Privacy on Trial: Texas Ruling Undoes Biden-Era Reproductive Care Protections

A Texas federal judge, in Purl v. United States HHS, has vacated a U.S. Department of Health and Human Services rule that was finalized during the Biden administration with an aim to protecting the privacy of patients seeking abortions and gender-affirming care, ruling that the HHS didn't have the authority to "fashion special protections" in areas of "great political significance." The final rule amended HIPAA's privacy rule to bar using or sharing protected health information (PHI) to investigate or prosecute patients or providers who have obtained or provided legal reproductive healthcare, including an abortion. The agency, then under the Biden Administration, had argued in issuing the final rule that, in view of state laws prohibiting or limiting abortions and other reproductive care, the rule was needed to "better protect patient confidentiality and prevent medical records from being used against people for providing or obtaining lawful reproductive health care." Learn more about the consequences of this decision.

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• HIPAA Privacy, Security, Breach Notification, and Other Administrative Simplification Rules
  Review the changes resulting from Purl v. United States HHS and the regulations at issue. Modifications to new HIPAA notice requirements were finalized in 2024 and pertain to coordination of regulations governing substance use disorder records under 42 C.F.R. Part 2 and new limitations on use or disclosure of PHI relating to reproductive health care. The compliance date for the new privacy notice rules is scheduled for February 16, 2026. 89 Fed. Reg. 32,976 (April 26, 2024) (2024 Rules). This effective date is dubious now that, on June 18, 2025, the reproductive health care provisions of the 2024 Rules have been vacated by the decision in Purl v. United States HHS, 2025 U.S. Dist. LEXIS 116234 (N.D. Tex. 2025).
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  See how, earlier this year, President Trump issued two executive orders targeting abortion inside and outside the United States, reinstating a ban on federal funding for certain international family planning groups and revoking a pair of Biden-era directives that had supported abortion access. Those executive orders had directed the Biden administration to inform hospitals of their obligation under the Emergency Medical Treatment and Labor Act to provide an abortion if necessary in an emergency. The other Biden order had called for the HHS to evaluate ways to use Medicaid to support patients who cross state lines for reproductive healthcare.

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