By Jessica Semler
Pittsburgh Current Columnist
Last week, the Pennsylvania State Legislature passed a doomed Telemedicine Bill intended to expand healthcare access across the Commonwealth. Some House Republicans added an amendment, a “poison pill,” using the bill as a vehicle to ban medication abortion coverage.
This is the third time in three years that something similar has happened, and it isn’t just Democrats who are disappointed in this tactic.
“It’s just totally confounding to me… and I’m pro-life,” said former House Rep. Mark Mustio, who also said the amendment was unconstitutional. At the time he even credited the last-minute amendment from State Representative Kathy Rapp as an example of why he wasn’t running for his seat again. “This puts the cap on the reason I’m retiring,” Mustio said. “Because it is absolutely asinine up here, when you have an issue that passes unanimously but you can’t get it across the goal line.”
In October of 2019, before the House added in the abortion restriction, the Senate passed the bill with near-unanimous support, 47-1. Citing the COVID-19 crisis as a reason to bring up this legislation again is valid, but with the presence of the abortion amendment, the Senate voted along party lines, 29-21. Governor Wolf says he will veto the bill. I explained this to my partner, who was perplexed. “To be clear: a bill that had already been passed in the State Senate, had been amended by a State Representative so that abortion-related services could not be provided over Telemedicine?” Yes. That’s how this started and it doesn’t get better.
State Representative Michelle Brooks said that she was disappointed with Gov. Wolf for letting their “philosophical differences” take precedence to granting healthcare access to folks in rural communities. It’s infuriating that Republicans are laying the third failure of the Telehealth legislation at Wolf’s feet, when they are the ones that added an amendment that is definitively incompatible with healthcare access.
To be clear, this ceases to be a philosophical difference of opinion about abortion when it becomes enshrined in law, which is what these Republicans are attempting to do. Like other efforts to restrict abortion, their reasoning is not based in science and reinforces stigma. Senator Larry Farnese summed it up perfectly: “We are in the middle of a pandemic and for some reason, we cannot control ourselves in this building because we seize on every opportunity even in the middle of a pandemic, we frustrate a woman’s legal right to abortion.”
The amended bill prevents the use of telemedicine for abortions, along with other reproductive services, under the guise of “safety.” Mifepristone is one of the two medication abortion drugs, and under the FDA is still listed under REMS (Risk Evaluation and Mitigation Strategy), which requires the medication to be dispensed only by certified prescribers and only in clinics, medical offices or hospitals. This isn’t justified, however. Major medical organizations including the American Medical Association, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians recommended removing the REMS restrictions, because of the drug’s high degree of effectiveness and the risk of a minor complication.
It’s also wild that medical abortions would be restricted by this telehealth bill when there is such a massive dearth of options for folks who need reproductive care in Pennsylvania, especially in rural communities. It always bears repeating: there are no rights when there is no access. Half of U.S. counties lack an OB-GYN in 2017, and 85% of counties in Pennsylvania have no abortion providers. The burdens that accompany obtaining an abortion are unnecessary. So many people have to drive several hours, spend money on gas and hotel rooms, pay for childcare for their existing children, all to have a procedure that has fewer complications than getting wisdom teeth removed. For a procedure that continues to be so politicized and stigmatized, telehealth would be a game-changer.
Mike Straub, Press Secretary to the PA House Republicans, tried to assuage folks’ concerns by saying, “There’s no effort to restrict people within existing abortion law, and people trying to obtain that medicine could obtain it in the same way that they can obtain it today.” This argument gets to the heart of anti-choice folk’s long game. For years, abortion has been forcibly separated from other types of reproductive care, and healthcare at large. Due to the Hyde Amendment and Title X restrictions, abortion clinics have to exist completely separately from family planning clinics so places like Planned Parenthood can continue to help folks get their needed gynecological care. Standalone clinics have been subject to thousands of legislative attacks all over the country and been forced to shut down as a result. Every OB-GYN practice in the country should be offering abortion care; one-third of people with uteruses will have an abortion by the time they are 45. We must challenge folks who treat this necessary care as something to debate, or something to philosophize about.
By being purposely siloed from the infrastructure and resources given to other forms of health care, abortion access continues to be peeled away. Telemedicine can and should revolutionize the way folks experience healthcare. Our underserved communities need and deserve this care. It is imperative that as we move forward into this new world, abortion care cannot be written off, or purposefully excluded. Abortion is healthcare. Healthcare is essential. Legislators can leave their personal beliefs out of it.