Telemedicine Abortion Ban Dooms Passage of Long-Awaited PA Telehealth Bill

A long-awaited bill aiming to establish new guidelines for telehealth in Pennsylvania – including coverage parity – will apparently go down in flames because it bans telemedicine abortions.

Governor Tom Wolf’s office has announced that he will veto SB 857 because of an amendment pushed through by Republicans last November that would prevent doctors from using telemedicine to prescribe drugs listed on the US Food and Drug Administration’s REMS list. That list includes mifepristone, a drug used to induce abortions.

Wolf, a Democrat, has long said he would veto any bills banning abortion.

“My administration is committed to reducing maternal mortality and giving women, children and families the support that they need to succeed,” Wolf said in a statement issued in October 2019. “This should be our focus, not regressive policies that make it harder for vulnerable people making difficult and deeply personal decisions.”

Pennsylvania’s Republican-controlled Senate passed the bill earlier this week after several hours of heated testimony.

The bill seeks to establish definitions for telemedicine and telehealth, provide temporary evaluation and treatment guidelines and ground rules for reimbursement, and give state departments up to two years to draft permanent rules and regulations.

It would also allow providers and insurers to negotiate rates for telehealth coverage, mandate that payers provide coverage for telehealth as they would for in-person services, prohibit them from denying coverage solely because it’s provided through telemedicine, and ensure that telehealth coverage be “consistent with the insurer’s medical policies.”

Democrats called the amendment a “poison pill,” while Republicans have argued that drugs dangerous enough to be included on the FDA’s REMS (Approved Risk Evaluation and Mitigation Strategies) list should not be prescribed by a doctor who isn’t in the same room as the patient.

Democrats and Planned Parenthood have long opposed the amended bill.

“There is absolutely no reason to accept the amended version of this bill to limit a person’s access to basic health care other than to continue anti-choice opponents’ efforts to chip away now and ultimately do away with a person’s right to a safe, legal abortion in Pennsylvania,” Ashley Lenker White, executive director of the Planned Parenthood Pennsylvania Advocates, reportedly said after the amendment was added. The organization estimates that 38 percent of the abortions performed in the state were done through the use of mifepristone.

A handful of states are waging similar battles over telemedicine abortions, and at least three bills now before Congress aim to make that ban national.

Earlier this month, Senators Elizabeth Warren (D-MA), Patty Murray (D-WA) and Tammy Baldwin (D-WI) jumped into the fray with a letter to the US Food and Drug Administration Commissioner Stephen Hahn, MD. The lawmakers are urging Hahn to relax restrictions on the use of Mifepristone.

“Significant scientific evidence, research, and clinical experience has affirmed that medication abortion is safe and highly effective,” they wrote. “Since 2000, over four million people in the United States have used mifepristone, and the adverse events reporting rate has been extremely low.”

“The medical community resoundingly agrees that any restrictions placed on the prescription and distribution of mifepristone are medically unnecessary,” they added, citing opinions from former FDA Commissioner Jane E. Emery and researchers at the University of California at San Francisco.