Amid the heated debate over abortion in the United States, the subject of data collection may seem shaky and irrelevant. But the information state and city governments collect about abortion patients is becoming the latest source of bitter national disagreement over the issue.
Some states with Republican-controlled legislatures have moved to require more information about each abortion, while some Democratic-controlled states have moved to require more information about patient identification and abortion providers. They are reducing the amount of information they collect out of concern that the information could be used for prosecution.
“In a very divided country, where abortion is legal in some places and illegal in others, revealing where you live or where you were born is more difficult than in countries where pre-viable abortion is legal. seems much more risky,” said Rachel Leboucher. He is dean of Temple University's Beasley School of Law and an abortion rights jurist. “Conflicts between states will only intensify, and data will be the first tool to determine how to materialize those conflicts,” she added.
Abortion rights advocates are particularly concerned that anti-abortion states could use the data to track patients who traveled out of state for abortions or who received drugs shipped from other states. It says that there are.
Such concerns are also spurring action at the federal level. The Biden administration on Monday announced rules to protect information about abortion patients and providers from being used in investigations and prosecutions. The rule is intended to prevent law enforcement in states that restrict abortion from obtaining information about patients who travel to states where abortion is legal and the abortion providers who treat them. It also aims to protect health care providers who provide unrelated medical care in a patient's home state.
In announcing the rule, Jennifer Klein, director of the White House Gender Policy Council, said, “No one can have their medical records accessed by them or others simply because they sought or received legal reproductive health care.” Doctors should not be used against their loved ones.”
In Kansas, the Republican-controlled Legislature recently passed a bill requiring abortion providers to ask patients 11 questions about their reasons for terminating a pregnancy. These include “whether having a baby will interfere with the patient's education, employment, or career.” “Patients already have enough children, or too many children.”
“We always need data: how many women are choosing to have an abortion because they can't afford to support their child, or perhaps because they are forced to do so, and who is forcing them? I think it would be good if the department could understand that,''' Republican state Sen. Beverly Gossage said in support of the bill.
Democratic Gov. Laura Kelly vetoed the bill, noting that Kansas voters approved a 2022 referendum protecting abortion rights. However, Congress may have enough votes to override the veto.
In New Hampshire, where abortion is legal but has not previously collected abortion data, the Republican-controlled Senate this month passed a bill that would make abortions mandatory in the state where the patient resides. Democrats particularly opposed the bill because it does not require, but does not prohibit, reporting certain information about patients.
The state of Illinois, which supports abortion rights, has stopped requiring health care providers to report specific patient data and is now collecting only aggregate numbers, saying it is “impossible to trace back to individual patients.” “We believe that this is the case,” said Karen Shelley, deputy general counsel in the Illinois Governor's Office.
She added: “The most secure data is the data that the state will never collect.”
For similar reasons, the state of Maine has stopped collecting some information, including data on past pregnancy history, race, and education.
Not all jurisdictions that support abortion rights are quick to heed concerns about data collection. New York City issued a warning to abortion providers last fall over the city's health department's proposal to update reporting regulations.
Under Democratic Mayor Eric Adams' administration's proposal, abortion pill providers, previously not explicitly subject to city reporting requirements, would be required to provide information about each patient, including date of birth, place of birth, and marital status. Certain information must be reported. status, previous pregnancies, previous abortions, and her first two letters of first and last name.
Like many patients from states that ban abortion, patients who travel to New York City seeking abortion pills must identify their state of residence.
Several abortion providers wrote letters or testified against the proposal. “This is an unwarranted expansion of government oversight of women's reproductive health decisions,” officials from Hey Jane, a prominent telemedicine abortion service, wrote to city officials in November.
Hey Jane CEO Kiki Friedman said in an interview that reporting requirements could be a disincentive for patients, saying patients “have concerns about where their data is going.” “There are many patients who ask whether they can disclose their information to the government.”
Health care providers said they were surprised that the proposal came from a New York City official who has worked to advocate for access to abortion. They noted that the city's proposal requires far more detailed information than New York state requires, and that state officials are considering collecting even less information.
“We should be ashamed of ourselves for making this bad situation worse in every corner of New York City,” Dr. Linda Prine, a longtime New York abortion provider, wrote in a letter to city officials. Ta.
Despite health care providers' concerns, the city's Board of Health adopted the proposal with only one change. Instead of collecting the first two letters of a patient's name, they would label the patient with a case number.
In an email shortly before the revised policy took effect in January, City Health Department spokesperson Patrick Gallahue defended the requirement.
“We need data to improve services, identify gaps, allocate resources to address inequalities and ultimately deliver better care,” he said, adding: “These changes will , it simply makes clearer the existing requirement that medical abortion data must also be shared.” The aim is to better deliver care to local communities. ”
City officials gave similar answers in a March interview, but three days after the interview, the city significantly changed its position and provided many details that could potentially identify individuals that were previously required. announced that it supports the deletion or making it optional.
Anne Williams-Isom, the city's deputy mayor for health and human services, later acknowledged in an interview that the change happened after the New York Times asked about it. “If you raise an issue, people will pay attention to it and you expect them to do the right thing,” she said.
City health officials said they now plan to ask the Board of Health to make changes to prevent patients from being identified. These changes include eliminating the reporting of information about a patient's marital status, date of last menstrual period, and previous pregnancies. Additionally, healthcare providers report the patient's age instead of date of birth. Instead of place of birth, providers would only report whether a patient was born in the United States. And providers would only report whether a patient lives in New York, not the state in which they live. The provider name can be omitted and some information is optional.
City Health Commissioner Dr. Ashwin Vasan said in an interview that “we all want to collect the minimum amount of data we need to perform our critical public health functions,” adding that the city is “trying to get access to it.” We will vigorously oppose anyone who does so.” Our data for unjustifiable reasons. ”
Some health officials in states with strict abortion restrictions acknowledge that the data could pose risks to patient privacy. In Indiana, abortion is allowed in limited cases, such as to protect the patient's health or life, or to cause a fatal fetal abnormality, but the health department requires a case-by-case report that includes demographics and provider information. We have decided to discontinue publication of the book. The department consulted with the state's public access adviser and concluded that such records “contain information that could potentially be reverse engineered to identify patients.”
Indiana Attorney General Todd Rokita, a vocal anti-abortion advocate, disagreed and sent a letter to the governor and legislative leaders saying that without such records, citizens cannot file complaints against abortion providers with the office. Because the documents cannot be submitted, enforcement action will be taken against the provider under Indiana law. could not be started.
With records stopped being released, “Indiana's pro-life laws are no longer enforceable,” he wrote.
He called on the Legislature to take action, saying Indiana's abortion data law “is intended to require publicly available reporting to hold abortion providers accountable and follow the law.” urged.