House approves S.28 expanding shield protections for legally protected health care services

The Vermont House on Thursday approved S.28, “an act relating to access to certain legally protected health care services,” advancing technical changes its sponsors say strengthen safeguards for patients and providers who seek or provide legally protected reproductive and gender-affirming health care. The third-reading vote was 97 in favor and 43 opposed.

The bill’s reporter from the House Health Care Committee, the member from Winooski, told the chamber the measure is intended to fill technical gaps in existing “shield” laws (Acts 13 and 14) and to extend reciprocity and consumer protections without adding new services. “This bill does not add new services nor does it expand reproductive services or gender affirming care,” the member said during the committee report, describing sections that address reciprocity with other states, exemptions from public-records disclosure and definitions of unprofessional conduct for regulated health professions.

Supporters said the bill clarifies application of protections for providers licensed under both the Office of Professional Regulation and the Board of Medical Practice, narrows circumstances under which protected health information may be disclosed to governments outside Vermont, and broadens the Consumer Protection Act to cover misleading advertising by any health-care provider. The reporter also described provisions intended to protect prescribers and pharmacists by allowing redaction of prescriber names on fulfilled prescriptions for medications used in legally protected care and by granting liability protection to covered entities that refuse disclosures consistent with the bill.

The bill was the subject of extended questioning and debate on the House floor. Members who opposed the bill raised concerns about newly added language permitting the use of adaptive questionnaires — sometimes used in asynchronous telehealth — to support prescribing medications to terminate pregnancy without an in-person examination. The member from Ferrisburg asked directly whether the added language would allow a provider to prescribe medication “without having an in person examination,” and the reporter replied that it did not change timelines for gestational limits and that the questionnaires are used at the prescriber’s discretion.

Opponents warned that relying on a questionnaire could allow inaccurate self-reported information about gestational age, potentially exposing patients to inappropriate care or providers to discipline. “We could have a person who claims to be six weeks along, fills out the questionnaire and is actually 13 or 14 weeks,” the member from Ferrisburg said, arguing that misreported information could result in unsafe prescribing and unfair disciplinary risk for clinicians.

Supporters, including several members who identified themselves as medical professionals, countered that asynchronous care and adaptive questionnaires are established practices supported by peer-reviewed evidence and that standards of care and professional discipline remain the responsibility of licensing boards and malpractice law. One member said clinicians and the legal counsel who helped draft the bill built protections into the language and that the bill also protects clinicians from harassment and violence tied to providing legally protected care.

Other substantive changes described in committee testimony and on the floor include: creation of statutory reciprocity for legally protected health-care activities performed in other jurisdictions if those activities would have been protected in Vermont; expansion of certain public-records exemptions to redact contact information for licensees and applicants; expansion of the types of licensed professionals required to report fetal deaths and a reduction in the mandated retention period for those reports from five years to two years; and amendments to the standard for court orders compelling disclosure so courts must find the information will not be used to impose liability based solely on seeking, obtaining, providing, or facilitating legally protected care.

Judiciary committee members offered two technical amendments focused on section 6 (disclosure of protected health information) and section 13 (confidentiality of prescriber and pharmacist information). The Health Care Committee accepted the Judiciary committee’s amendments before the House acted on the amended committee report.

Committee testimony and floor remarks referenced a range of witnesses who appeared before the House Health Care Committee, including representatives of the Vermont Medical Society, Planned Parenthood of Northern New England, the Office of Professional Regulation, Vermont Legal Aid, the Vermont Department of Health, pharmacists, and an anti-abortion policy analyst. The Health Care Committee reported the bill favorably with amendments by a vote of 8-3-0.

The House approved the committee-recommended amendments and then ordered third reading. On third reading the bill passed by roll call, 97-43.

Votes at a glance - S.28 (third reading, as amended): passed, roll-call vote 97 yes, 43 no. - S.18 (licensure of freestanding birth centers): passed in concurrence with proposal of amendment by voice vote. - H.243 (regulation of business organizations): postponed to Wednesday, April 23 (motion passed). - H.507 (development in wetlands): introduced and referred to Committee on Environment (first reading). - H.508 (amendments to Burlington charter): introduced and referred to Committee on Government Operations and Military Affairs (first reading). - Senate bill carrying an appropriation (S.36) relating to the Medicaid payment model for residential substance use disorder treatment services: referred to Appropriations pursuant to House Rule 35(a).

What’s next S.28 will return to the Senate as the House has proposed its amendments. If both chambers agree to the same text, the bill would move to the governor. The House also postponed action on H.243 to allow further committee consideration.

(Quotes and attributions are taken from proceedings of the Vermont House floor on April 17, 2025.)