Policy Update

State Policy

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Telehealth & Abortion: State Trends and Policy Watch 

Both telehealth and abortion related legislation, regulation, and litigation are on the rise, and have been since the post-Dobbs and COVID Era. Our State Trends & Policy Watch demonstrates how policy and current events intersect and continue to shape the healthcare landscape for millions of patients across the country. Abortion does not exist in a silo in our healthcare system, and neither does telehealth.

• Expanding Access via Scope of Practice & Workforce: Arizona (HB 2530), New Mexico (S B001), and Michigan (SB 303) are making progress expanding interstate licensure through the Interstate Medical Licensure Compact (IMLC). Importantly, New Mexico (S B001)included protections for reproductive healthcare across state lines for doctors licensed through the IMLC. New Jersey (Executive Order) temporarily extended the ability for certain Advanced Practice Clinicians (APCs) to continue to practice independently, prolonging COVID-era expansions until legislation is passed. Rhode Island (HB 7741) introduced a bill that would prohibit out-of-state boards from sanctioning APCs solely because a healthcare service was delivered using telemedicine rather than in person and also expanded the ability to form a patient-provider relationship. Additional legislation has been introduced in New Jersey( (S 2996): and Arizona (HB 2530). 
  
  • New Jersey (Executive Order): Temporarily extends the ability of (Advanced Practice Nurses) APNs and Physicians Assistants (PAs) to practice independently to ensure continued medication abortion and contraceptive services. 
  • New Jersey (S 2996): Seeks permanent "Full Practice Authority," removing physician supervision requirements for APNs after a specific period of practice. 
  • Arizona (HB 2530): Would broaden the pool of providers by allowing nurse practitioners, midwives, and PAs to perform both medication and surgical abortions. 
  • New Mexico (S B001): Would join the Interstate Medical Licensure Compact (IMLC) to allow out-of-state physicians to fill healthcare workforce shortages. The bill would also prevent state boards from helping other states investigate doctors for care that is legal in NM (specifically abortion, reproductive healthcare, and gender affirming care) and would ensure that any licensure suspensions originating from an IMLC state with an abortion or gender-affirming care bar, directly relating to the provision of such care shall be removed immediately. 
  • Michigan (SB 303):  Seeks to prevent its withdrawal from the Interstate Medical Licensure Compact (IMLC), as the state's participation is set to expire on March 28, 2026. Unlike NM, this IMLC bill does not contain any additional protective layers for abortion or gender affirming care for doctors licensed through the IMLC. 
  • Rhode Island (HB 7741): Introduced legislation prohibiting state boards from sanctioning APRNs, physicians, or PAs solely because a healthcare service was delivered via telemedicine rather than in person, provided the service is necessary and clinically appropriate. It also protects Rhode Island-licensed providers from being sanctioned by the state if another jurisdiction seeks to discipline them for providing telemedicine services to patients outside Rhode Island, as long as certain conditions are met, such as the existence of an established patient-provider relationship and recent in-person visits. Notably, this bill gives Rhode Island more authority over regulating providers in their state that are offering telehealth, even when their patient is across state lines.
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• Removing Telehealth Barriers & Administrative Hurdles: Legislation or rulings aimed at eliminating "unnecessary" steps (like waiting periods) that impede telehealth provision of care. This trend may also allow for the expansion of services and improved access to care. Arizona (Judicial Ruling) made the most access improvements to TMAB, specifically when a court struck down the 24-hour waiting period and the ban on telemedicine abortion services. Other legislation is being watched in Washington (HB 2535) and Vermont (SB 245).
  
  • Arizona (Judicial Ruling): Struck down a 24-hour waiting period and a ban on telemedicine for abortion services, citing the 2024 constitutional amendment.
  • Arizona (HB 2530): Explicitly removes mandatory ultrasounds and the 24-hour waiting period to streamline direct-to-patient telehealth. Introduced. 
  • Washington (HB 2535): Requires student health centers to provide medication abortion and ensures students have private spaces/tech support for telehealth appointments. In committee as of March. 
  • Vermont (SB 245): Introduced legislation modernizing telehealth by allowing recorded consultations (with mutual consent), prioritizing patient autonomy and clinical documentation.
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• ‍Increasing Patient & Provider Protections: We continue to see the introduction and passage of more robust bills designed to shield providers from punitive out-of-state laws criminalizing or preventing access to safe and effective abortion care and protect patient privacy. Hawaii (HB 2038) became the latest state to introduce a bill that allows patients’ and providers’ names to be removed from mifepristone labels.  New York (AB 8656, S 8544) continues to lead expansive protections with a new bill protecting providers from "criminal diversion" charges if they prescribe medication abortion drugs according to World Health Organization (WHO) guidelines, even if FDA approval is rescinded. Additional protections have been introduced in New Mexico (SB001).
  
