A proposed bill in Ohio could limit access to a commonly prescribed abortion pill
By: Natalie LaFleur
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ATHENS, Ohio (WOUB) — A bill moving through the Ohio Legislature doesn’t mention the word abortion once, but supporters and opponents both recognize it would restrict access to abortion pills.
House Bill 324, known as The Patient Protection Act, would require any prescription drug that causes severe adverse side effects to become harder to obtain. The state director of health would be required to create a list of high-risk drugs that cause severe adverse effects in more than 5% of the drug’s users.
In other words, the bill would mandate a state “watch list” of drugs. The bill mentions hemorrhaging, infection and sepsis as examples of the “severe adverse side effects.”
Mifepristone is a commonly prescribed abortion pill that was approved by the FDA years ago.
If patients hope to acquire one of the drugs listed, they would be required to schedule in-person appointments, be warned by a doctor about the risks before being granted a prescription and schedule a follow-up appointment. This would make prescribing the drug a longer and more extensive process.
Many Ohioans in the southeast region rely heavily on telehealth services due to a lack of transportation and proximity to medical centers. Additionally, the more appointments required for patients could possibly create a financial burden for lower-income residents.
Opponents of the bill have raised concerns about the study. It was not peer-reviewed and was done using insurance claims made by hospitals or women who took mifepristone.
Opponents argue the issue with insurance claims is they can be made for routine check-ups or when patients want to double-check that the amount of bleeding they are experiencing is normal.
Vague descriptions are used for some of the highest categories of complications such as “ER Visit” and “Other abortion-specific complications,” opponents note. The number of sepsis and infection cases, which are among the bill’s list of severe adverse effects, is significantly lower.
The bill’s proponents note that the study only included claims classified as Grade 3 (severe) and Grade 4 (life-threatening). They did not include Grade 1 (mild) or Grade 2 (moderate).
However, that does not automatically mean every included hospital visit was unquestionably a dangerous complication. That depends on how valid the coding/classification choices were. Opponents also note that this is the only study with these results.
When the bill was moving through the House, six proponents shared testimonies in support. They stressed that a dangerous drug should not be prescribed with haste through telehealth services. They also argue that the bill’s emphasis is the safety of patients, not preventing abortion.
“We’ve also heard reports of medicines like that being prescribed without very good follow up at all,” said Ohio Right to Life Director Carrie Snyder. “And one case in particular was someone was struggling with suicidal thoughts after taking this. And then the provider actually just doubled the dose, rather than having some kind of in-person visit and actually digging into what the problem was. They doubled the dose and that person actually committed suicide. So just very tragic things that, in my view, are preventable with good public policy around telehealth.”
“But when you have these, you know, the threshold being 5%, when things are shown to be dangerous with very serious hemorrhaging, sepsis, those type of things that require hospitalization, that there just needs to be a better care around that both before and after that takes place,” Snyder said.
Opponents argue the bill is a politically motivated attempt to limit access to abortion pills. Roughly 50 parties spoke in opposition, including Planned Parenthood Advocates of Ohio.
“So literally written into the bill, it does not require actual peer reviewed research published in scientific journals to determine the efficacy or the safety of medication,” said Danielle Firsich, director of public policy for Planned Parenthood Advocates of Ohio.
“So, they’re literally saying, OK, there are hundreds of peer reviewed, published, accredited research studies that show the efficacy and safety of mifepristone. But if you can find one, if you can find one that says it has a higher adverse impact rate, the director of health can use that to limit access to the medication entirely. That is not science or medically based.”
Firsich said the study proponents of the bill cite as justification for putting mifepristone on a watch list is an example is this.
“The study they’re using was self-published and not peer reviewed, and it was so flawed that it has been debunked by every major medical organization. And they have refused to release their data set, so it can’t be replicated or tested. I mean, I could effectively go on to a blog tomorrow and write a self-published research study about whatever I wanted and insist that there’s a higher adverse impact rate.”
Unlike mifepristone, the day-after pill, commonly known as “Plan B,” would not be affected by the Patient Protection Act, as it is not a prescription medication. This bill only affects drugs that require a doctor to prescribe them. Firsich said that it “wouldn’t be surprising” if the proponents attempted to include this pill as well.
The bill has already cleared the House and is now before the Senate Health Committee, where it has had two hearings. The next hearing is scheduled for Wednesday.