Civil rights advocates in North Dakota hope the federal government keeps pursuing plans to expand privacy protections for patients seeking out-of-state reproductive care.

Their pleas come amid a controversy over GOP-led opposition in some states. Specifically, Republican attorneys general from 19 states, including North Dakota, want the Health and Human Services Department to stop its pursuit of updating a HIPAA privacy rule. It would shield abortion care records of patients from states now banning the procedure who travel to states considered "safe havens."

Cody Schuler, advocacy manager for the ACLU of North Dakota, said officials should not be pushing to maintain access to such information.

"People have a right to access abortion and gender-affirming care in states where it's legal, even if it's not legal in their state," Schuler asserted. "We need clear legal protections to prevent hostile states from interfering with necessary health care nationwide."

Schuler feels Republican attorneys general want to keep the door open to pursue investigations for such situations. But in a letter issued last month, the GOP officeholders contended there is a false narrative they want to treat pregnant women as criminals, and add the proposed rule interferes with their ability to enforce their own laws.

Meanwhile, Schuler noted it is helpful when places like Minnesota offer protections for out-of-state residents seeking abortions or gender-affirming care. Since the landmark Roe-versus-Wade law was overturned, advocates are highly motivated to enshrine any protections they can out of concern the balance of power could one day shift in "safe haven" states.

"At any point in time, a new attorney general could take office in any of these states," Schuler pointed out. "Legislatures could swing, governors' offices could swing. "

And reproductive rights voices said having a patchwork of different laws is creating confusion and inequalities for patients while prompting physicians to leave states with abortion bans. As for the HIPAA rule, a final decision is expected to be published later this year. It's unclear if opponents will file a lawsuit.


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Nevada health-care providers, patients and advocates are responding to the U.S. Supreme Court case that'll determine the future of the Emergency Medical Treatment and Labor Act.

The federal law mandates Medicare-funded hospitals provide patients with stabilizing care in emergency situations, which include abortions.

Dr. Christine Miyake is an emergency physician with the Valley Health System in Las Vegas, and said abortions are sometimes a necessary part of health care.

"I saw a patient who ruptured her membranes early and developed a severe uterine infection," said Miyake. "She was dying from that infection. If they were not able to provide the abortion, she surely would have died - as no amount of antibiotics would've helped her."

Miyake said abortion bans around the country have driven physicians out of their respective states - causing hospitals to shut down their labor-maternity wards, making it harder for women to access what she called "basic pregnancy care."

In Nevada the right to an abortion is protected though state law, but an initiative petition is working to enshrine abortion rights in the state's constitution.

Laura Campbell is the director of the National Organization for Women's Nevada Chapter, and said she received lifesaving care while she was pregnant - and contended that EMTALA is key to protecting the very care that saved her life.

But anti-abortion proponents argue that state laws that ban abortion access can coexist with the federal law. Campbell disagreed.

"With total bans on abortions in neighboring states like Arizona, Utah, and Idaho," said Campbell, "there is no question that Nevadans deserve to have their abortion rights protected in the state constitution to ensure that no judge or politician can strip away the right to make their own health-care choices."

Eighty-six percent of the public supports protecting access to abortion for patients experiencing pregnancy-related emergencies, according to a recent KFF poll.




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The Missouri Legislature has approved a law to stop its Medicaid program, known as MO HealthNet, from paying Planned Parenthood for medical services for Medicaid patients.

The decision follows a court ruling which found not reimbursing Planned Parenthood through Medicaid goes against Missouri's constitution.

Emily Wales, president and CEO of Planned Parenthood Great Plains, said they have joined forces with Planned Parenthood St. Louis Region and Southwest Missouri and stand behind providing health care to those who need it. She argued the Legislature is causing confusion despite a clear decision from the highest court.

"Despite the court's repeatedly ruling that 'defunding' Planned Parenthood health centers is unconstitutional, lawmakers continue to deny critical care like birth control, cancer screenings, wellness exams and STI testing and treatment from the patients who need it," Wales stressed.

According to the Missouri Family Health Council, Planned Parenthood health centers serve nearly half of patients who rely on family planning safety net providers in the state. Planned Parenthood Great Plains and St. Louis Region Southwest Missouri will continue serving patients and is looking for alternative solutions for funding.

The new law also blocks Planned Parenthood from being a recognized provider in the state's Medicaid program. Wales pointed out it could hurt health care for people who rely on the safety net.

"There are not enough other providers in the health care safety-net system to absorb Planned Parenthood's patients," Wales pointed out. "At Planned Parenthood, we'll continue to do everything we can to serve our patients, no matter what."

Planned Parenthood Great Plains provides health care to more than 30,000 people in 13 health centers across Missouri, Arkansas, Kansas and Oklahoma. The St. Louis Region and Southwest Missouri chapter has been serving for more than 90 years.

The U.S. Supreme Court is set to hear oral arguments today in a case about whether patients have access to emergency room abortions in states banning the procedure.

Idaho v. United States could determine if providers can perform medically necessary abortions for women experiencing complications under decades-old rules known as the Emergency Medical Treatment and Labor Act.

Dr. Polly Wiltz, a second-year emergency medicine resident at University Hospitals in Cleveland, said she is worried about her ability to care for patients who need abortions, if protections end.

"We are putting ourselves at risk for allowing legislators -- allowing people who do not have medical training -- to pick and choose which procedures, which life-stabilizing treatments and medications can and cannot be applied in the emergency department," Wiltz pointed out. "It's infringing on patient rights."

The Center for American Progress said pregnant patients with severe complications who are denied abortions could develop severe sepsis requiring limb amputation, uncontrollable uterine hemorrhage requiring hysterectomy, kidney failure requiring lifelong dialysis, hypoxic brain injury and other severe conditions.

Wiltz added most of the patients with pregnancy complications coming into the hospital lack access to routine OBGYN-related care.

"Regarding pregnancy related complaints, I see first trimester pregnant patients every single day," Wiltz noted. "In my shift, I have caught ectopic pregnancies that have ruptured."

Hospitals made up 33% of the facilities providing abortions in 2020, according to data from the Pew Research Center. Last fall, a majority of Ohio voters chose to approve a constitutional amendment, "Issue 1," establishing a statewide right to abortion and reproductive care in the aftermath of the Roe versus Wade decision.


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