August 15, 2014 — Although many Republican lawmakers generally support telemedicine, they have backed state and federal efforts to restrict its use in abortion care, Politico Pro reports.
Twenty-one states and Washington, D.C., require private insurance to cover services provided via telemedicine, according to the American Telemedicine Association. However, 15 states -- 14 of which lean Republican -- bar physicians from using telemedicine in the delivery of medication abortion, according to the Guttmacher Institute.
The states with overlapping laws -- requiring telemedicine coverage but banning its use for abortion -- are Arizona, Louisiana, Michigan, Mississippi, Missouri, Texas and Oklahoma, according to Politico Pro. Meanwhile, Planned Parenthood in Iowa is awaiting a judge's decision in a lawsuit challenging state regulations that banned its telemedicine program.
While much of the legislation banning telemedicine abortion is at the state level, Rep. Steve King (R-Iowa) in 2012 backed a federal bill that would have banned the service across state lines and prohibited the use of federal funding for it.
How Telemedicine is Used in Abortion Care
In a telemedicine abortion, a patient consults with a physician at another location via video messaging software, similar to Skype. Trained staff members at the patient's location conduct ultrasounds, blood tests and other screenings.
If the physician concludes that a medication abortion is appropriate for the patient, he or she remotely opens a container that holds the drugs and watches the patient take the first pill in the regimen during a video conference.
ATA has not offered guidelines for the use of telemedicine for medication abortion. However, the American Congress of Obstetricians and Gynecologists has said that the service is safe.
An ACOG group that developed practice guidelines on first-trimester abortion found that rates of adverse events were about the same for telemedicine and conventional abortion care. In addition, telemedicine abortion patients report high satisfaction rates, ACOG found.
Meanwhile, Rep. Diane Black (R-Tenn.) and other abortion-rights opponents claim that telemedicine abortion should be restricted because of safety concerns. "There's a lot of risk in someone having an abortion without having medical people around them," Black said.
Ob-gyn Dan Grossman, vice president of research at Ibis Reproductive Health and a member of the group that drafted the guidelines, said, "Like many of the laws that restrict abortion services, [safety claims are] not based on actual evidence or science." Instead, the telemedicine bans are "just an effort to restrict access to abortion," he said (Pittman, Politico Pro, 8/14).