When people go into the medical field, they often do so with the noble goal of helping people stay healthy and safe. That is certainly the case for Dr. Carmen Purl, who regularly treats patients for illnesses, injuries, and other ailments at her family medicine practice in Dumas, Texas.
But new regulations announced by the Biden administration threatened the ability of physicians such as Dr. Purl to protect and advocate for those in their care.
HIPAA and the privacy rule
In 1996, Congress passed the Health Insurance Portability and Accountability Act (HIPAA). The act’s main purpose was to make the health-care system more efficient and “simplify the administration of health insurance.”
HIPAA generally prevents health-care providers from disclosing a patient’s health information “without authorization” from the patient. But the act explicitly preserves state authority to enforce laws “providing for the reporting of disease or injury, child abuse, birth, or death, public health surveillance, or public health investigation or intervention.”
HIPAA protections also include a privacy rule enacted by HHS in 2000 and designed to protect patients’ sensitive information while allowing the flow of health information needed to provide and promote high-quality health care for the public. But the Biden administration illegally changed this rule to further its pro-abortion agenda.
The Biden administration’s illegal rule changes
In April 2024, the U.S. Department of Health and Human Services published changes to the privacy rule that would have hindered the ability of states to enforce laws relating to abortion and experimental drugs and surgeries for children.
Specifically, the rule changes prohibited doctors from reporting abuse or responding to state investigations to protect public health when the information concerns abortion or so-called gender transition procedures, which the Biden administration deceptively labeled “reproductive health care.”
HHS admitted in its explanation of the rule changes that they were a response to “[t]he Supreme Court’s decision in Dobbs [that] overturned Roe v. Wade and Planned Parenthood of Southeastern Pennsylvania v. Casey, thereby enabling states to significantly restrict access to abortion.”
In other words, because the Biden administration disagreed with the Supreme Court’s ruling in Dobbs, it illegally changed federal law to try to prevent states from enforcing laws limiting abortion.
Doctors have a responsibility to protect their patients, and that includes reporting any suspected abuse. But the Biden administration tried to prevent health-care professionals such as Dr. Purl from fulfilling this duty.
A doctor seeks to protect her patients
Dr. Purl owns and operates her own clinic, Dr. Purl’s Fast Care Walk In Clinic, in Dumas, Texas. She operates the clinic according to her ethical beliefs that elective abortion harms both the mother and the unborn child, and that life-altering gender-transition efforts for children are also harmful.
Dr. Purl regularly encounters patients who have had or are considering having abortions. For some of Dr. Purl’s patients, their reproductive health information has suggested that they may have been victims of abuse.
Texas law requires Dr. Purl to report suspected abuse or neglect of a child to state officials. It also requires her to report suspected abuse, neglect, or exploitation of a vulnerable adult. But under the HHS changes to HIPAA’s privacy rule, Dr. Purl was prohibited from reporting many of these facts.
For example, the rule changes arguably would have prevented Dr. Purl from reporting information about a patient being pressured to undergo an abortion, a patient who had received an abortion in another state, or a minor patient undergoing or being scheduled for experimental cross-sex hormones, prescriptions, or surgeries.
If Dr. Purl had violated the HHS rule changes, she would have faced federal punishment of up to 10 years in prison and $250,000 in fines. Alliance Defending Freedom filed a lawsuit on Dr. Purl’s behalf challenging the Biden administration’s unlawful rule changes.
In December 2024, a federal district court issued a temporary ruling prohibiting government officials from enforcing the rule changes against Dr. Purl while the lawsuit proceeded. And six months later, the same court issued a permanent ruling eliminating the Biden administration’s unlawful rule changes.
The government has no authority to prohibit doctors from effectively protecting and advocating for their patients by reporting abuse. Thanks to the district court’s ruling, doctors around the country are free to protect their patients by reporting suspected abuse and to safeguard the health and safety of mothers and children.
Purl v. U.S. Department of Health and Human Services
- April 2024: HHS published changes to HIPAA’s privacy rule prohibiting doctors from reporting abuse relating to abortion or experimental “gender transition” efforts for children.
- October 2024: ADF attorneys filed a lawsuit on behalf of Dr. Purl challenging the harmful rule changes.
- December 2024: A federal district court ruled that the government may not enforce the privacy rule against Dr. Purl while her lawsuit proceeds.
- June 2025: The federal district court permanently struck down the Biden administration’s unlawful rule changes.
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