Three years after the Supreme Court overturned Roe v. Wade, states continue to diverge on reproductive health care access. Some have moved to restrict abortion and related services, while others have enacted protections for those seeking or providing reproductive care. This divide has led to increased legal actions, particularly as states with restrictive laws attempt to enforce them beyond their borders.
Texas and Louisiana have taken legal action against out-of-state doctors who prescribe abortion medication to residents of their states. These efforts have been met with resistance from states like New York, which have implemented shield laws intended to protect providers and patients from investigations tied to other states’ abortion restrictions. Legal experts say these conflicts are likely to persist as states hostile to abortion seek records from jurisdictions with protective measures in place.
Challenges are also being made at the federal level regarding privacy protections for reproductive health information. In spring 2024, the Department of Health and Human Services’ Office of Civil Rights updated the HIPAA Privacy Rule to prevent healthcare entities from sharing patient data with law enforcement if the care was legal where it occurred—a move supported by the Center for Democracy & Technology (CDT). According to CDT, “The rule was designed to increase the trust between patients and doctors, as patients who fear their medical data might be shared without their knowledge, and even used against them in court, might otherwise be deterred from seeking care.”
Multiple states, including Texas and Tennessee (joined by 14 others), challenged this update. Texas went further by contesting not only the 2024 revision but also the original HIPAA Privacy Rule established in 2000. In another case, Purl v. Department of Health and Human Services, a Texas doctor argued that new privacy provisions could hinder her ability to report suspected abuse; a district court judge ruled in her favor and vacated the 2024 rule nationwide.
“If the lower court’s decision withstands any appeal, it will diminish health care outcomes,” CDT stated. “If patients can’t trust that doctors and insurance companies will keep their reproductive health data private, patients are less likely to be candid and open with their doctors or to seek care in the first place.”
Recent reports indicate law enforcement agencies are not limiting themselves to HIPAA-regulated sources when seeking reproductive health information. States have obtained commercially available data from private companies—including location data—to track individuals traveling for reproductive care.
This environment places responsibility on companies that collect consumer data—both inside and outside of healthcare—to manage sensitive information carefully. As CDT noted: “Many types of data can reveal sensitive information about a person’s health and healthcare choices. Search queries, browsing history, the contents of electronic communications, and a person’s location data can all reveal such private information…”
CDT urges companies across sectors to follow best practices in handling personal data: “Without thoughtful action, a company’s data practices may be complicit in exposing its customers to criminal prosecution or civil litigation for health care that is still legal in the majority of the United States and that was constitutionally protected for almost 50 years.”