Shield Laws and the Battle to Provide Reproductive Health Services

Following the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization in 2022, which reverted the issue of abortion access back to the states, the landscape for access to reproductive care has become significantly divisive. Some states have remained abortion-permissive, with access to reproductive care remaining unchanged – or even expanded. Other states have grown increasingly abortion-restrictive, creating criminal and civil causes of action against clinical care providers who perform abortion services in those states if it impacts their residents.

Notwithstanding the Dobbs decision, abortion rates overall have remained steady due to abortion-by-mail services post Dobbs. The latest data from the Guttmacher Institute (and related policy analysis) estimate that about 63% of all abortions in the U.S. are medication abortions, up from 53% pre-Dobbs. Notably, these figures include abortions “provided under the protection of abortion shield laws,” though, given the legal and political pressures surrounding the issue, many states do not share reproductive care statistics with states like Texas that have enacted a total ban on abortion care. Consequently, the data cited above omit abortion pills mailed to residents in states with total abortion bans, and it is therefore likely that medication abortion “plays an even more prominent role in the US abortion access landscape than the state figures presented here suggest.”

Abortion-restrictive states, frustrated by having their restrictions bypassed, have sought to enforce restrictive state laws against out-of-state care providers. However, state-level “shield laws” in abortion-permissive states have made such enforcement difficult. Generally shield laws do the following: (i) shield in-state providers from legal actions initiated in or by other states where abortion access is restricted; (ii) prevent state and local government agencies from cooperating with out-of-state investigations seeking to enforce reproductive care bans; (iii) enhance privacy protections for patients and providers alike in the reproductive care context; and (iv) create legal mechanisms permitting individuals targeted by out-of-state enforcement actions to recoup legal costs incurred or damages awarded by out-of-state courts.

Opponents of shield laws cite the “full faith and credit clause” of the Constitution, requiring states to recognize the laws of sister states, to argue shield laws are unconstitutional. Proponents of shield laws argue other states may not “commandeer [their] courts to enforce” out-of-state abortion bans, effectively invoking the penal judgment exception (which prevents one state from penalizing conduct a sister state intends to protect).

Currently, 22 states and the District of Columbia have enacted shield laws protecting reproductive health care and/or gender-affirming care. Connecticut’s shield law (the first in the nation) prohibits government officials and state agencies from supporting investigations seeking to impose claw and criminal penalties for providing reproductive or gender affirming care, prohibits the governor from extraditing individuals charged in abortion-restrictive states if the conduct in question is permissible under Connecticut law, and prohibits state courts from issuing summons or orders to appear in another state court in connection with cases involving the provision of reproductive or gender-affirming care.

Under Connecticut’s shield law, providers who furnish reproductive health care services are protected against professional discipline based solely on the provision of reproductive care and are permitted to file “clawback” lawsuits to recoup any damages that may have been awarded by an out-of-state court, including costs and attorney fees, that result from out-of-state actions stemming from the provision of reproductive care. Moreover, malpractice insurers may not penalize providers based solely on the provision of reproductive or gender-affirming care, and Connecticut’s rules on health data sharing are considerably more protective than those conferred under the HIPAA Privacy Rule. Recent proposed amendments to Connecticut’s shield law would have expanded protections to include telemedicine (HB 7135) but stalled in committee earlier this year.

Shield laws nationwide, however, continue to progress. Most notably, California is expected to pass Assembly Bill 260 later this month after amendments made earlier this week. If passed, the bill would permit California-based pharmacies to ship the pills for medication abortions without printing the names of the patient, prescribing physician, or pharmacist on the package. California’s enhanced shield laws may have national reverberations in the battle over access to reproductive care.

On September 8, 2025, New York Attorney General, Letitia James, announced she was intervening in a case filed against a New York government official in a New York court by Texas Attorney General, Ken Paxton, who was seeking to enforce a Texas default judgment against a New York provider. The case centers around New York’s shield law, but the outcome will yield nationwide implications over the constitutionality of shield laws in general.

We expect that battles to pierce the state shield laws will continue and lessons will be learned for states that have shield laws regarding what more needs to be done to protect their reproductive health service providers.

As new developments arise, we will continue to update our Dobbs Decision Resource Center. In the meantime, please contact one of the lawyers in Shipman’s Health Law practice group if you have questions about this ever-changing legal landscape.