Pharmacies Could Violate Federal Anti-Discrimination Laws by Denying Access to Meds That May End Pregnancy, HHS Warns
- July 15, 2022
Pharmacies that refuse to fill prescriptions for medications because they also could be used to terminate pregnancy could violate federal anti-discrimination laws, according to new guidance the Department of Health and Human Services (HHS) Office for Civil Rights issued July 13.
The guidance, which applies to roughly 60,000 U.S. retail pharmacies, comes after reports that some pharmacies were denying women access to certain drugs to manage a miscarriage or complications from pregnancy loss or for other conditions like rheumatoid arthritis because the medications also could be used for ending a pregnancy.
“Discrimination against pregnant people on the basis of their pregnancy or related conditions . . . is a form of sex discrimination,” the guidance says. Under federal law, “pregnancy discrimination includes discrimination based on current pregnancy, past pregnancy, potential or intended pregnancy, and medical conditions related to pregnancy or childbirth.” The guidance also notes that refusing to fill a prescription for drugs that treat chronic inflammatory conditions also could amount to disability discrimination.
As recipients of federal financial assistance, including Medicare and Medicaid payments, pharmacies are prohibited under Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act from discriminating against pharmacy customers “with regard to supplying medications; making determinations regarding the suitability of a prescribed medication for a patient; or advising patients about medications or how to take them,” the guidance says.
The guidance lists specific scenarios where pharmacies could run afoul of federal anti-discrimination laws by refusing to fill an individual’s prescriptions.
For example, an individual experiencing a first-trimester miscarriage who is prescribed treatment with mifepristone and misoprostol to assist with the passage of the miscarriage, or an individual prescribed methotrexate to halt an ectopic pregnancy. Misoprostol also is prescribed for individuals with severe and chronic stomach ulcers, and methotrexate is a standard immunosuppressive treatment for rheumatoid arthritis.
In these instances, pharmacies that deny access to the medications could be discriminating on the basis of sex or disability, according to the guidance.
The guidance is the latest issued by the agency in the wake of the Supreme Court's decision overturning Roe v. Wade. President Biden last week issued an executive order aimed at protecting access to reproductive health care services. The ordered directed HHS to submit a report to the President within 30 days detailing efforts to protect access to medication abortions, emergency medical care, and contraceptives. HHS also must launch outreach and public education efforts on accessing reproductive health care services, including abortions.