The latest #WeCount report shows that the exploit of telehealth for abortion care continues to grow in the U.S., especially since five states have passed laws protecting providers who work with patients living in states with bans. (Warodom Changyencham/Getty Images)
This week, separate Ohio House committees considered two Ohio bills that could impact abortion medications and access to them.
Opponents of a bill to further regulate drugs, which could include abortion drugs, have deeply criticized a study by supporters of the measure and argued about the unintended consequences envisioned in the legislation.
Ohio State University epidemiology professor Dr. Alison Norris said a study on the safety of the abortion drug mifepristone cited by bill supporters to demonstrate the drug’s dangers was “deeply flawed,” raising concerns about the type of sources of evidence the bill would allow the Ohio Department of Health to exploit in determining drug risks.
The study counted emergency room visits for any reason as part of mifepristone’s “adverse effects,” Norris said, leading to a conclusion that flies in the face of “more than 100 peer-reviewed studies conducted over more than 25 years … that build a solid base of scientific evidence showing that mifepristone is safe.”
Quoting other studies and data from the CDCNorris found that the risk of childbirth was 14 times greater than that of abortion.
“The example of mifepristone regulation presented in supporter testimony shows how HB 324 could tie health care for Ohioans to misleading and poorly analyzed data,” Norris told the House Health Committee on Wednesday. “This could lead to a change in standard medical care that will harm Ohioans.”
The bill in question, House Bill 324aims to identify drugs that have “serious side effects” in more than 5% of users. Under the bill, data from the FDA, insurance claims and patient reports would be used by the state health department to determine the level of risk associated with prescription and over-the-counter drugs, particularly the risk of death, hospitalization for infection or hemorrhage, organ failure or sepsis.
Classifying a drug as causing grave side effects in more than 5% of users would require dispensing the drug only after a personal examination and scheduling a follow-up visit. This would limit Ohioans’ ability to exploit telehealth for certain medications.
Mifepristone is just one of many drugs that could be affected by the legislation, and the inability to prescribe via telehealth could impact rural communities and older Ohioans, as well as those seeking reproductive care, supporters said at the committee hearing.
“The bill’s extremely broad definitions could impact access to drugs such as Plavix, Wellbutrin, metformin, atorvastatin, amoxicillin and ibuprofen, to name a few,” said Lora Miller, director of government affairs and public relations for the Ohio Retailers Council.
Plavix is a drug used to prevent blood clots, Wellbutrin is an antidepressant, metformin is used to treat diabetes, atorvastatin treats high cholesterol, amoxicillin is an antibiotic, and ibuprofen is a commonly available over-the-counter pain reliever.
“Patients struggling with common medical conditions, especially those with limited insurance, may incur unnecessary costs and delays,” Miller said.
Republicans on the committee sought to clarify provisions in the bill, emphasizing that it would not affect any drugs below the 5% risk threshold. State Rep. Angela King, R-Celina, listed specific side effects included in the bill after Miller listed the effects of drugs like amoxicillin and Wellbutrin, which range from vaginal hemorrhaging to urinary tract infections. King pointed out that the bill mentioned hospitalizations due to infections, not just the infections themselves.
“A urinary tract infection can certainly result in hospitalization,” Miller replied. “I can tell you this because it landed me in the hospital.”
Miller said the bill would hit low-income patients particularly tough, as written “due to additional visits, costs and travel requirements.”
“The bill unintentionally exacerbates community health disparities in Ohio,” she said. “The absence of any exemptions virtually guarantees that existing barriers to access to care and medicines will become more acute.”
Opponents say the legislation could also create duplication. Both Miller and Norris said federal law and the FDA already dictate the risks associated with the exploit of various drugs, and Norris said there are already “very robust systems” of medical training, ethical codes and regulations in place to ensure that “health care providers balance the risks against the benefits of the drugs they prescribe.”
“I don’t think this law is necessary because it requires an additional level of scrutiny and has deep methodological problems within it,” Norris said.
Medicaid financing
In another committee, supporters praised a bill that would eliminate state Medicaid funding for reproductive health clinics that perform abortions. Federal law already prohibits the exploit of Medicaid funds for abortion services, but religious and anti-abortion groups have indicated that this is not enough to prohibit indirect funding of abortion services.
Ohio Right to Life Director Katie DeLand began her testimony House Bill 410 on the Ohio House of Representatives’ Medicaid Committee, thanking the General Assembly for allocating $20 million for pregnancy resource centers in the state’s latest operating budget. Pregnancy resource centers are largely religious centers that provide services such as ultrasounds and postpartum supplies such as diapers.
Grants through the state that went to pregnancy resource centers in particular, it prohibits the transfer of any funds to facilities promoting or providing abortion services and centers, also known as crisis pregnancy centers, have been criticized for providing medically substantiated information to discourage customers from having abortions.
“House Bill 410 builds directly on this work and sets a clear position: While Ohio will invest in prenatal and family resources, we will not fund abortion services that end a child’s life,” DeLand said.
The bill that DeLand and others supported this week aims to prevent state Medicaid funding from going to any facility that includes abortion services as part of its operations, or even from funding things like “administrative costs” or “referral activities.”
“Redirecting these funds to abortion providers ensures that Ohio’s resources are invested in real health care and life-sustaining services, such as pregnancy resource centers, which received funding earlier this summer,” DeLand told the committee.
The Ohio Catholic Conference also supported the bill, calling abortion “one of the most, if not the most, controversial topics of our time.”
“While a majority of Ohioans voted to amend the constitution to allow abortion, we must also consider the conscience of the 1.6 million Ohioans who did not,” said Marsha Forshon, deputy director of the CCO.
There are legal acts two of several currently vigorous in the Ohio General Assembly, causing pro-abortion rights advocates to once again question whether the Legislature is honoring the 57% vote in 2023 that added reproductive rights, including abortion, to the Ohio Constitution.
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