A federal judge in Texas has ruled that the Biden administration likely overstepped its authority by implementing a rule aimed at enhancing privacy protections for individuals seeking abortions and gender transition treatments. The ruling, issued by U.S. District Judge Matthew Kacsmaryk, blocks the U.S. Department of Health and Human Services (HHS) from enforcing the regulation against a Texas doctor who challenged it as unlawful.
Judge Kacsmaryk, appointed during Donald Trump’s presidency, granted a preliminary injunction to Dr. Carmen Purl and her medical practice. The injunction prevents enforcement of the rule, which was set to take effect on Monday, just before the compliance deadline.
Julie Marie Blake, a lawyer with the conservative Christian legal group Alliance Defending Freedom, represented Dr. Purl in the case. “Doctors and states should be able to protect patients from abuse,” Blake stated. “The court rightly ruled that this unlawful rule change would have weaponized laws about privacy that have nothing to do with abortion or gender identity.”
HHS has declined to comment on the ruling.
Context of the Rule
The privacy rule, introduced by HHS in April 2024, is part of the Biden administration’s broader effort to safeguard reproductive healthcare following the Supreme Court’s 2022 decision to overturn Roe v. Wade. That landmark ruling had previously guaranteed abortion access as a constitutional right nationwide.
The regulation aims to protect patients’ medical records from being disclosed to law enforcement authorities in states that have banned or heavily restricted abortion. It also seeks to address efforts by Republican-led states, including Texas, to limit out-of-state travel for abortion services. President Joe Biden has emphasized the importance of protecting medical privacy, stating, “No one should have their medical records used against them, their doctor, or their loved ones just because they sought or received lawful reproductive health care.”
Legal and Advocacy Responses
The Center for Reproductive Rights, a proponent of the rule, criticized the lawsuit as a “shameful” attempt to intimidate individuals seeking reproductive healthcare. Liz Taylor, a lawyer with the organization, said, “This is about keeping people’s health information private and protected. Yet, anti-abortion extremists want to eviscerate every protection left for patients who need an abortion.”
The rule relies on HHS’s authority under the Health Insurance Portability and Accountability Act (HIPAA) to safeguard patient privacy. It prohibits healthcare providers and insurers from sharing information about legal abortions with state authorities intending to penalize individuals involved.
Specific Challenges
Dr. Purl’s lawsuit raised concerns that the rule might restrict her ability to report abuse or violations involving minors. She argued that the regulation could hinder her from reporting cases where a patient was coerced into an abortion or when a minor was scheduled for gender-affirming treatment in violation of Texas law.
HHS countered that the rule does not prevent the reporting of child abuse, stating that it only forbids the disclosure of abortion-related information to authorities seeking punitive action. However, Judge Kacsmaryk expressed doubts about the practical application of the rule, stating, “Even if a more nuanced reading of the 2024 Rule allowed child-abuse reporting to Texas (child protective services), a nonlawyer licensed physician is not equipped to navigate these intersecting legal labyrinths.”
Broader Implications
This ruling marks another pivotal moment in the ongoing debate over reproductive rights and medical privacy. Judge Kacsmaryk is already well-known for his 2023 decision to suspend the FDA’s approval of the abortion pill mifepristone, a ruling partially overturned by the Supreme Court to preserve access to the medication.
The case underscores the complexities of balancing patient privacy with state-level restrictions in a post-Roe legal landscape, setting the stage for further legal challenges and debates over reproductive healthcare access.
