- Interest has surged at telehealth abortion clinic Choix since the draft Supreme Court opinion leak.
- The US government permanently allowed abortion pills to be delivered by mail in December 2021.
- Choix said the reversal could mean more people travelling to other states to access abortion services.
The draft Supreme Court opinion, leaked on May 3, could seek to overturn Roe v. Wade – a landmark ruling that protects women's right to abortions. If the legislation is overturned it could mean abortion becoming illegal in 23 states.
California-based Choix is a telehealth clinic – an online health service that delivers remote care – for sexual and reproductive needs run by nurse practitioners and doctors.
Choix, licensed to deliver its services in California, Colorado, and Illinois, said it's seen a spike in the number of visitors to the website and patient inquiries about the type of care it provides, as well as increased inquiries about what states it serves since the leak.
"We're getting a lot of interest. People probably want to know if they should ever need this care where they might be able to go. I think the surge was really about people learning more," co-founder and chief executive Cindy Adam said.
The US government lifted a ban on mail-order abortion pills in April 2021 after the Supreme Court previously voted to ban the abortion pill from mail delivery. The Food and Drug Administration (FDA) decided in December last year to permanently allow the abortion pills to be delivered by mail rather than requiring it to be administered in person.
It's going to be challenging for patients to get care with the possible overturning of Roe v. Wade, according to Choix. The reversal could mean people travelling out of state to access telehealth abortion services.
"We suspect and we're seeing an increase in certain parts of states where it's easier for people to travel. We'll probably see really big surges in Southern California and parts of Illinois where it's easier to access care and they are really going to be the focus of patient travel," Adams said.
Choix patients do not have to show proof of residency to get access to its services, but they need to confirm their ID with a selfie as part of its intake process. They are only required to have an address in the state it serves so that Choix knows patients are getting care at or near that address.
"It will be an unfair challenge, to say the least, to see how restrictive states challenge us. It'll be interesting to see how they come after telehealth abortion clinics because they don't require this of other telehealth providers," Adam said.
Telehealth refers to health care services that can be offered to patients remotely, such as through the comfort of their own home using technology including video conferencing. Telehealth companies can offer remote patient monitoring including services like online consultations and therapy.
These services gained popularity during the pandemic, as utilization spiked to more than 32% of outpatient visits taking place through telehealth in April 2020, data from McKinsey shows. That rate stabilized to between 13% and 17% across all telehealth services, per the report.
Choix offers abortion services by letting customers sign up to its website, create a patient portal account, and fill out an online medical questionnaire. Once a patient submits their online questionnaire, a medical provider will review it within 24 hours and then determine eligibility.
If a patient chooses to proceed, they complete final consent forms and its partner pharmacy will mail the prescription for the abortion care medications, which are the exact same medications that a patient would receive if they went to a brick-and-mortar clinic.
Choix, which was founded in 2020, said its colleagues in the brick-and-mortar clinics are already seeing an increasing request for appointments in states like Illinois, which is causing longer wait times for in-person care.
"We hope that our model will help alleviate capacity issues so that we can help reserve in-person visits for patients who really require or who really prefer in-person care," Adam said.
One of the challenges telehealth abortion clinics face as a newer form of care is that many people are still learning about the safety and efficacy of medication abortion in general, and the knowledge gap is even greater around medication abortion via telehealth, according to Choix.
There is a lot of misinformation about the safety of medication abortion via telehealth and concerns over data privacy, it added.
"We still get calls a lot of weeks just wanting to make sure that we're real and that a human answers the phone. And they're so relieved when they do hear that we're here and that we're real," Adam told Insider.
"As understanding about abortion care via telehealth grows — and as access continues to get more restricted — we anticipate even greater influxes of patient care requests," she added.