plan B, an emergency contraceptive, in its Missouri locations after the state was the first to initiate its trigger anti-abortion law. The system rescinded its decision hours later, citing the state legislation's "ambiguity."

"The uncertainty even among state officials about what this law prohibits [...] continues to cause grave concern and will require careful monitoring," a spokesperson for the health system told Becker's.

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