Health Equity blog

In the aftermath of Dobbs v. Jackson Women’s Health Organization in 2022, New York became one of eight states that subsequently enacted a “telemedicine abortion shield law” intended to protect abortion providers who prescribe abortion pills – such as mifepristone – to patients in other states. Testing the shield law’s legalities, in January, Louisiana indicted a New York physician for prescribing abortion pills to one of its residents. Earlier this month, the same physician was civilly fined $100,000 by the Texas Attorney General under similar circumstances involving a patient residing within its jurisdiction. Both Texas and Louisiana enforce strict near-total bans on abortion. These cases highlight the deep political divide that exists among the states with regard to abortion and at least one of these cases is expected to make its way to the U.S. Supreme Court.

In the aftermath of Dobbs v. Jackson Women’s Health Organization in 2022, New York became one of eight states that subsequently enacted a “telemedicine abortion shield law” intended to protect abortion providers who prescribe abortion pills – such as mifepristone – to patients in other states. Testing the shield law’s legalities, in January, Louisiana indicted a New York physician for prescribing abortion pills to one of its residents. Earlier this month, the same physician was civilly fined $100,000 by the Texas Attorney General under similar circumstances involving a patient residing within its jurisdiction. Both Texas and Louisiana enforce strict near-total bans on abortion. These cases highlight the deep political divide that exists among the states with regard to abortion and at least one of these cases is expected to make its way to the U.S. Supreme Court.

The latest report from the Centers for Disease Control and Prevention (CDC) on maternal mortality rates in the United States reveals a concerning statistic. In 2023, the maternal death rate overall, as well as among specific races, fell below prior year levels, with one notable exception – Black women. The maternal death rate among Black women in 2023 remained essentially the same as 2022, at a rate of approximately 50 per 100,000 births. White women, on the other hand, saw a significant decrease, dropping from a rate of 19 to 14.5 per 100,000 births. Hispanic and Asian women also experienced a significant decrease in maternal mortalities in 2023.

The 2025 Rural Health State of the State report issued by the Chartis Center for Rural Health exposes the dire circumstances facing sustained access to care in rural areas of the United States. “Care deserts” continue to proliferate at a time when the population health status of the more than 46 million residents living in these rural areas is already on a downward spiral. The Chartis report also opines that nearly half of all rural hospitals in the United States are operating in the red, and 432 rural hospitals are vulnerable to permanently closing their doors. In the past year alone, 18 rural hospitals have already either ceased operations or discontinued inpatient services.

President Trump has issued an unprecedented number of executive orders so early in his presidency, many of which have health equity implications, such as those impacting transgender care. While a president may issue executive orders to direct federal agencies to take steps within the scope of the president’s constitutional authority or as delegated by Congress, executive orders may not exceed that authority or otherwise override federal laws and statutes. Many of President Trump’s administrative actions are being challenged in court as exceeding that authority. Just Security, an online platform affiliated with NYU School of Law, has established a webpage that tracks litigation in response to executive orders, memoranda, proclamations, and other actions taken by the Trump Administration. With the rapidly evolving legal challenges to President Trump’s actions, Just Security’s well-organized website provides a handy tool to stay abreast of the latest developments.

Included in a number of Executive Orders (EOs) signed on his first day in office, President Trump directed the U.S. to withdraw from the World Health Organization (WHO) claiming mishandling of the organization’s response to the COVID-19 pandemic, failure to undertake needed reforms and inequitable financial burden placed upon the U.S. compared to other participating nations. On the same day, President Trump issued an Executive Order that only recognizes the biological sexes of male and female, prohibiting any Federal laws or regulations designed to accommodate gender identity that deviates from such assignments of sex at birth. Further, it prohibits the use of “gender” rather than “sex” in any Federal policies or documents.

Before leaving office, members of the Department of Health and Human Services (HHS) under the Biden Administration released its Strategic Plan for the Use of Artificial Intelligence in Health, Human Services, and Public Health. While recognizing the evolving space, the plan includes actions HHS should consider as AI adoption in health care continues to grow.  While not its focus, the plan recognizes there are inherent risks in AI in health care, such as algorithmic biases that may unintentionally hinder equity. Additionally, responsible AI should ensure equitable access and beneficence, which means ongoing appropriate human oversight and involvement are imperative. In particular, historically underserved populations, such as rural communities and people with disabilities, need to be the focus of AI equitable access to ensure a more diverse and inclusive research and delivery healthcare landscape.

On January 14, HHS’s Office of Civil Rights (OCR) issued guidance on the implementation of  HHS’s updated final rule, which went into effect July 2024, governing the application of Section 504 of the Rehabilitation Act of 1973 to child welfare agencies that receive Federal financial assistance from HHS. These regulatory provisions clarify Section 504’s applicability in the child welfare context and do not cover all disability rights laws applicable to child welfare agencies. Among the issues addressed are requirements that ensure individuals with disabilities are not discriminated against in any programs and activities, including parent-child visitation, reunification services, and child placement, among others.

On January 6, the Centers for Medicare and Medicaid Services (CMS) announced 15 states – including California – have been chosen to participate in its Transforming Maternal Health (TMaH) Model. TMaH is the latest CMS model structured specifically to improve maternal health care for individuals enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Unique to the TMaH program will be a whole-person approach to pregnancy, childbirth, and postpartum care that tackles the physical, mental health, and social needs encountered during and immediately following pregnancy. This model seeks to reduce persistent disparities in both access and treatment.

In mid-January, the DEA issued three new telemedicine rules (available here, here, and here) to make permanent some of the temporary telemedicine flexibilities created during the COVID-19 public health emergency while also instilling new patient protections. Such patient protections include establishing a Prescription Drug Monitoring Program (PDMP) to aid the healthcare industry in protecting against abuse and the diversion of controlled substances into the ever-looming threat of the illegal drug market.