A pediatrician from the University of Miami talks to a 13-year-old patient while administering the HPV vaccine, which studies have shown to be highly effective against cervical cancer. Iowa’s law, which goes into effect July 1, prohibits Iowans under the age of 18 from consenting to vaccinations related to sexually transmitted diseases and infections such as HPV. (Photo: Joe Raedle/Getty Images)
Several laws restricting access to drugs that can be used to terminate a pregnancy and other laws restricting minors’ access to sexual and reproductive health care – including the HPV vaccine – go into effect on Wednesday, July 1, in Iowa, Mississippi and Tennessee.
Earlier this year, state legislatures considered multiple bills that would have added legal restrictions to mifepristone and misoprostol, but only a few became law. The 13 states that have passed near-total abortion bans already have restrictions in place, but some have proposed more in connection with modern methods of obtaining medications online or via telehealth.
There is also an ongoing federal lawsuit that will decide whether U.S. Food and Drug Administration rules allowing mifepristone to be dispensed via telehealth will remain in effect. This ruling will apply throughout the country.
Governor Kim Reynolds signs bills restricting access to abortion pills and the HPV vaccine
Kimya Forouzan, chief state policy adviser at the Guttmacher Institute, said the increased efforts to restrict access underscore the importance of shield laws in states protecting access to abortion.
Legislation strengthening the state’s shield law goes into effect today in Hawaii. Those provisions include prohibiting the utilize or disclosure of a patient’s health information to investigate someone who has received reproductive or gender-affirming care, as well as adding malpractice insurance and contract health care coverage for providers in the state to prevent excessive rate increases, Forouzan said.
Iowa
Iowa modern law requires in-person dispensing of medications, including mifepristone and misoprostol, which limits access to telehealth. Mifepristone and misoprostol are usually used in combination to terminate a pregnancy in the first trimester or to treat miscarriages. Iowa has a six-week abortion ban, before many people realize they are pregnant.
The law also made changes to the reporting of abortion and pregnancy loss, requiring a health care provider to report to the state whether a patient took mifepristone or misoprostol within 14 days of pregnancy loss. It doesn’t require a patient to provide such information to a doctor or force a doctor to ask questions, Forouzan said, but it can come up when a patient asks questions or raises concerns.
“The reporting requirement really raised alarm bells for us because we know that mandatory state reporting of abortions can cause a lot of harm and increase the sense of surveillance that patients experience,” Forouzan said.
Lawmakers also passed a bill prohibiting Iowans under the age of 18 from consenting to vaccinations related to sexually transmitted diseases and infections. Shipment reported from Iowa Capital that Republican lawmakers found the bill consistent with other state vaccine laws – HPV and hepatitis B vaccines were previously exempt. Science has shown HPV vaccine prevents several strains of human papillomavirus, which can be transmitted during sexual activity and potentially cause cervical and other cancers.
Mississippi
The Mississippi has passed law in April, adding mifepristone and misoprostol to the state’s drug trafficking law, making distribution or intent to distribute drugs a felony punishable by up to 10 years in prison. This goes into effect today.
Republican lawmakers in Mississippi say the bill is intended to prevent mifepristone and misoprostol from being shipped to residents and undermine the state’s abortion ban, but providers say it causes more harm, especially to patients who have experienced miscarriages.
Dr. Bhavik Kumar, a family medicine physician in Texas, told Stateline in March that the law creates confusion and prevents patients from seeking timely care and providers from providing care out of fear.
“Providers suddenly have to think about regulations and policies that have nothing to do with patient safety,” Kumar said.
Tennessee
Tennessee has added modern restrictions on medication abortions that allow the state’s attorney general to bring civil lawsuits and impose financial penalties for violating the state’s medication dispensing requirements for in-person abortions.
Tennessee has a near-total abortion ban, but some states have tried to enforce those laws against prescribing providers to their residents, such as Louisiana, where the attorney general unsuccessfully tried to extradite a provider on charges.
The law provides for a fine of $10,000 per violation, up to $1 million.
Stateline reporter Kelcie Moseley-Morris can be reached at: kmoseley@stateline.org.
This story was originally produced by state linewhich is part of States Newsroom, a nonprofit news network that includes the Ohio Capital Journal and is supported by grants and a coalition of donors as a 501c(3) public charity.
