Tennessee Gov. Bill Lee signed a bill into law on Thursday that would make providing abortion via telehealth a Class E felony, punishable with a fine of up to $50,000.

The state already required physicians to be physically present with patients when providing medication for abortion.   

Now, the new law adds criminal penalties for failing to do so. It will go into effect in 2023.  

WHY IT MATTERS

Medication abortion, which is approved by the U.S. Food and Drug Administration for up to ten weeks' gestation, consists of a two-drug regimen.

Tennessee's new law does not require physicians to monitor a patient when they take the medications, but it does mandate a follow-up visit within two weeks of administration.  

"A manufacturer, supplier, pharmacy, physician, qualified physician or other person shall not provide an abortion-inducing drug via courier, delivery or mail service," reads the law's text. 

"A criminal penalty shall not be assessed against a patient upon whom a chemical abortion is attempted or performed," it continues.

The legislation comes on the heels of a leaked draft of a U.S. Supreme Court opinion suggesting that the nation's highest court is prepared to overturn Roe v. Wade, the 1973 case that legalized abortion care nationwide.   

Tennessee is among several states with so-called "trigger laws" that would then outlaw abortion shortly after such a decision.    

The state has several existing requirements in place that pose hurdles to care, including a 48-hour waiting period, mandatory in-person ultrasounds and anti-abortion counseling, and bans on coverage for the procedure through insurance offered on the Affordable Care Act exchange.  

"It’s frightening to see politicians pile on restriction after restriction after restriction on abortion care, especially when you consider we are talking about an FDA-approved medication," said Kirsten Moore, director of the EMAA Project, to Healthcare IT News.

"The practical effect of these laws will be to push patients to self-source the medication and then deny them access to the support of licensed healthcare providers as they manage their abortion," Moore continued.

Following the news about Roe, experts also warned that maternal mortality rates could skyrocket 20% or more in states with abortion restrictions, according to a USA Today report.   

Studies have shown that people denied wanted abortions are more likely to experience serious complications from the end of pregnancy and more likely to experience poor physical health for the years following the pregnancy.  

In Tennessee, 98 women died within a year of pregnancy in 2020, the most recent period for which data is available. Between 2017 and 2020, 113 women died from pregnancy-related causes, while 177 deaths during that period were deemed to be "pregnancy-associated." Black women were 2.5 times more likely to die of a pregnancy-related cause during that time period than white women.  

THE LARGER TREND  

In the wake of the Supreme Court news, several companies that offer abortion via telemedicine say they've seen a surge of interest in their services.

Before the pandemic, the FDA had longstanding policies that required mifepristone, one of the medications used in abortion, to be dispensed at a clinic, hospital or medical office.

However, the upsurge of interest in telehealth during COVID-19 included abortions.   

In December 2021, the FDA opted to permanently modify its regulations, thereby enabling abortion via telehealth in more than half the country.  

Still, 19 states, including Tennessee, require clinicians to be physically present when dispensing medication.   

ON THE RECORD  

"Medication abortion by mail and telehealth was already banned in Tennessee; this new law, which increases penalties, is nothing more than a ploy by Gov. Lee to gain attention in this fraught moment," said Ashley Coffield, president and CEO of Planned Parenthood of Tennessee and North Mississippi, in a statement provided to the Associated Press.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.