Bill Overview
Title: Protecting Access to Medication Abortion Act
Description: This bill directs the Food and Drug Administration (FDA) to take steps to allow patients to receive prescriptions for mifepristone, a drug approved by the FDA for medical abortion, via telehealth and for prescriptions for the drug to be filled by mail. (Mifepristone is subject to a Risk Evaluation and Mitigation Strategy, which imposes various safety-related requirements. During the COVID-19 public health emergency, the FDA suspended enforcement of the current strategy's requirement that the drug must be dispensed in person, and this suspension is still in effect. In December 2021, the FDA stated the data supported modifying the strategy to remove the in-person dispensing requirement.) Under this bill, the FDA must require the holder of the relevant approved drug application to submit a proposal to modify the strategy. The modification shall (1) remove the in-person dispensing requirement, (2) allow patients to access prescriptions for mifepristone via telehealth, and (3) authorize all pharmacies certified to dispense mifepristone to patients to do so via mail.
Sponsors: Rep. Bush, Cori [D-MO-1]
Target Audience
Population: Individuals seeking medication abortion, particularly women of childbearing age
Estimated Size: 1000000
- The primary population impacted is people who are seeking medication abortions, as the bill directly addresses access to mifepristone, a key drug used for this purpose.
- Medication abortion is commonly used in the first trimester of pregnancy, often up to 10 weeks, so women in early stages of pregnancy seeking abortion will be directly impacted.
- The bill would make it easier for individuals in areas without easy access to clinics to obtain an abortion through telehealth, particularly affecting those in rural or underserved areas globally.
- Globally, according to the Guttmacher Institute, there are about 56 million abortions per year, with medication abortions becoming increasingly common.
- In many countries where telehealth services are expanding, similar measures could potentially impact millions as access to medication abortion becomes easier and safer.
Reasoning
- The population primarily impacted by this policy includes women and people of childbearing age who are seeking medication abortions. This is a significant portion of the population, as over 600,000 abortions are performed annually in the US, with medication abortions constituting more than half.
- The policy could have a larger impact on individuals in rural or underserved areas and states with restrictive abortion laws due to easier access through telehealth. This estimation considers both urban and rural perspectives and examines a spectrum of socioeconomic backgrounds to gauge the policy's overall reach.
- Budget constraints require the policy to be efficient in implementation, targeting education, healthcare infrastructure, and public awareness campaigns on how to safely access telehealth services and mail-in prescriptions.
- The policy mainly focuses on safety-related modifications and telehealth access, aligning with the current trends of digital health services and remote healthcare solutions which have been accelerated by COVID-19 conditions.
- By covering a variety of people in different scenarios, the simulated interviews provide insights into both the scope of impact and the constraints faced by individuals when accessing medication abortion services.
Simulated Interviews
student (rural Texas)
Age: 23 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- The policy could offer me a safer and more private way to access medication abortion without traveling to a distant clinic, which is both costly and time-consuming.
- I believe this will provide crucial access for people like me who might have limited support networks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 4 |
| Year 3 | 8 | 3 |
| Year 5 | 9 | 3 |
| Year 10 | 9 | 3 |
| Year 20 | 9 | 3 |
graphic designer (Los Angeles)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I may not be directly impacted since clinics are accessible, but I believe telehealth options can provide more privacy and convenience.
- This policy supports the right to choose and access necessary healthcare without stigma.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
healthcare administrator (New York City)
Age: 42 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 8.0 years
Commonness: 10/20
Statement of Opinion:
- This policy will reinforce the importance of equal healthcare access and support the use of telehealth in improving women's health services.
- I'm optimistic about the reduction of barriers for women across the country.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 7 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
stay-at-home parent (Midwest region, USA)
Age: 33 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- Our healthcare access is quite limited, so providing remote access to necessary services would be a significant relief.
- I feel that being able to receive medication by mail with a telehealth prescription is a step forward.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 9 | 3 |
| Year 10 | 9 | 3 |
| Year 20 | 8 | 3 |
software engineer (Seattle)
Age: 26 | Gender: other
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- While I don't require these services, I support policies that enhance healthcare access through technology.
- This law is about equity and ensuring everyone can access what they need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
middle school teacher (Florida)
Age: 38 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 12.0 years
Commonness: 9/20
Statement of Opinion:
- This policy would make a significant difference in communities like mine where seeking an abortion can lead to social backlash.
- It provides a necessary degree of separation between patients and judgment.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 9 | 5 |
| Year 3 | 9 | 5 |
| Year 5 | 9 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 3 |
small business owner (Mississippi)
Age: 44 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I think this policy could provide crucial options for people like us who have family obligations and can't afford time and money for out-of-state travel.
- Access needs to be safe and discrete, and I hope this change brings that.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
legal consultant (Chicago)
Age: 30 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 4.0 years
Commonness: 14/20
Statement of Opinion:
- This policy aligns with the advocacy work we're pushing for, ensuring access and rights are preserved.
- Having a framework for telehealth is a future-forward approach that we need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
student (college town in Pennsylvania)
Age: 21 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 6.0 years
Commonness: 11/20
Statement of Opinion:
- A policy like this can lower the barriers significantly, both financially and emotionally.
- Insurance is a big issue for students, so telehealth can reduce overall costs significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
healthcare worker (Atlanta, Georgia)
Age: 27 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 13/20
Statement of Opinion:
- I see firsthand how hard it can be for people to access healthcare services they need, and believe this policy could alleviate such issues.
- It's essential to adapt to new methods of healthcare delivery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Cost Estimates
Year 1: $50000000 (Low: $30000000, High: $70000000)
Year 2: $45000000 (Low: $25000000, High: $65000000)
Year 3: $0 (Low: $0, High: $0)
Year 5: $0 (Low: $0, High: $0)
Year 10: $0 (Low: $0, High: $0)
Year 100: $0 (Low: $0, High: $0)
Key Considerations
- The FDA's current protocols regarding mifepristone distribution may already cover some regulatory aspects, potentially reducing novel costs.
- State-level laws may influence the bill's effectiveness in practice, creating variability in its economic impact across the country.
- The availability of telehealth services and mail delivery systems is expected to increase access but may vary significantly across different geographic regions.