Texas Attorney General has filed a lawsuit against the U.S. Department of Health and Human Services (HHS) challenging the new HIPAA rule on reproductive healthcare confidentiality. This case raises complex questions about the balance between patient privacy and the right of states to investigate medical procedures, particularly following the overturning of Roe v. Wade in 2022. This upcoming trial could have major repercussions for reproductive rights and medical confidentiality in the United States.
The legal context: the reversal of Roe v. Wade
The Supreme Court’s reversal in 2022 of Roe v. Wade, which guaranteed the constitutional right to abortion for almost 50 years, has profoundly impacted the legal framework for reproductive rights in the United States. Following this reversal, abortion legislation is now left to the discretion of the individual states, resulting in a patchwork of laws that vary greatly from state to state. While some states, like Texas, have adopted strict bans on abortion, others, like California and Illinois, actively protect reproductive rights.
In this context, the issue of protecting health data linked to reproductive care has become crucial. In response to many women’s fears about the use of their medical data in abortion-related lawsuits, the Biden administration issued an update to the HIPAA Privacy Rule in 2024. This rule prohibits healthcare providers from sharing sensitive medical information with law enforcement in states with restrictive abortion laws, such as Texas.
The new HIPAA Privacy rule: issues and protections
The new “HIPAA Privacy Rule to Support Reproductive Health Care Privacy” is designed to protect the data of patients seeking reproductive health care, particularly in the case of abortion in states where this is still legal. It prohibits healthcare professionals, insurers and other covered entities from passing medical information to law enforcement agencies in the context of investigations or criminal prosecutions concerning legal reproductive care.
HHS asserts that this rule is necessary to protect patient confidentiality and prevent the misuse of medical information. In particular, the measure is intended to prevent health information from being used against patients traveling to other states for care, a growing fear with the proliferation of restrictive laws in states like Texas.
Texas argues violation of states’ rights
Ken Paxton, Texas Attorney General, has filed a federal lawsuit to block implementation of this new HIPAA rule. He argues that the new regulation violates states’ rights by preventing them from investigating potential violations of their laws. According to Paxton, Texas has the right to demand medical information as part of criminal investigations, including those involving third parties helping women access abortion, an activity considered illegal in that state.
Texas accuses the HHS rule of undermining states’ ability to enforce their laws. Paxton also points out that this rule, along with the original 2000 HIPAA rule, places excessive restrictions on how states can access health records in legal investigations, creating an unfair obstacle to state law enforcement. The suit also alleges a violation of the Administrative Procedure Act (APA), claiming that HHS exceeded its authority in promulgating such a restrictive regulation.
Reactions and implications of the legal action
The Texas legal action has drawn strong criticism, particularly from reproductive rights advocates, but also from several other states. Illinois Attorney General Kwame Raoul thus denounced the lawsuit as an attempt to intimidate women from accessing necessary medical care. For him, medical information, especially that relating to reproductive health, must remain private, regardless of the laws of another state. He also expressed his commitment to protecting patients and providers from outside interference.
Supporters of the HHS rule believe it is essential to prevent the improper disclosure of health data and preserve access to care. They fear that rescinding this protection could discourage women from seeking legitimate medical care for fear that their information could be used against them.
Other voices, including supporters of the Texas position, consider that federal regulations unfairly infringe on the rights of states to enforce their own laws, including those prohibiting abortion. They argue that the HIPAA law, while important for privacy, was not originally intended to offer such far-reaching protection in the context of reproductive healthcare.
This legal case pits fundamental principles against each other: health privacy versus the power of states to enforce their laws. If Texas prevails, it could weaken current protections for reproductive health data and make it easier for states with restrictive laws to access sensitive medical information. On the other hand, a victory for HHS would strengthen the confidentiality of health data, protecting patients’ rights across the country, particularly in states where access to abortion remains legal. The outcome of this legal battle will undoubtedly have profound repercussions for reproductive rights and medical confidentiality across the United States.
Photo credits: Наталья Евтехова, AdobeStock
