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The Hill
15-04-2025
- Health
- The Hill
More Americans are using online-only clinics to have abortions, data show
The number of abortions in the U.S. keeps rising with more Americans turning to online-only clinics for medication abortions, according to new data released Tuesday. In-clinic abortion in states without bans on the procedure have remained relatively stable in recent years. There were 1,038,100 clinician-provided abortions in states without abortion bans last year, an increase of less than 1 percent from 2023, according to a report from the reproductive rights group the Guttmacher Institute. Meanwhile, the portion of abortions in those states that were provided through an online-only clinic has gone up, rising to 14 percent in 2024 from 10 percent in 2023 which translates to an increase of about 40,000 abortions, according to the nonprofit. The number of medication abortions accessed through an online-only clinic is 'almost certainly higher,' the report notes, since the survey did not take into account the abortions provided in states with bans on the procedure under a shield law provision. Overall, the country's abortion numbers have remained stable despite numerous state bans on abortions that have been rolled out since the 2022 overturning of Roe v. Wade. There are currently 12 states with total abortion bans in effect. Iowa and Florida enacted bans at six weeks of gestation last year that have 'drastically narrowed' the options for abortion access among in-state and out-of-state residents. Abortion shield laws have been enacted in states where abortion is legal to protect patients and health care providers from civil, criminal and professional consequences for providing abortion care to people who live in states with abortion restrictions. At least 34,500 medication abortions were provided in the first half of 2024 via a shield law in states where abortion is banned, according to the Society for Family Planning. The increased use of online-only clinics could be linked to the roughly 9 percent decrease in Americans traveling out of state to receive an abortion. About 155,000 people crossed state lines for an abortion in 2024 and the year before roughly 169,000 people traveled out of state to receive abortion care, according to the report. 'Where it is available, telehealth provision of abortion can significantly mitigate many of the barriers that patients face when seeking abortion services, such as lowering the costs and time needed to travel to a provider,' a policy analysis released along with the survey reads. While travel for abortion care has dropped, travel to states with less restrictive abortion policies remains a 'critical pathway' for those seeking abortion care in states with bans or severe restrictions on the procedure, the survey notes. Especially since the overwhelming majority of abortions are still performed in clinics The four states that offered the most abortions to out-of-state residents in 2024 were the same as in 2023: Illinois, North Carolina, Kansas and New Mexico. Abortions for out-of-state residents made up 69 percent of all abortions performed in New Mexico in 2024. Illinois provided abortion care to 35,000 out-of-state residents last year or 39 percent of all abortions performed in the state.
Yahoo
19-02-2025
- Health
- Yahoo
Louisiana, New York battle over abortion laws: What comes next
Louisiana's attorney general is seeking to extradite a New York doctor who prescribed and sent abortion medication through the mail to a resident of the Pelican State, escalating a legal battle surrounding the doctor that could test the limits of state abortion shield laws. The doctor, Margaret Carpenter, faces allegations from both Texas and Louisiana that she violated their laws by helping state residents get abortion pills. Texas Attorney General Ken Paxton (R) sued Carpenter in December for allegedly prescribing and sending abortion medication to a woman in the state last year, and a grand jury in Louisiana indicted her for the same reason last month, prompting state Attorney General Liz Murrill (R) to request her extradition last week. Abortion in Louisiana is almost entirely banned unless deemed necessary to save the life of the mother or prevent 'permanent impairment' of a life-sustaining organ. New York, meanwhile, is one of eight states that has enacted an abortion shield law since the 2022 overturning of Roe v. Wade, the landmark decision that granted Americans a constitutional right to abortion. Those laws are meant to protect health care providers from criminal penalties if they prescribe medication used for abortions to people in states where abortion is restricted or banned. Between 6,000 and almost 10,000 people in states with bans or restrictions on abortion receive care through a shield law every month, according to data from the Society for Family Planning. New York Gov. Kathy Hochul (D) has pledged to protect Carpenter, and she quickly rejected the Louisiana attorney general's request to extradite the doctor last week. 'I will not be signing an extradition order that came from the governor of Louisiana, not now, not ever,' she said. The future of the case is unclear, but legal experts agree that New York will likely not have to extradite Carpenter. There is a chance, however, that she could be extradited if she travels out of New York, even to Democratic-led states like California and Vermont. 