This piece first appeared in our weekly newsletter, The Fallout.

One of the truly useful steps the Biden administration took in the wake of the Supreme Court reversing Roe v. Wade was strengthening privacy protections for patients seeking reproductive health care. Now, the conservative legal movement has those protections directly in its sights with four lawsuits that, if successful, would open the door to anti-choice cops and prosecutors accessing reproductive health-care records to prosecute patients and providers for having or facilitating an abortion or other lawful reproductive health care.

The 2024 Privacy Rule issued under the Health Insurance Portability and Accountability Act (HIPAA) was, frankly, one of the Biden administration’s only good responses to the Dobbs v. Jackson Women’s Health Organization decision. The rule specifically prohibits using or disclosing protected health information to investigate or criminalize anyone for providing or receiving reproductive care. This protects doctors or other covered entities, for example, from having to comply with subpoenas for medical records if officials try to access those records to prosecute someone for seeking, assisting with, or providing lawful reproductive health care.

In late 2024 into early 2025, a coalition of conservative state attorneys general that include Texas’ Ken Paxton and Tennessee’s Jonathan Skrmetti—along with at least one anti-choice doctor represented by the Alliance Defending Freedom—all filed lawsuits claiming the 2024 rule interferes with the states’ investigative powers and prevents doctors from reporting child abuse claims. Notorious anti-abortion judge Matthew Kacsmaryk is presiding over the latest challenge and could use the case as an opportunity to potentially declare all of HIPAA unconstitutional.

These lawsuits are in the initial stages, and they all seek to invalidate the 2024 Privacy Rule permanently. Doing so would make it easier to criminalize abortion patients and providers. And given the legal fight over New York’s shield laws, recent arrests of a Houston-area midwife and her co-worker, and Kacsmaryk’s apparent eagerness to get rid of all health privacy protections entirely, you can see why I’m watching these cases closely.