State attorneys general in 18 states — including Tennessee’s — are fighting with the Biden Administration over medical records related to reproductive care.
The conflict highlights what has become a major issue in the evolving abortion debate: crossing state lines to get the procedure.
When the U.S. Supreme Court struck down Roe v. Wade last year, it fundamentally altered the country’s abortion landscape. About half of the country is under some form of a ban. Conversations about protecting access have shifted away from keeping clinics open in states like Tennessee, and toward finding alternate options like mail-order medication or traveling to so-called haven states.
The political conversation has shifted, too. This week, political commentator Rachel Maddow criticized several attorneys general, who are fighting the federal plan to protect abortion patients who travel out of state for the procedure. The proposal would update HIPAA, the policy that protects medical privacy, to shield medical records regarding reproductive care from law enforcement and other government agencies.
Tennessee Attorney General Jonathan Skrmetti was among the critics who signed a letter to the administration.
“Tennessee’s Republican Attorney General now says he intends to, effectively, follow you out of state to get your medical records to see if you got an abortion somewhere else,” Maddow said. “Even in a state where it’s legal.”
Broadly, the letter argues that the Supreme Court gave the public and their elected representatives the power to restrict abortion, and that the Biden Administration is inappropriately interfering with the process. The 17-page document, which was first obtained by the Mississippi Free Press, also dives into several more granular legal concerns.
In an interview, Skrmetti tells WPLN News that the policy would interfere with normal state functions that aren’t controversial, such as monitoring mismanagement of Medicaid and insurance spending.
“This applies to reproductive health care, which means any health care related to a reproductive system or reproductive organs,” he said. “Which of course entails the hot-button issues, but it could entail all sorts of other pieces of medical practice. We couldn’t investigate a urologist for fraud potentially, under this rule.”
Skrmetti noted that none of the state laws banning abortion in the U.S. seek to prosecute abortion patients, only providers.
That being said, supporters of abortion access worry about a culture of fear and confusion amid the new abortion bans. A widely cited example: the unclear wording around exemptions has left doctors wondering how much danger is enough to be considered a life-threatening situation for the patient. Advocates say that confusion can lead to delayed care, and that the privacy protections the Biden Administation is considering could assuage some of that concern.
Reproductive health care would also entail gender-affirming care. That’s been a tense political issue in Tennessee this summer. The legislature placed several restrictions on the services.
Skrmetti’s office has been obtaining medical records to investigate Vanderbilt University Medical Center on allegations a doctor in that system was committing insurance fraud to fund ongoing gender-affirming services. In interviews with WPLN, trans Tennesseans and civil rights advocates have said the investigation appears to be another case of Tennessee officials targeting trans people.
Similarly, the AG’s office commented that the VUMC investigation is focusing on providers, not patients.
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