Policy Update

State Policy

Arizona: 

• Introduced H.B. 2463 to repeal any existing restrictions concerning the use of telemedicine for abortion care. While this bill would have reversed Arizona’s explicit ban on telehealth for medication abortion, it unfortunately died in committee.
  
• Litigation Update: In May, The Center for Reproductive Rights & the American Civil Liberties Union, filed a lawsuit on behalf of two abortion providers to overturn the 24-hour waiting period and prohibition on the use of telemedicine in abortion cases. The law at issue includes a ban on the mailing of abortion pills to patients.

California:

‍Two bills are moving through the legislature to expand access to telehealth for abortion care and fill gaps in preexisting telehealth shield laws. 

• AB 54, the “Access to Safe Abortion Care Act,"  would allow pharmacies to label medication abortion drugs with the healthcare practice name instead of the individual prescriber, protecting pharmacists and increasing privacy and safety for TMAB providers. It would mandate health insurance coverage for mifepristone and would enable MediCAL reimbursement for MAB via asynchronous care after establishing the patient-provider relationship.
• AB 260 seeks to immediately strengthen and expand legal, regulatory, and insurance protections for abortion and medication abortion access, shielding patients, providers, and facilities from out-of-state legal actions and would ensure broad coverage and privacy for reproductive health care.

Colorado:

• Passed SB 25-129 allowing prescription labels for certain medications, including mifepristone, misoprostol and the generics, to include the name of the health care practice instead of the practitioner, upon request. This change allows for additional privacy and potentially increased safety for health care providers who prescribe these specific medications, particularly for TMAB providers whose patients may be located in or travel to abortion ban states.

Massachusetts:

• Introduced H.1130, which would boost telehealth and digital equity in MA by mandating coverage, developing education, and establishing pilot programs and task forces to improve access.
• Introduced H.4250, which would include a $5 million investment to ensure continuity of abortion and abortion-related care in the event of a loss of federal funding. MA currently reimburses telehealth for medication abortion care, so the passage of this bill would further ensure such reimbursement continues. The governor vetoed this bill in July and it is currently being amended. 
• Introduced S.1579, which seeks to eliminate barriers and expand abortion access for patients under the age of 16. Currently, MA providers cannot offer telehealth for abortion care to patients without parental involvement, creating an unnecessary barrier to care. 
• Enacted S.2543, which strengthens legal, privacy, and access protections for reproductive and gender-affirming care in MA, shielding patients, providers, and supporting organizations from out-of-state legal actions, enhancing confidentiality and nondiscrimination, and allowing pharmacies to list a provider’s practice name, rather than their own, on certain reproductive health prescriptions.

Missouri:

• Introduced S.B. 94 which modifies provisions relating to telehealth services, by increasing telehealth accessibility, is moving through the legislature. The  legislation expands and clarifies the definitions and regulations surrounding telehealth and telemedicine. It defines key terms such as "asynchronous store-and-forward transfer," "clinical staff," "distant site," "health care provider," "originating site," and "telehealth or telemedicine," emphasizing the inclusion of audiovisual and audio-only technologies and provides in-state licensure exceptions for informal consultations, emergency services, and episodic consultations by out-of-state providers via telehealth. So long as TMAB remains permitted in Missouri, these telehealth expansions can help increase access to care.
• Litigation Update: In July, a Jackson County circuit court judge issued a preliminary injunction blocking the enforcement of Missouri’s abortion bans and several targeted regulations of abortion providers. The new preliminary injunction clears the way for Missouri’s Planned Parenthood members to again provide procedural abortion care. While a number of restrictions were overturned, the 72 hour waiting period remains in place, making TMAB possible, although only through hybrid care. 

Michigan:

• Litigation Update: Michigan courts ruled that their abortion restrictions—including a 24-hour waiting period—are unconstitutional and that abortion rights are codified in the state’s constitution. Virtual-only (also known as direct to patient) TMAB is currently permitted in Michigan as the 24-hour waiting period law is currently blocked by a preliminary ruling.

