The Biden administration on Wednesday said retail pharmacies and pharmacists must provide patients with the medication they were legally prescribed even if it could be used in an abortion.

The guidance to about 60,000 retail pharmacies from the Department of Health and Human Services (HHS) comes amid reports of pharmacists turning away women seeking abortion medication, or even medication used primarily to treat other ailments but that can cause abortions.

“The Department is committed to improving maternal health—including for individuals who experience miscarriages—and vigorous enforcement of our civil rights laws is one way in which we plan to do so,” the guidance stated.

Senior HHS officials said civil rights laws, including provisions of the Affordable Care Act, require pharmacists and pharmacies that receive federal funding to supply prescribed medication.

This can include mifepristone, used in combination with misoprostol, to assist with a first-trimester miscarriage. Those drugs are also used in medication abortion, which is now illegal in some states in the aftermath of the Supreme Court overturning Roe v. Wade.

In another example, the agency said pharmacists must dispense methotrexate, a common drug used to treat rheumatoid arthritis or other autoimmune conditions. The drug is also used off-label to end ectopic pregnancies. 

If the pharmacy refuses to fill the individual’s prescription or does not stock methotrexate because of its alternate uses, it could be violating the patient’s civil rights, officials said. 

“HHS is making a very bright line here on federal law,” a senior agency official told reporters. “This is meant to remind folks of their obligation when they take federal funding and to remind folks of obligations under federal civil rights laws.” 

“HHS is committed to ensuring that people are able to access reproductive health care, free from discrimination,” HHS Secretary Xavier Becerra said in a statement.

A senior official told reporters the guidance “helps take a step in this direction in help providing patients, providers and pharmacists and pharmacies reassurances that federal law can help protect that access to care.”

The guidance follows President Biden’s executive order on reproductive health issued Friday and comes as the White House fends off criticism for its seemingly sluggish response to the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization, which overturned the constitutional right to an abortion established by Roe.

The White House earlier this week reminded doctors and hospitals that they need to follow federal law and provide abortions if there is a medical emergency and the health or life of the patient is at risk, regardless of state law.