'As long as she stays in New York, we may hear nothing more of that case,' said Greer Donley, an associate professor of law at the University of Pittsburgh School of Law. 'The trial literally cannot happen without her presence.' Mary Ziegler, a law professor at the University of California, Davis, believes that current interpretation of U.S. law provides Carpenter with protection from extradition. The extradition clause in the U.S. Constitution and the federal law that implements it primarily determine how extradition requests are treated at a national level. Under federal law, Ziegler said, New York would only be forced to turn over Carpenter if she was in the state of Louisiana when she committed an alleged crime. 'The way that the precedent works at the moment is that you do not have to extradite people who were not in the state that is seeking extradition where the crime was committed,' she said. But individual states are allowed to pass their own statutes on how they want to deal with extradition as well, according to Ziegler. Most states have passed uniform legislation stating that they will, in general, extradite any person they are asked to hand over. State shield laws create exceptions to those extradition laws, which is why Carpenter potentially runs the greatest risk of being turned over to Louisiana if she travels to a state without one. That risk is even greater if she travels to a state without a shield law that is also a Republican-led state and has more restrictive abortion laws than New York, both attorneys said. But traveling to a Democratic-led state could also pose risks to Carpenter even if it has a shield law in place due to one major flaw in how the laws are written, according to Ziegler. 'On the one hand Democratic-led states [with shield laws] are not going to want to extradite you but on the other hand their laws are probably going to say they should,' she said. Several Democratic-run states — California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington, according to a shield law tracker from health care nonprofit KFF — have abortion-related shield laws that specifically provide protections for providers regardless of patient location. But while such laws have been written to protect state residents from extradition, investigations and other criminal prosecutions, they do not offer those reciprocal protections for non-state residents who committed their alleged crimes from other states, Ziegler said. 'I think that's something that shield states might want to address,' she added. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
19-02-2025
- Health
- The Hill
Louisiana, New York battle over abortion laws: What comes next
Louisiana's attorney general is seeking to extradite a New York doctor who prescribed and sent abortion medication through the mail to a resident of the Pelican State, escalating a legal battle surrounding the doctor that could test the limits of state abortion shield laws. The doctor, Margaret Carpenter, faces allegations from both Texas and Louisiana that she violated their laws by helping state residents get abortion pills. Texas Attorney General Ken Paxton (R) sued Carpenter in December for allegedly prescribing and sending abortion medication to a woman in the state last year, and a grand jury in Louisiana indicted her for the same reason last month, prompting state Attorney General Liz Murrill (R) to request her extradition last week. Abortion in Louisiana is almost entirely banned unless deemed necessary to save the life of the mother or prevent 'permanent impairment' of a life-sustaining organ. New York, meanwhile, is one of eight states that has enacted an abortion shield law since the 2022 overturning of Roe v. Wade, the landmark decision that granted Americans a constitutional right to abortion. Those laws are meant to protect health care providers from criminal penalties if they prescribe medication used for abortions to people in states where abortion is restricted or banned. Between 6,000 and almost 10,000 people in states with bans or restrictions on abortion receive care through a shield law every month, according to data from the Society for Family Planning. New York Gov. Kathy Hochul (D) has pledged to protect Carpenter, and she quickly rejected the Louisiana attorney general's request to extradite the doctor last week. 'I will not be signing an extradition order that came from the governor of Louisiana, not now, not ever,' she said. The future of the case is unclear, but legal experts agree that New York will likely not have to extradite Carpenter. There is a chance, however, that she could be extradited if she travels out of New York, even to Democratic-led states like California and Vermont. 'As long as she stays in New York, we may hear nothing more of that case,' said Greer Donley, an associate professor of law at the University of Pittsburgh School of Law. 'The trial literally cannot happen without her presence.' Mary Ziegler, a law professor at the University of California, Davis, believes that current interpretation of U.S. law provides Carpenter with protection from extradition. The extradition clause in the U.S. Constitution and the federal law that implements it primarily determine how extradition requests are treated at a national level. Under federal law, Ziegler said, New York would only be forced to turn over Carpenter if she was in the state of Louisiana when she committed an alleged crime. 