New York:

‍The legislature has enacted and introduced multiple bills impacting the expansion of telehealth for abortion care, including: 

• Enacted/ Issued:
  
  • A.3007A, which prohibits insurers from adverse action against providers for legally protected health activity, safeguarding telehealth for medication abortion providers from increased coverage costs related to abortion services.
  • S.36A, permitting prescription labels for medication abortion prescription drugs (mifepristone, misoprostol and their generic alternatives) to include the name of the prescribing health care practice instead of the name of the prescriber at the prescriber's request, protecting provider privacy.
  • S.3007, which repeals NY’s abortion reporting requirements. The law also lists abortion as a form of emergency treatment that hospitals must provide. The removal of the medically unnecessary requirement removes a significant administrative burden for telehealth abortion providers in the state. 
  • Issued Medicaid updates, including expanded eConsult coverage in outpatient settings, and updated its Medicaid Telehealth Policy Manual to clarify various policies, helping to ensure that telehealth is reimbursed by state Medicaid with greater clarity and function.  
• Introduced:
  
  • S.1438A, which establishes a New York State Abortion Clinical Training Program within the Department of Health. Its goal is to train health care practitioners in performing abortion, including TMAB, and related reproductive health services. 
  • S.4914B, which protects individuals who provide or receive legally protected health activity from criminal or civil liability or professional sanctions imposed by jurisdictions outside the state. 
  • A.609, which requires coverage for delivery of contraceptive care through store and forward technology, including telemedicine services. 
  • S.929 is awaiting Governor Hochul’s signature and would regulate how companies collect and sell health care information, establish data privacy standards for entities that collect personal data related to individuals’ health and provide additional rights and protections to users related to consent and deletion of private health information. 

Vermont:

Enacted S28 in May, expanding its shield law to protect medication abortion and trans health care. The law permits facility names on prescriptions, bans deceptive advertising, allows telehealth prescribing of medication abortion,  protects out-of-state providers, enables new patient communication methods, and expands the telehealth abortion workforce by removing restrictions on physician assistants and APRNs.

Virginia:

• Enacted S.B.1041 establishing telehealth sexual assault forensic examinations, allowing health care providers to conduct examinations under the supervision of a sexual assault forensic examiner. VA provides funding for abortion care in cases of rape or incest. In states where abortion care can only be provided in the case of rape or incest, using telehealth to perform a forensic examine can offer survivors a more discreet and less invasive route to care. 
• Enacted S.B.842 directing the VA Department of Housing and Community Development to prioritize broadband access for mobile telehealth clinics using federal funding. VA allows for telehealth for medication abortion and the expansion of broadband access can help support the reach of abortion care. 
• Passed H.B. 1904, which allows a physician to provide consultation via telehealth, including audio-only consultation, when a certified nurse-midwife, licensed certified midwife, or pediatric nurse practitioner is providing coverage for the 24-hour on-call duty roster and a physician is incapable of arriving on site within 30 minutes of notification.
• Passed S.B. 1352/H.B. 1635, allowing collaboration and consultation between advanced practice registered nurses or certified midwives and a physician to be provided through telemedicine. 
• Passed H.B. 2473, which allows the Board of Pharmacy to register entities providing telemedicine services to prescribe controlled substances remotely, as long as the prescribing complies with federal telemedicine regulations and the patient is not physically present with the practitioner.

Louisiana:

‍On August 1st, HB575 went into effect. The law extends the window for abortion lawsuits from three years to five years and allows out-of-state doctors and activists to be sued, effectively enabling people to sue out-of-state doctors who mail abortion pills via telehealth into the state.

Maine:

‍Passed ME LD583 which permits practitioners prescribing mifepristone, misoprostol, or their generics, to request the drug label display their facility's name instead of their own. This increases safety and privacy for prescribers.

Maryland:

‍Enacted MD S.B.0372 (effective June 1, 2025) the “Preserve Telehealth Access Act of 2025” which outlines provisions to enhance telehealth services by removing previous limitations on audio-only care, ensuring payment parity for telehealth visits, including audio-only under state medicaid and by private insurers. 

