As recipients of federal financial assistance, including Medicare and Medicaid payments, pharmacies are prohibited from discriminating on the basis of race, color, national origin, sex, age, and disability in their programs and activities under a range of federal civil rights laws.

For instance refusal to fill a prescription for mifepristone, a common abortifacient, as a treatment for individuals that have experienced early pregnancy loss and miscarriage, or refusing to fill prescribed contraception when other forms are offered by the pharmacy are examples of potential sex-based discrimination.

Additionally, refusal to fill prescriptions for methotrexate or misoprostol based on their potential uses for medication abortions could discriminate on the basis of disability. Methotrexate is often prescribed to stop ectopic pregnancies as well as treat rheumatoid arthritis and cancers, and misoprostol can treat severe and chronic stomach ulcers, all conditions which may be defined as disabilities under federal civil rights law.

DHHS also released legal guidance on Tuesday which said hospitals must provide abortions when the pregnant individual’s life is at risk.

In a statement DHHS Secretary Xavier Becerra said “We are committed to ensuring that everyone can access health care, free of discrimination… This includes access to prescription medications for reproductive health and other types of care.”

The guidance is part of the Biden administration’s growing response to the US Supreme Court decision Dobbs v. Jackson that overturned the federal right to abortion. President Biden signed an executive order directing DHHS to protect abortion access last Friday, and Tuesday the administration announced a Reproductive Rights Task Force to monitor state legislatures and abortion rights across the country.