'The way that the precedent works at the moment is that you do not have to extradite people who were not in the state that is seeking extradition where the crime was committed,' she said. But individual states are allowed to pass their own statutes on how they want to deal with extradition as well, according to Ziegler. Most states have passed uniform legislation stating that they will, in general, extradite any person they are asked to hand over. State shield laws create exceptions to those extradition laws, which is why Carpenter potentially runs the greatest risk of being turned over to Louisiana if she travels to a state without one. That risk is even greater if she travels to a state without a shield law that is also a Republican-led state and has more restrictive abortion laws than New York, both attorneys said. But traveling to a Democratic-led state could also pose risks to Carpenter even if it has a shield law in place due to one major flaw in how the laws are written, according to Ziegler. 'On the one hand Democratic-led states [with shield laws] are not going to want to extradite you but on the other hand their laws are probably going to say they should,' she said. Several Democratic-run states — California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington, according to a shield law tracker from health care nonprofit KFF — have abortion-related shield laws that specifically provide protections for providers regardless of patient location. But while such laws have been written to protect state residents from extradition, investigations and other criminal prosecutions, they do not offer those reciprocal protections for non-state residents who committed their alleged crimes from other states, Ziegler said. 'I think that's something that shield states might want to address,' she added.
Yahoo
14-02-2025
- Health
- Yahoo
Two states are coming after a New York doctor for mailing abortion pills. Here's what's next.
Since the fall of Roe v. Wade, tens of thousands of people in states with abortion bans have continued to access the procedure through telehealth. But two separate cases targeting a New York physician could test the laws put in place to protect doctors who prescribe and mail abortion medications, jeopardizing the future of abortion access across the country. Dr. Margaret Carpenter has allegedly prescribed and mailed abortion pills to patients in Texas and Louisiana, both states where abortion is almost completely illegal. Texas Attorney General Ken Paxton has filed a civil lawsuit accusing Carpenter of practicing medicine in Texas without a license and violating the state's abortion ban. In Louisiana, a grand jury has indicted Carpenter on criminal charges for allegedly violating the state's abortion ban. The cases test statutes known as shield laws, which have been passed in eight states since the end of Roe. The laws — enacted in California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington — say that the state government will not comply with civil or criminal prosecutions targeting health care providers who perform abortions from their home states, including mailing medication to patients in places where the procedure is outlawed. Those laws have enabled many people to receive abortions despite living in places with abortion bans. The Society for Family Planning estimates that close to 10,000 people in states with bans or restrictions get care through shield laws each month; between the start of 2023 and March 2024, it was more than 65,000 people. Research shows that providing abortion through telehealth, using the medications mifepristone and misoprostol, is highly safe and effective through the first trimester. In Texas, a county judge issued an order Thursday blocking Carpenter from sending abortion medications to the state and fining her $100,000. Carpenter did not attend the hearing. The same day, New York Gov. Kathy Hochul, in compliance with her state's shield law, rejected a request from Louisiana's Republican governor to extradite Carpenter. 'The ruling in Texas does not change that under Shield Laws, patients can access medication abortion from licensed providers no matter where they live. New York, led by Governor Hochul, remains committed to protecting this care,' Julie Kay, a lawyer who, along with Carpenter and New York-based shield law provider Dr. Linda Prine, co-founded the Abortion Coalition for Telemedicine, said in a statement. Carpenter has not been reachable for comment. Prine declined to comment. Kay's remarks were in a written statement. Kay added that the Louisiana case is 'inconsistent with New York state law,' and said the coalition will keep defending shield laws like New York's. The cases represent a remarkable evolution from less than three years ago, when, soon before Roe's overturn, Republicans argued that they would not support policies that could put doctors in prison. 'The attempts to punish a provider who was providing what I understand to be legal care in her state for a patient who desired an abortion is aggressive and threatening,' said Dr. Jonas Swartz, an OB-GYN and abortion provider in North Carolina. 