Rhode Island Senate passes Healthcare Provider Shield Act

The Rhode Island Senate passed a bill Thursday that would defend doctors’ ability to provide reproductive health services and gender-affirming care, which includes therapies, surgeries and other medical services for transgender and nonbinary people.  

The 29-7 vote passed largely along partisan lines, with every Republican senator — Jessica de la Cruz, Anthony DeLuca II, Elaine Morgan, Thomas Paolino and Gordon Rogers — voting against the bill. Sens. Roger Picard and Leonidas Raptakis were the only two Democrats to vote against it, and Sen. Victoria Gu was not present.

The Healthcare Provider Shield Act, sponsored by Sen. Dawn Euer and nine fellow Democrats, broadly states that it would stop “any individual” from interfering with access to reproductive or gender-affirming health care services in Rhode Island. More specifically, that means protecting doctors and other health care providers from legal action originating outside state lines — from places where abortion and other reproductive or gender-related health care services have been limited because of the Supreme Court’s 2022 overturn of Roe v. Wade.

“Any public act of a foreign jurisdiction that prohibits, criminalizes, sanctions, or authorizes a person to bring a civil action against or otherwise interferes with a person, provider, payer, or other entity in this state that engages in legally protected healthcare activity…shall be an interference with the exercise and enjoyment of the rights secured by this chapter,” the bill reads.

In Euer’s own words on the Senate floor: “What this bill does is it makes sure that Rhode Island gets to regulate our doctors,” she said. “We get to regulate and determine the standards of care here in Rhode Island for our Rhode Island professionals.”

The shield in question casts a wide shadow. Among the bill’s provisions: Public agencies would be forbidden from using any time, money or other resources on interstate investigations. The state’s courts would not enforce any penal measure from another state involving the specified health services. The governor could not extradite a person to their home state on the basis of their receiving an abortion or gender-affirming surgery in Rhode Island.

Shield laws, a 2023 article in NEJM Evidence argues, “are one of the bright spots for abortion access in this new environment where there is no national right to abortion.”

But their true utility has not been tested. “So far, given how new abortion bans and shield laws are, they have not yet needed to be used,” the article led by David S. Cohen, a Drexel University law professor, continues. “However, even if these laws are never used, their mere existence can be an important countervailing force against states that may otherwise consider imposing their abortion bans across state lines.”

But things may have already changed since that article, especially in regards to transgender medical care, as evidenced by points Euer made when she introduced the bill to her senate colleagues — like a legal battle between Texas and Seattle Children’s Hospital over a transgender patient’s medical records.

The newness of shield laws and the slightly-less-new threats to reproductive health and transgender health care has not stopped other states from forging their own defenses. Regionally, shield laws involving transgender care and abortion have been enacted in Massachusetts, Maine, Connecticut, Vermont, New York and New Jersey. New Hampshire and Rhode Island lack shields in both categories.

Sen. Pam Lauria, a primary care nurse practitioner, rose in support of Euer’s legislation: “It might seem a little strange that I would complain about politics, but politics does not belong in my exam room, or any health care provider’s exam room.”

Denouncing science denialism, Lauria posed the bill as an economic good. “You’ve heard me talk a lot about the need for health care workforce bills,” she said. “Well, this is a health care workforce bill, because if we want to keep our providers here in Rhode Island or providers to come to Rhode Island. We have to protect the job that they’re trained to do.”   

 A 2023 article in Columbia Law Review makes clear the unclarity in interstate litigation: “The Constitution’s general prohibition of state restrictions on interstate travel, burdens on interstate commerce, or application of a state’s law outside its borders should make it difficult for antiabortion states to enforce these laws,” the article reads. “Yet, these constitutional defenses are underdeveloped and subject to debate, leaving courts as the ultimate arbiters of these interstate battles.” 

Euer’s bill first appeared for public discussion at a March 7 meeting of the Senate Committee on Judiciary. Testimonies that night ranged from supportive to skeptical, with doctors and other health providers showing up in support. 

But the bill only headed for the Senate floor last week on Thursday, April 25, when the Senate Committee on Judiciary passed an amended version that lead sponsor (and the committee’s chair) Euer said made no substantial changes, other than moving the bill’s public policy portion from general law into public law. Sen. Anthony DeLuca, a Warwick Republican, was the sole committee member who voted against the bill’s passage out of Judiciary.

“I rise today in support of this bill, and in an unintended coincidence, today marks 11 years since the governor signed marriage equality into law.” Euer said Thursday. “And so this bill is incredibly important. The timeliness of us having this on the floor today is not lost on me, because I got my start in the real world of politics in Rhode Island on that marriage equality campaign.”  

The companion House bill — H7577, led by Democratic Rep. John Edwards of Tiverton and nine other Democrats — has stagnated since a March 5 meeting of the House Committee on Judiciary.