Federal guidance on abortion pills causes confusion among Georgia pharmacists

ATLANTA — Pharmacists say Georgia’s evolving restrictions around access to abortion coupled with recent guidance from the federal government have created confusion over distribution of medication that can terminate pregnancies.

The Biden administration earlier this month warned pharmacists nationwide that they are required to fill prescriptions for pills that can induce abortion. Refusing to give out the prescribed medication “may be discriminating” on the basis of sex or disability and could amount to a violation of federal civil rights laws, the US Department of Health and Human Services said.

Bob Coleman, CEO of the Georgia Pharmacy Association, said the organization is working with national pharmacy associations to get clarity.

“We understand that confusing and sometimes contradictory information is being shared,” he said. “Unfortunately, the HHS guidance puts highly trained health care professionals that were at the forefront of providing immunizations during the COVID pandemic in a seemingly impossible situation.”

The guidance to pharmacists is among the many maneuvers by Democrats since the US Supreme Court overturned Roe v. Wade, nearly all of which have caused conservatives to balk.

Georgia Republican US Rep. Buddy Carter, a pharmacist, called the HHS message to his colleagues a “gross abuse of executive authority.”

“There is no constitutional right to an abortion, and as such, there is no constitutional obligation for pharmacists to knowingly dispense drugs intended for an abortion,” Carter said in a statement. “This administration has a habit of using health care professionals as political pawns, from vaccines to abortions, and that abuse must come to an end.”

Coleman said the Georgia Pharmacy Association “wholly agrees” with Carter’s position that bureaucrats shouldn’t dictate how pharmacists do their jobs.

The US Supreme Court in June ended a nearly 50-year precedent asserting the constitutional right to an abortion, leaving regulation of the procedure up to each state.

Since then, there have been reports of women of childbearing age who have prescriptions for various ailments being denied the medication in states where abortion is not now legal because the pills could also end a pregnancy. Three drugs — mifepristone, misoprostol and methotrexate — are often prescribed for conditions such as Cushing’s syndrome, stomach ulcers and autoimmune disorders and can also cause an abortion.

First approved by the Food and Drug Administration in 2000, “medication abortion” has increasingly become the preferred method for terminating a pregnancy up to 10 weeks. Those seeking to terminate a pregnancy are prescribed two pills: mifepristone, taken first, and then misoprostol.

The guidance to pharmacies was sent days after President Joe Biden signed an executive order meant to protect access to abortions and contraception in the wake of the Supreme Court decision.

In a separate letter to health care providers, HHS Secretary Xavier Becerra also warned that frontline workers are obliged to stabilize patients even if that means medical or surgical abortions. He cited emergency situations such as ectopic pregnancies, miscarriage complications, emergent hypertensive disorders and severe preeclampsia.

Democrats in the US House also passed several abortion access measures, including one that would create federal protections for the right to terminate a pregnancy and another guaranteeing a right to travel for an abortion. This week, House Democrats are scheduled to vote on legislation that would codify in federal law the right to access birth control.

All but a handful of Republicans, including all eight in Georgia’s delegation, opposed the bills that passed with near-universal support from Democrats. But these proposals are likely to die without action in the Senate, where support from at least 10 of 50 Republicans is needed to avoid a filibuster.

Conservative lawmakers have also spoken out about abortion in other ways. In addition to calling for the HHS to rescind its guidance to pharmacists, Carter co-introduced a bill last week that would prohibit the use of federal funds to pay for patients to travel for an abortion.

Another Georgia lawmaker, US Rep. Andrew Clyde, was among 56 Republicans who signed a letter to Biden asking him to pull back his executive order on abortion.

Clyde and US Rep. Jody Hice has also criticized the University of Georgia for maintaining a database of pregnancy resource centers that steer women away from getting abortions, saying the map of sites has been used to target these facilities since the high court’s ruling, citing a Fox News report.

Meanwhile in Georgia, a federal appeals court is expected to rule soon on whether a restrictive 2019 abortion law can go into effect. It was put on hold, awaiting the Supreme Court ruling in a Mississippi-based case that resulted in the controversial June decision. As of Tuesday, abortions up to 22 weeks of pregnancy are still legal in Georgia.

Reproductive rights groups and abortion providers sued Georgia in 2019 after the Legislature passed an abortion law outlawing the procedure in most cases once a doctor can detect fetal cardiac activity, typically about six weeks into a pregnancy and before many women know they are pregnant.

Judges asked attorneys to file additional documents in response to last month’s ruling in the Mississippi case, which were due Friday. The federal appeals court could uphold Georgia’s anti-abortion law or the three-judge panel could return the case to US District Judge Steve Jones in Atlanta with instructions to uphold it. Jones put the Georgia statute on hold in 2020.

With so much uncertainty around how Georgia’s abortion law could change and how the Supreme Court’s decision will be applied, health care providers who perform abortions are left scrambling, state Rep. Renitta Shannon told the US House Oversight Committee last week.

“Providers told me that they are worried that even when you make an exception for the life of the pregnant person that they would be challenged as to when it’s appropriate to make a decision for abortion,” the Decatur Democrat said. “This put fear in doctors.”

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