'We've become desensitized to it, but it's a really big deal.' What comes next is the first test of the relatively new shield law infrastructure and the health care model it has enabled. These cases likely will not halt telehealth abortion immediately. But they are expected to yield complex, drawn-out legal battles — one that could end up in the U.S. Supreme Court — with vast possible ramifications. Abortion opponents have voiced frustration with the prevalence of shield laws, and the workaround they've provided for patients seeking abortions. In Texas, anti-abortion activists are pushing for legislation to stop this practice. John Seago, the head of Texas Right to Life, has suggested that more cases, similar to the one against Carpenter, are in the pipeline. There is a risk that cases like Louisiana's and Texas' could deter some providers from offering care through shield laws, Swartz suggested. But others who have been providing telehealth abortion — and relying on shield laws to do so — said previously that individual state-based legal actions would not necessarily stop them. 'We all have gone into this eyes wide open that we knew there would be legal challenges,' Dr. Angel Foster, a physician who co-founded a shield law practice called the Massachusetts Medication Abortion Project, told The 19th in early February. 'We're so confident what we're doing is legal in the state of Massachusetts. Our practice complies with all laws, policies and regulations in the Commonwealth, so we continue to provide legally compliant, high-quality affordable abortion care, and will continue to do so.' A California-based shield law physician, who asked that his name be withheld because of threats of violence against abortion providers, expressed similar confidence. 'I comply with California law to the letter and the spirit,' he said. 'As long as it's legal and ethical to provide these services, I can do so irrespective of other states' actions.' New York's law is likely to prevent enforcement of Texas' judgment, as long as Carpenter physically stays out of the Lone Star State, argued David Cohen, a constitutional law scholar at Drexel University who has advised many states on the construction of their shield laws. 'This case is very clear,' he said. 'Dr. Carpenter would be on incredibly strong ground here and never have this judgment enforced against her in New York state court.' New York's shield law clearly says that the state will not extradite someone for providing an abortion if they did so while physically in the state. Because Louisiana alleges that Carpenter mailed medication to the patient — and did not come to Louisiana to do so — the Empire State is unlikely to comply. Still, Carpenter could be at risk of extradition to Louisiana if she goes to another state, Cohen said, because the shield law's protections only apply within New York's borders. 'If I were Dr. Carpenter, I would not leave the state of New York,' he said. The Texas and Louisiana cases will likely progress to other courts. Texas could ask a New York state court to enforce its judgment against Carpenter. But New York will likely argue that the shield law prevents it from doing so. The case would likely continue to progress through the state's courts, and could possibly then be litigated in federal court — one with jurisdiction over New York. Louisiana's case would likely take a similar route, Cohen said. The state could pursue its extradition request in New York state court or, eventually, in federal court. Lawyers for the state could seek intervention from the Supreme Court as well. That process could take months or even years, involving questions of state extradition and jurisdiction that have not been litigated in more than 150 years. Some observers believe the case could be resolved at the Supreme Court. Some suggested that a greater threat to broader telehealth than these court cases would be any federal action meant to disrupt shield laws. When federal and state laws conflict, federal laws typically triumph. President Donald Trump said on the campaign trail that he did not want to take federal action to restrict abortion, saying instead that the issue should be left up to individual states. But earlier this month, Attorney General Pam Bondi said she would 'love to work with' Louisiana prosecutors to stop shield law-backed health care. It's not clear what that might look like in practice. The Justice Department does not play a role in resolving disputes over extradition, Cohen said, and could not on its own compel New York to satisfy Louisiana's request. But one avenue for federal action could be launching a separate case and invoking an 1873 anti-vice law called the Comstock Act, which has not been enforced in decades but was never repealed. Anti-abortion activists believe it could be used to halt mailing of abortion medications. Under President Joe Biden, the Justice Department said it did not believe Comstock prohibited mailing these pills. But abortion opponents have been pressing the Trump administration to change that policy. The Supreme Court's most conservative members, Justices Samuel Alito and Clarence Thomas, have also expressed openness to that legal interpretation. That approach, too, could spark its own legal battle. 'If there was any meaningful reinterpretation [of Comstock], I think lawsuits would be fast and furious,' Foster said. The post Two states are coming after a New York doctor for mailing abortion pills. Here's what's next. appeared first on The 19th. News that represents you, in your inbox every weekday. Subscribe to our free, daily newsletter.
