In October, fifteen Democratic governors announced the formation of a state public health alliance designed to counter turmoil at federal agencies under the Trump administration. Leaders of the Governors' Public Health Alliance said it will serve as a hub for governors and public health leaders to monitor disease outbreaks and establish public health policy guidance, including telehealth and abortion.
Summary of Fall Policy Updates:
While Fall is typically slower on the state legislative front, we have seen a few notable bills introduced impacting access to telehealth for abortion care. New York introduced a bill to extend state Freedom of Access to Clinic Entrances (FACE) Act protections to locations connected to telehealth services, and Massachusetts introduced a bill to mandate equal coverage and prohibit prior authorization for telehealth, significantly boosting digital equity. On the federal side, a district court ruled the FDA is required to re-evaluate and remove overly strict limitations on mifepristone. Concurrently, federal privacy assurances for HIPAA covered-telehealth abortion providers diminished when the administration chose not to challenge a June ruling that vacated the HIPAA Privacy Rule designed to protect reproductive health care data. A full analysis of state and federal policy updates over the last quarter can be found here.
State Policy
New York
- Introduced Assembly Bill A9227, a first-of-its-kind bill extending state Freedom of Access to Clinic Entrances (FACE) Act protections for abortion clinics to include telehealth services related to pregnancy, reproduction, miscarriage, and contraception.
- Introduced Assembly Bill A9182, which provides that no facility fee shall be charged for services when a hospital-based facility is a distant site for health care services delivered by telehealth, unless the service is provided by a health care provider not authorized to bill a professional fee separately for the service.
District of Columbia
- Introduced DC B26-0356, which clarifies and narrows the scope of remote patient monitoring coverage for pregnant and postpartum patients in D.C. to specifically include blood pressure and glucose monitoring, aiming to improve maternal health outcomes.
Massachusetts
- Introduced H.1130, which aims to enhance telehealth services and digital equity by mandating coverage reimbursement for telehealth e-consults and e-visits (amongst other services), including interpreter services. It also requires the development of education programs to assist individuals with low digital health literacy. Importantly, the act prohibits prior authorization requirements for telehealth services that would not apply to in-person services and ensures that physicians can provide telehealth services from any location, provided patient confidentiality is maintained.
- Introduced H.2222, which would establish a commission to study and improve telehealth services, with a report due by December 31, 2026.
- Introduced H.4344, which requires state health insurers to cover doula services, including via telehealth, without cost-sharing, establishes a Doula Advisory Committee, and guarantees patient access to doulas during labor and delivery, aiming to improve maternal and infant health outcomes and promote health equity.
Wisconsin
- Introduced 440.18, which allows out-of-state health care providers to offer telehealth services in Wisconsin by registering with the Department of Safety and Professional Services (DSPS) or an applicable credentialing board. To qualify, providers must have an active and unencumbered credential from another state, not have faced disciplinary actions in the past five years, and designate an agent for service of process in Wisconsin. The bill mandates that DSPS publish a list of registered telehealth providers, including their credentials and disciplinary history. This is language adapted from the Uniform Telehealth Act.
Federal Policy
Trump Administration:
- The ACLU and Reproductive Freedom for All have both taken legal action against the Trump administration regarding new mifepristone regulations. Reproductive Freedom for All filed a lawsuit in October, alleging the administration is withholding public records about its communications with anti-abortion groups concerning the medication. The ACLU followed suit in November, filing its own lawsuit to compel the administration to comply with a Freedom of Information Act (FOIA) request for related records.
Congress:
- In the agreement to end the federal government shutdown, Congress passed a temporary extension of Medicare telehealth waivers, which allow patients to continue accessing a broad range of telehealth services from home, preserving the more flexible coverage and provider options established during the COVID-19 public health emergency, and had previously expired on October 1, 2025. The telehealth waivers that had expired will now be extended through January 30, 2026.
Food and Drug Administration (FDA):
- After a 4-year approval process, the FDA approved another generic version of mifepristone, manufactured by Evita Solutions, the third company to manufacture mifepristone.
- In a case brought by the ACLU, a federal court mandated the FDA to re-evaluate its unnecessarily strict limitations on mifepristone. The court determined the current restrictions violate federal law by ignoring the significant evidence supporting the pill’s safety and efficacy. This ruling directly contradicts the Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.'s recent investigation into mifepristone, which was based on a discredited pseudo-study.
Health and Human Services (HHS)
- The "HIPAA Privacy Rule To Support Reproductive Health Care Privacy", a Biden Administration policy that aimed to enhance protections for reproductive health care data, was vacated by a June decision. The Trump Administration has confirmed it would not appeal the ruling. This dismissal, along with the government's non-challenge of the Purl ruling, appears to conclude the HIPAA reproductive health care protections previously offered by the policy.
Legislative Tracker
Keep up with the bills that RHITES is following across the country! Using our Legislative Tracker, select states and bills to get information on their current status in their state legislatures.
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