Texas' abortion pill lawsuit marks new challenge to interstate telemedicine

Texas has sued a New York doctor for prescribing abortion pills to a woman near Dallas, launching one of the first challenges in the U.S. to shield laws that Democrat-controlled states passed to protect physicians after Roe v. Wade was overturned.

Texas Attorney General Ken Paxton filed the lawsuit on Thursday in Collin County, and it was announced Friday.

Such prescriptions, made online and over the phone, are a key reason that the number of abortions has increased across the U.S. even since state bans started taking effect. Most abortions in the U.S. involve pills rather than procedures.

Mary Ruth Ziegler, a law professor at the University of California, Davis, School of Law, said a challenge to shield laws, which blue states started adopting in 2023, has been anticipated.

And it could have a chilling effect on prescriptions.

“Will doctors be more afraid to mail pills into Texas, even if they might be protected by shield laws because they don’t know if they’re protected by shield laws?” she said in an interview Friday.

The lawsuit accuses New York Dr. Margaret Daley Carpenter of violating Texas law by providing the drugs to a Texas patient and seeks up to $250,000. No criminal charges are involved.

Texas bars abortion at all stages of pregnancy and has been one of the most aggressive states at pushing back against abortion rights. It began enforcing a state law in 2021 — even before the U.S. Supreme Court overturned Roe v. Wade and opened the door to state bans — that barred nearly all abortions by allowing citizens to sue anyone who provides an abortion or assists someone in obtaining one.

Paxton said that the 20-year-old woman who received the pills — mifepristone and misoprostol, which are typically used in medication abortions — ended up in a hospital with complications. It was only after that, the state said in its filing, that the man described as “the biological father of the unborn child” learned of the pregnancy and the abortion.

"In Texas, we treasure the health and lives of mothers and babies, and this is why out-of-state doctors may not illegally and dangerously prescribe abortion-inducing drugs to Texas residents,” Paxton said in a statement.

A phone message left for Carpenter was not immediately returned, nor was an email to the Abortion Coalition for Telemedicine, where she's co-medical director and founder.

Anti-abortion advocates, who legally challenged the Biden administration’s prescribing rules around mifepristone, have been readying provocative and unusual ways to further limit abortion pill access when Trump takes office next year. They feel emboldened to challenge the pills’ use and seek ways to restrict it under a conservative U.S. Supreme Court buttressed by a Republican-controlled Congress and White House.

Earlier this year, the U.S. Supreme Court ruled that a group of anti-abortion doctors and their organizations lacked the legal standing to sue to try to have the U.S. Food and Drug Administration's approval of mifepristone rescinded. But since then, the Republican state attorneys general from Idaho, Kansas and Missouri have sought to have some of the rules around the pills tightened — including to bar telemedicine prescriptions.

Also this year, Louisiana became the first state to reclassify the drugs as “controlled dangerous substances.” They can still be prescribed, but there are extra steps required to access them.

Lawmakers in at least three states have introduced bills for next year aimed at barring or restricting use of the pills.

“I began to think about how we might be able to both provide an additional deterrent to companies violating the criminal law and provide a remedy for the family of the unborn children,” said Tennessee state Rep. Gino Bulso, who is sponsoring the legislation there that includes a provision barring use of the medications for abortion.