Ohio: 

• Litigation Update: In Planned Parenthood Southwest Ohio v. Yost, the Court granted a preliminary injunction against enforcing OH’s bill (OH SB 260) which effectively prohibits advanced practice clinicians (APCs) from providing medication abortion via telemedicine. By allowing qualified providers—such as nurse practitioners, physician assistants, and certified nurse-midwives—to deliver this care, the decision significantly expands access, particularly through telehealth.

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Federal Policy

Food and Drug Administration (FDA):

• Whole Women’s Health Org v. FDA: In May, a Federal District Court in Virginia heard arguments regarding mifepristone restrictions, marking the Trump administration's first court appearance on medication abortion. The case challenges existing requirements for providers and patients. We advocate for removing these restrictions and will monitor the case.
• In June, California, Massachusetts, New York, and New Jersey filed a Citizen Petition requesting the FDA eliminate the current REMS for mifepristone or stop enforcing unnecessary restrictions on the provision of the medication. Eliminating these barriers can pave the way for greater, more equitable access to telehealth prescribing for medication abortion by increasing the providers and pharmacies available for virtual services. 
• In May, an individual, James Brinkruff, filed a Citizen Petition requesting immediate suspension of the approval of mifepristone for medication abortion, an FDA study of mifepristone when used via telehealth, and imposition of requirements for in-person dispensing and a follow-up appointment. 

Federal Communications Commission (FCC):

• In June, in FCC v. Consumers’ Research, the Supreme Court preserved the Universal Service Fund, an initiative stemming from the 1934 Communications Act. For decades, this fund has been a vital lifeline, connecting over 100,000 schools, 12,000 libraries, 54 million students, 16,000 rural health care providers, and more than 7.5 million low-income households to the internet. It helps low-income families, veterans, and students stay connected to their doctors, classrooms, jobs, communities, and loved ones.

Rollback of HIPAA Protections for Reproductive Healthcare:

A recent U.S. District Court ruling by Trump appointee, Judge Matthew Kacsmaryk, vacated most of a Biden administration rule aimed at protecting reproductive health care privacy. The judge argued the 2024 rule overstepped its authority by unlawfully limiting state public health laws, redefining terms beyond statutory limits, and delegating excessive power to the Department of Health and Human Services (HHS). This decision, unlikely to be appealed by the Trump administration, increases the risk of state law enforcement investigations for patients seeking reproductive health care in restrictive states.

Rollback of the Digital Equity Act:

‍The Trump administration canceled the Digital Equity Act in May, a program from the 2021 Bipartisan Infrastructure Law. This act was the first federal funding for digital inclusion at state and local levels, designed to close the digital divide by providing grants for broadband access and digital skills training in underserved communities.

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The U.S. Drug Enforcement Agency (DEA) extended the COVID-19 telemedicine flexibilities for prescribing controlled medications for a third time and waived the in-person visit requirement for prescribing  controlled substances through 2025.

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The Centers for Medicare & Medicaid Services (CMS)extended several telehealth waivers through 2025 including permitting virtual supervision for residents in all teaching settings for virtual services and updated the definition of an interactive telecommunications system to include two-way, audio-only communication for any Medicare telehealth service furnished to a beneficiary in their home. Congressional action is needed in 2025 to make these waivers permanent.

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In July, Congress passed the “One Big Beautiful Bill Act” (OBBA). While the bill severely weakens the ability for states to provide Medicaid funding for reproductive healthcare services, it does help expand access to telehealth more broadly. Some highlights:

• TMAB Impact: The OBBB directly targets health care organizations that offer abortion services, barring them from receiving Medicaid reimbursements for any reproductive health care services they provide, not just abortions. In July, a federal judge blocked a provision in the bill that would strip Medicaid funding from Planned Parenthood, ruling it likely unconstitutional for targeting the organization due to its abortion services. 
• Telehealth Expansion: The bill makes permanent the telehealth safe harbor for Health Savings Accounts (HSAs) under high-deductible health plans (HDHPs). This means that HDHPs can continue to cover telehealth services before the deductible is met without impacting HSA eligibility, a provision that had previously been temporarily extended due to the CARES Act. This change is effective for plan years beginning after December 31, 2024.

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