  • New York (AB 8656): Passed state senate as of March and allows mifepristone/misoprostol to be dispensed without the patient or dispenser’s name/address on the label to protect privacy. 
  • Hawaii (HB 2038): Allows patients to opt-out of having their name/address on the prescription label for medication abortion. The Committee on HHS deferred this measure. 
  • New York (S 8544): Passed the state senate and assembly as of March and protects providers from "criminal diversion" charges if they prescribe medication abortion drugs according to WHO guidelines, even if FDA approval is rescinded. 
  • New Mexico (SB001 - Protections): Was signed by the NM Governor in February and includes "Shield Law" provisions that prevent state boards from helping other states investigate providers for care that is legal in NM.‍
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• Restricting Telehealth for Abortion Care & Access to Mifepristone & Misoprostol: As telehealth remains a steady, safe, effective and popular way for patients to receive abortion care, anti-abortion lawmakers continue their attacks with more restrictive bills that ultimately impact telehealth access much more broadly than just abortion care. This includes legislation in Iowa (SSB 3115), Ohio (HB 324), and Nebraska (LB 512), where we have seen attempts to require an in-person visit, a policy that is rejected by the telehealth industry for health care generally.  Many of these lawmakers have introduced bills designed to put unnecessary restrictions on medication abortion access, limiting the ability to provide safe and effective telehealth services, regardless of the standard of care.  We are also keeping an eye on legislation in South Carolina  (HB 4760) and Arizona (HB 2364). 
  
  • Iowa (SSB 3115): Requires a mandatory in-person visit before a prescription can be issued, effectively ending the telehealth model in the state. 
  • Ohio (HB 324): Effectively aims to restrict MAB by banning telehealth prescriptions for abortion drugs, requiring in-person visits, mandating specific warnings about severe complications (like sepsis or organ failure) for patients, and allowing potential lawsuits against providers or fathers if complications arise from inadequate information.
  • Nebraska (LB 512), similar to Iowa, requires an appointment with a physician before receiving abortion-inducing drugs, as well as attending a follow-up visit to monitor for complications. The measure also outlines additional medically unnecessary steps that physicians must take before prescribing the medication. 
  • South Carolina (HB 4760): Limits the "defense" against criminal abortion charges only to cases where a physician provides the drug in person. 
  • Arizona (HB 2364): Mandates that only physicians provide medication abortion and strictly prohibits delivery via courier or mail. 

• Criminalization & Reclassification of Medication: Another popular anti-abortion trend is to attempt to limit access to abortion by reclassifying mifepristone and misoprostol, which are common medications, as controlled substances or creating high-level felonies for distribution.  While states are permitted to add substances to set their own drug schedules, these regulations have typically been reserved for drugs that have high rates of misuse, diversion or overdose, which neither Mifepristone or Misoprostol demonstrate. Abusing state controlled substance laws to meet political agendas is a slippery slope for the future of all pharmaceuticals and the future of telehealth more broadly, as there are heightened restrictions on controlled substance prescriptions and distribution via telehealth. We have seen such attempts recently in South Carolina  (HB 4760), Iowa (HF 2155), Mississippi (HB 1613), West Virginia (SB 599), and Maryland (HB 302).  
  
  • South Carolina (HB 4760): Reclassifies mifepristone and misoprostol as Schedule IV controlled substances and creates felony penalties for distribution.
  • Iowa (HF 2155): Makes manufacturing or distributing abortion-inducing drugs a Class C felony. 
  • Mississippi (HB 1613): Amends drug trafficking laws to include the transfer or sale of medication abortion as a felony offense. 
  • West Virginia (SB 599): Prohibits abortifacients and creates private causes of action (lawsuits) for supplying them. 
  • Maryland (HB 302): Prohibits "causing the ingestion" of an abortion-inducing drug under the "Women’s Freedom From Coercion Act."

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Federal Policy  

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• Federal legislation has extended many Medicare telehealth flexibilities through December 31, 2027, ensuring the continued waiver of geographic site and in-person requirements. The policy expands the list of eligible providers to include rural health centers and maintains the essential use of audio-only technology. This federal stability, although not permanent, provides a critical foundation for the ongoing expansion of telehealth abortion access nationwide.
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• On January 14, the Senate HELP Committee held a hearing purporting to examine the safety of medication abortion by recycling long-debunked disinformation about the medication, despite extensive medical evidence demonstrating its safety and efficacy. Hearings like this harm women and people seeking care and fuel fear in order to justify further unnecessary and dangerous restrictions on abortion care. This rhetoric also undermines trust in the provision of care via telehealth, casting doubt on a proven, safe way millions across the country access essential care, including reproductive care. Dr. Nisha Verma, MD, MPH, FACOG, a board-certified obstetrician-gynecologist and Fellow with Physicians for Reproductive Health, testified before the committee, speaking to her clinical experience and emphasizing the established safety of medication abortion and the importance of evidence-based reproductive health care. Read her written testimony here, and watch the hearing here.

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