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On March 1, champions of reproductive freedom in the General Assembly introduced the RBG Act (House Bill 188/Senate Bill 167), a bill that would remove many of the existing barriers to accessing an abortion in North Carolina. These restrictions serve no medical purpose and instead interfere in personal and private decisions about whether and when to have a child.

The bill seeks to remove five medically unnecessary restrictions currently in place in North Carolina:

  • State-mandated counseling

  • 72-hour mandatory delay

  • Ban on advanced practice clinicians (APCs) from providing abortion

  • Ban on abortion via telemedicine

  • Ban on most insurance plans covering abortion

State-mandated counseling

A patient seeking an abortion in North Carolina is currently required to listen to medically-inaccurate and biased counseling. The script was written by politicians — not doctors —  with the goal of dissuading people from having abortions. No other medical procedure in North Carolina is subjected to such scripts. By removing this requirement, physicians would be able to provide accurate, compassionate counseling to their patients based on health care, not politics

72-hour mandatory delay

After a patient receives the state-manded counseling, they must then wait at least 72 hours before they can come in for their abortion, causing an automatic delay of at least three days for every patient.

The mandatory delay pushes patients seeking an abortion to obtain that care later in pregnancy, increasing both risks and the patients’ expenses related to this care. No other medical procedure in North Carolina subjects every patient seeking the procedure to such a delay, and it is one of the most extreme in the country. What’s more, this law burdens, stigmatizes, and interferes with a person’s health care and inflicts physical and psychological harm. The assumption that a person who has decided to have an abortion has not thought through their decision is insulting. By removing this mandatory delay, those seeking an abortion can get the care they need when they need it and can avoid the additional costs that may be associated with two appointments, such as taking time off of work, finding childcare, and getting a hotel.

Ban on advanced practice clinicians from providing abortions

Only physicians are legally allowed to provide surgical abortions and prescriptions for medication abortions in North Carolina. This ban arbitrarily limits the types of medical professionals who are authorized to provide abortion care.

In North Carolina, 91% of counties do not have an abortion provider. By removing this restriction, more medical professionals, like clinicians, nurse practitioners, and physicians assistants, could provide abortion. These are highly trained professionals that are able to provide this care in other states — just not in North Carolina.

Ban on medication abortion via telemedicine

Telemedicine has shown itself to be a safe, effective, and crucial way for patients to access health care, and abortion is no different.  There is no health or safety justification for treating telemedicine for abortion differently than any other comparable treatment or procedure for which telemedicine is used.

By allowing providers to administer medication abortion via telemedicine, we can increase access to this safe and effective way to end an early pregnancy, particularly for people who live in rural areas. 

Ban on most insurance covering abortion care

The law currently prohibits many health insurance plans from covering abortion by banning the state treasurer from including abortion coverage in the state health insurance plan outside of very limited circumstances. The state’s Medicaid program and local and county employee health insurance plans are also barred from covering abortion in most cases. Further, current law also bans private insurance plans from offering abortion coverage — purchased with private dollars — on the North Carolina Healthcare Exchange. 

Those excluded from coverage are more likely to be people who are already failed by our health system, including women of color, young people, transgender and non-binary people. These gaps have been further exacerbated by the pandemic, which has fallen hardest on people of color and women, especially Black and brown women. Removing this ban is an important part of ensuring that people with low incomes have control over their economic security.

By eliminating these unnecessary restrictions, we can correct some of the wrongs done by the General Assembly in the past and move forward towards more accessible abortion for all in the future.

Unfortunately, with the current makeup of the General Assembly, the RBG Act is not likely to become law this session. In order to pass this important piece of legislation and others that protect and expand access to health care, we need to elect more legislators who believe in and will fight for reproductive freedom. Elections have consequences, and we hope folks will join us in that effort as we gear up for 2022.


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