Vermont committee hears split testimony on S.28 over telemedicine, advertising and fetal-death confidentiality

The House Health Care Committee on March 20 heard extended testimony on S.28, a bill titled an act relating to access to certain legally protected health care services, with witnesses sharply divided over telemedicine abortion, regulation of health-care advertising and changes to fetal-death records.

Mike Fisher, health care advocate for the Office of the Health Care Advocate, told the committee his office supports S.28 as passed by the Senate. "It strikes a good balance at protecting health care workers who are providing care, legally protected care, and, and protecting the public, from misleading or, you know, advertising intentionally designed to mislead the public," Fisher said, adding his office tracked the bill and provided support in the Senate but did not do the bulk of the drafting.

Why it matters: S.28 would affect how certain abortion care is delivered in Vermont, how speech about health services is regulated and who can access fetal-death information in civil or criminal cases.

Opponents centered much of their testimony on First Amendment and safety concerns. Sharon Toborg, policy analyst for the Vermont Right to Life Committee, said S.28 "kind of doubles down" on provisions that targeted pregnancy resource centers under Act 15 (May 2023) and warned the bill treats all speech about health care as commercial speech. Toborg told the committee the prior provisions in Act 15 are the subject of a federal challenge brought by the National Institute of Life Advocates and two Vermont pregnancy centers and that a district judge found the centers "stated a plausible claim for violations of First Amendment rights." She said the bill would expose organizations to enforcement by the attorney general, noting the possibility of fines of up to $10,000.

Toborg also urged the committee to remove a provision she said would make fetal-death reports confidential and thus unavailable in civil or criminal proceedings. "If that could prevent [parents] from seeking justice," she told the committee, "that is concerning." She further argued the bill expands carve-outs to professional standards enacted in Act 15, including allowing out-of-state telehealth providers and prescribing based on an electronically administered adaptive questionnaire.

Physicians and telemedicine providers who testified supported asynchronous, questionnaire-based models for medication abortion as safe and necessary to maintain access. Dr. Linda Prine, a family physician who has prescribed medication abortion by questionnaire, said the model "is extremely efficient and it keeps the costs really low" and that providers operating under shield-law protections offer on-call follow-up for patients. Dr. Prine said the medicines are "extremely safe" and that requiring synchronous video or in-person visits would delay care and increase cost.

Dr. Renee Johansen, a board-certified OB-GYN who described starting a telehealth practice in anticipation of Vermont's 2023 shield law, said peer-reviewed studies support asynchronous care and use of dynamic online questionnaires. She said the model can be essential for people in abusive situations or remote locations who cannot take part in a live visit. Johansen also disputed claims about "abortion pill reversal," saying such reversal protocols had been discredited and that a randomized trial was stopped because patients in the reversal arm experienced hemorrhaging.

On patient safety and timing, witnesses gave differing technical details. Toborg said mifepristone is approved for use up to 10 weeks and asserted medication-abortion complication rates are higher than surgical abortion; Johansen and Prine countered that the World Health Organization lists the medicines as essential and that many telemedicine programs safely use protocols for early pregnancy care. Johansen told the committee that, in her practice, most patients seek care within the first six weeks after their last menstrual period and that access by mail or telemedicine can prevent later, riskier procedures.

Several witnesses urged that pharmacies be allowed to omit prescriber names from mailed packaging to protect clinicians practicing under shield laws. Dr. Prine said Washington and New York had passed such changes and described cases in which providers were identified from packaging; Johansen and Prine said many shield-law providers use mail-order pharmacies based outside the patient’s state.

Committee members asked technical questions about the questionnaire, gestational limits and pharmacy labeling; witnesses provided links and said they would share forms and study citations. No motion or committee vote was taken during the session; the committee recessed and planned to reconvene later.

Ending: The committee paused for a break and scheduled a return to business; no final action on S.28 occurred during the March 20 hearing.