In a blow to federal protections for sensitive medical information, a Texas federal judge has struck down a Biden administration rule that aimed to shield abortion and gender-affirming care records from state law enforcement.
Judge Matthew Kacsmaryk, sitting in Amarillo and appointed during the Trump presidency, declared that the U.S. Department of Health and Human Services (HHS) overstepped its legal authority when it finalized the rule last year. According to the court, HHS had no clear mandate to create “special protections” for what the judge dubbed “politically favored medical procedures.”
At the heart of the rule was a prohibition against doctors and insurers sharing information about legally obtained abortions with law enforcement from states seeking to penalize those involved. The Biden administration had pitched it as a necessary firewall against rising efforts by certain states to monitor — and punish — reproductive and gender-related healthcare, even when those services are accessed lawfully across state lines.
Wednesday’s ruling, which follows a preliminary injunction issued late last year in favor of a Texas physician challenging the rule, now halts the privacy measure nationwide.
The challenge was backed by Alliance Defending Freedom, a conservative legal organization, whose counsel called the overturned rule an “abuse of privacy laws” allegedly misused for political ends.
The Biden administration had rolled out the privacy expansion as a countermeasure to the post-Roe fallout — after the Supreme Court’s 2022 decision dismantled federal abortion rights. With several Republican-led states, including Texas, aggressively pursuing individuals who cross borders for abortion access, the administration sought to insulate patient data from being turned into legal ammunition.
But for now, that shield has been dismantled. A separate challenge from the state of Texas continues in a Lubbock federal court, with HHS signaling that its stance on the issue may evolve — notably under review by officials appointed during the Trump era still within the agency’s ranks.
President Biden, at the time of the rule’s rollout, had made the stakes clear: “No one should have their medical records used against them, their doctor, or their loved one just because they sought or received lawful reproductive health care.”
That principle, for now, remains in legal limbo.
