Ever since the U.S. Supreme Court overturned Roe v. Wade and eliminated the constitutional right to abortion in 2022, some health care providers have been on edge about offering reproductive health care.
With the federal protection removed, many states began passing laws restricting access to abortions and criminalizing the activities of those who provide or assist in that type of care, even if they’re located in other states.
In response to those restrictions, Rhode Island has joined more than a dozen states in passing a “shield law” to protect doctors and other health care professionals who provide reproductive and transgender care to patients from states where those services are illegal.
State legislators passed the Health Care Provider Shield Act in June, and it was signed into law by Gov. Daniel J. McKee days later.
The law – which had the backing of the Rhode Island Medical Society – aims to prevent situations in which health care providers in Rhode Island could face criminal lawsuits for providing reproductive care or gender-affirming care for patients who either traveled from a state where the procedures are illegal, or help was provided through telehealth appointments.
“We started becoming concerned that [laws in other states] could impact those patients who should reach us in Rhode Island to be able to access that care, or actually impact us, who was providing that care,” said Heather Smith, an obstetrician gynecologist who practices at Women & Infants Hospital and former president of the Rhode Island Medical Society.
Stacy Paterno, medical society executive vice president, says it seemed like more of a reality after the Texas attorney general subpoenaed a Seattle children’s hospital in 2023 for private medical records of a Texas resident who received gender transition-related care in Washington state. A Texas law prohibits the use of puberty blockers and hormone therapy for transgender youths.
The subpoena effort was dropped in April, but there were several other cases across the U.S. where providers were facing criminal suits for providing reproductive or gender-affirming care where it was still legal.
No health care providers in Rhode Island have been targeted with criminal charges, but several faced malpractice lawsuits, according to Paterno.
Following the Dobbs v. Jackson Women’s Health Organization ruling by the Supreme Court that overturned the Roe v. Wade precedent, McKee issued an executive order protecting health care professionals and patients in Rhode Island from legal liabilities related to granting or receiving reproductive health services.
While the executive order was welcomed by providers, it wasn’t clear how much protection it offered and it didn’t cover gender-affirming care.
“We weren’t sure that [the order] was actually going to actually hold up at a court of law,” Paterno said. “And we were concerned for providers because we saw what was happening across the country.”
As a result, a coalition of dozens of organizations pushed for a state shield law that protects medical providers that give transgender and reproductive health care from lawsuits from those in other states. Matching bills were introduced by Rep. John G. Edwards, D-Tiverton, and Sen. Dawn Euer, D-Newport.
Edwards notes that the law doesn’t change anything about the medical procedures themselves.
More specifically, the law protects providers who are licensed and practicing in Rhode Island from arrest and extradition, subpoena for testimony and documents, wiretapping and other kinds of surveillance, and any kind of disciplinary action taken based on action against them in other states. The law also bans state public agencies from cooperating with out-of-state investigations of health care that is legally protected in Rhode Island and protects personal medical information from being shared with law enforcement agencies in other states. It does not protect providers from facing malpractice lawsuits.
Backing for the legislation in the General Assembly was largely along political party lines, in a 31-6 vote in the Senate and 50-15 vote in the House.
The law received overwhelming support from others, too, according to Gretchen Raffa, chief policy and advocacy officer for Planned Parenthood Votes! Rhode Island, which is the political arm of Planned Parenthood of Southern New England Inc.. Among the supporters of the bill included state leaders such as R.I. Secretary of State Gregg M. Amore, Attorney General Peter F. Neronha and Dr. Utpala Bandy, then-interim director of the R.I. Department of Health.
It’s a step that has also been taken by other Democrat-led states. More than a dozen states – including Massachusetts and Connecticut – have shield laws protecting health care professionals and others from investigations by other states where abortions and gender-affirming care is restricted.
While the legislation hasn’t made much of a difference to Rhode Island’s health care providers yet, Paterno expects it to help the state retain and recruit providers in the long term.
Paterno says she attended an advocacy day at the Statehouse in which a lawmaker asked a group of medical residents whether the Healthcare Provider Shield Act would affect their decision of where to practice.
Every one of the residents raised their hands, Paterno says.
“It helps us say that we’re a state that cares about our providers,” she said. “When you’re a provider thinking about where to start your practice or locate, you want to be in a state that is supportive of you.”