Vermont lawmakers have given final approval to a bill intended to increase safeguards around reproductive and gender-affirming health care.
Democrats said would fill 鈥渢echnical gaps鈥� and improve the state鈥檚 current shield laws 鈥� which provide legal cover for Vermont health care providers and patients.
鈥淲e are not adding any new health care activities,鈥� said Winooski Rep. Daisy Berbeco, a Democrat, to House members last week. 鈥淭hese are things that are already legally protected in Vermont.鈥�
The legislation would make abortion medication accessible online, broaden which health care service advertising is regulated by consumer protection law, and add privacy options for providers of reproductive and gender-affirming care.
Some Republicans questioned whether certain measures in the bill 鈥� like preventing misleading or deceiving health care services advertising 鈥� were necessary, or were examples of overregulation.
But S.28 proponents emphasized the need to bolster protections in order to preserve reproductive and gender-affirming care services.
nationwide: harassment, 鈥� and now, interstate prosecution. In late January, a by another state for providing medication abortion across state lines.
to enact shield protections, and so far,
How well these protections hold up for providers prescribing medication abortion across state lines via telehealth could be a major factor in the overall availability of abortion, according to Middlebury College economics professor Caitlin Myers.
鈥淭he stakes are high,鈥� said Myers, who studies abortion care access across the U.S. 鈥淪hield laws really increased the visibility, the accessibility of medication abortion, and a lot of people are ordering abortion medications under these laws.鈥�
More (online) access to abortion medication
S.28 would update state statute to allow providers to use online questionnaires to prescribe abortion medication. The questionnaires would be 鈥渄eveloped by or in consultation with health care providers with clinically appropriate expertise鈥� that would allow a provider to get a patient鈥檚 medical history and ask follow-up questions.
Several , including West Windsor OB-GYN Renee Johannensen, . They said studies have
鈥淚t should be noted that this type of care is typical in the provision of reproductive healthcare,鈥� Johannensen wrote. 鈥淸It] is often specifically what people want because of issues with privacy, for instance if they are victims of domestic violence.鈥�
And Johannensen said without the ability to use online questionnaires, Vermont鈥檚 shield laws don鈥檛 effectively work to prescribe abortion medication to people in other states.
The , and the all told lawmakers they supported the use of online questionnaires for abortion medication.
The Vermont Board of Medical Practice, however, disagreed, that the practice would 鈥渘ot constitute quality care.鈥�
More regulation around health services advertising
Another measure in S.28 would put all advertising about health care services under state consumer protection law.
鈥淎dvertising strategies and educational information about health care options that lack transparency, use misleading or ambiguous terminology, misrepresent or obfuscate services provided, or provide factually inaccurate information are a form of manipulation that disrespects individuals, undermines trust, broadens health disparity, and can result in patient harm,鈥� the bill reads.
Applying this standard to all health care services is a broadened version of language in Vermont鈥檚 existing shield law intended to protect patients. That current law specifically targets centers that discourage abortion, also known as crisis pregnancy centers, and
Two Vermont crisis pregnancy centers and the anti-abortion organization National Institute of Family and Life Advocates sued the state over the existing law in 2023. The lawsuit alleges in part that Vermont is censoring crisis pregnancy centers from advertising their services.
A federal judge last summer allowed the suit to move forward, writing: 鈥淧laintiffs have stated a plausible claim for violation of their First Amendment rights.鈥�
about S.28, Sharon Toborg, the Vermont Right To Life Committee policy analyst, said the state was opening itself up to more litigation with the language in the bill.
鈥淪.28 defines all 鈥榓dvertising鈥� about health care services or proposed services 鈥� by any person 鈥� as commercial speech, even if there is no economic motivation underlying the speech,鈥� Toborg wrote. 鈥淚t is not permissible to simply decree speech is 鈥榗ommercial鈥� as an excuse to restrict it.鈥�
More privacy for providers
Some of the remaining measures included in S.28 focus on improving privacy for providers of reproductive and gender-affirming health care.
For instance, the legislation allows providers to request the removal of their name or initials from 鈥渘on-controlled鈥� medicine prescribed for reproductive or gender-affirming care.
The Vermont Medical Society applauded this effort in its testimony to legislators.
鈥淎s prescribing medication for abortion and gender affirming care become more and more politicized and legally risky for both patients and prescribers, removing prescriber identifying information from pill bottles that may cross state lines is one additional step Vermont can take to protect access to these evidence-based medications,鈥� the organization wrote.
Pharmacy representatives told lawmakers they understood the intent of removing provider names from prescriptions, but they weren鈥檛 sure how to put it into practice.
鈥淒espite the willingness, the implementation of S. 28, Sec. 11. would be, as far as we can tell, impossible,鈥� .
The association noted that there is no option in pharmacy software to replace a prescriber鈥檚 name on a label with the more general name of the provider鈥檚 facility.
