Reproductive Health Care Shield Laws: How a Legal Conflict Between New York and Texas Might Shape Access to Abortion, Miscarriage, and Pregnancy Care
October 15, 2025
Overview
The divide between states seeking to restrict abortion and states permitting it continues to widen, as the former pursue new, increasingly draconian, maneuvers to restrict abortion access and the latter bolster protections in response. The inter-state conflict incited by this divide is coming to a head in a legal struggle between Texas and New York. The lawsuit, Texas v. Bruck, challenges enforcement of a New York shield law and threatens the viability of such legal safeguards moving forward, with major consequences for reproductive health care access.
More than three years after Dobbs v. Jackson Women’s Health Organization, the divide between states seeking to restrict abortion and states permitting it continues to widen, as the former pursue new, increasingly draconian, maneuvers to restrict abortion access and the latter bolster protections in response. The inter-state conflict incited by this divide is coming to a head in a legal struggle between Texas and New York in the New York Supreme Court for Ulster County. The lawsuit, Texas v. Bruck, challenges enforcement of a New York shield law and threatens the viability of such legal safeguards moving forward, with major consequences for reproductive health care access.
Reproductive health care shield laws, which have been adopted in about half of the states, create protections for patients, providers, and others supporting access to care by shielding them from out-of-state efforts to impose civil or criminal liability, or professional disciplinary action, in connection with care that is lawful in the shield law state. Shield laws vary somewhat, but they generally bar state agencies, courts, and others from cooperating with out-of-state actions targeting specified health care activity. Some state shield laws include privacy protections for reproductive health information—safeguards that fill a vital role following the June 2025 court ruling that eliminated nationwide protections in the HIPAA Rule to Support Reproductive Health Care Privacy.
The New York shield law at the center of Texas v. Bruck prohibits state and local employees from cooperating with out-of-state agencies and from expending time, money, or other resources “in furtherance of any investigation or proceeding that seeks to impose civil or criminal liability or professional sanctions upon a person or entity for any legally protected health activity occurring in th[e] state.” New York invoked this law in response to a civil action brought by the Texas Attorney General against New York doctor Maggie Carpenter, claiming that she had practiced medicine in Texas without a license and aided an abortion in violation of state law by prescribing abortion pills via telemedicine to a patient in Texas.
Dr. Carpenter did not respond to the complaint, and, in February 2025, the Texas court issued a default judgment against her, ordering her to pay a civil penalty of $100,000. But when Texas tried to enforce the judgment in Ulster County, New York, where Dr. Carpenter resides, Acting County Clerk Taylor Bruck refused to docket the judgment, citing New York’s shield law. Bruck again refused to docket the judgment after Texas sought enforcement a second time.
In July 2025, in a move that may determine the ability of anti-abortion states to extend their reach beyond their borders, Texas sued Bruck, contending that the Full Faith and Credit Clause of the U.S. Constitution obligates the Ulster County Clerk to recognize the Texas judgment. In September, the New York Attorney General announced that she has formally intervened as a party in the lawsuit.
Generally speaking, the Full Faith and Credit Clause requires a state to give judgments from the judicial proceedings of another state conclusive effect. But the U.S. Supreme Court has found an exception to this general rule for “penal judgments,” and the outcome in Texas v. Bruck may turn on whether the judgment against Dr. Carpenter falls under this exception. A judgment is penal when the underlying law, rather than granting a right to a private individual, imposes punishment for an offense against the public. As indicated in the 1892 Supreme Court case Huntington v. Attrill, even if a judgment arises out of a civil action—as did the judgment against Carpenter—it may still be treated as penal if “’the wrong sought to be redressed’ is ‘a breach and violation of public rights and duties, which affect the whole community, considered as a community.’”
Bruck comes amidst several other actions targeting providers based in shield law-states for prescribing abortion pills via telemedicine. In addition to the Texas action, Dr. Carpenter was criminally indicted in Louisiana, although New York has refused to recognize the extradition warrant. According to recent court filings in separate litigation, a California doctor, Remy Coeytaux, is the subject of an outstanding 2024 arrest warrant in Louisiana for mailing abortion pills to a patient there. Dr. Coeytaux has also been sued by a Texas man in a civil suit, leading the Texas Attorney General to issue a cease and desist letter that orders Dr. Coeytaux to stop prescribing abortion medication in the state.
As patients increasingly seek abortion care through telemedicine and continue to travel out of state for care, Bruck will have critical implications for the availability of safe, quality services. The viability of shield laws like the one at issue in Bruck will dramatically influence the accessibility of abortion services. But the implications are likely to extend to miscarriage and pregnancy care as well.
In a dynamic already evidenced in states hostile to reproductive rights, restrictive abortion policies create climates of confusion and fear around all types of reproductive health care. Unsure of what is legal and wary of potential punishment, providers in these states have delayed or denied care to pregnant people, resulting in medical emergencies and numerous deaths. If providers must identify, understand, and abide by every law nationwide that could be used to target them—a matter that raises complex choice of law and jurisdictional questions—fear, uncertainty, and resultant barriers to care may increase substantially.
While Bruck focuses on recognition of out-of-state judgments, other components of shield laws, such as privacy protections for information related to reproductive health care, may come under attack later if Texas succeeds in requiring out-of-state enforcement of its judgments and investigations of providers in states permitting abortion ensue accordingly.
Attorneys general in Indiana and Missouri have recently tried to obtain or disclose patient information related to abortion care provided in their states, highlighting how states with abortion restrictions exploit reproductive health information for enforcement purposes.
Threats to patient privacy, particularly with respect to stigmatized and criminalized care, impede access, with outsized harm for the health of young people, people who use drugs, and others subject to oversurveillance. Shield laws provide a degree of reassurance that this sensitive information will be protected from such harmful intrusions. The campaign to undermine shield laws thus poses a clear threat to the reproductive health of people across the U.S.
This post was written by Emma Kaeser, J.D., Staff Attorney, Network for Public Health Law—Mid-States Region.
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