Republicans Are Changing State Medical Board Rules So It’s Easier For Doctors To Prescribe Hydroxychloroquine And Ivermectin

Republicans in state legislatures across the country are pushing, and in some cases passing, bills that limit medical boards’ authority over COVID treatments.

Republicans in states across the country are pushing bills that would prohibit medical boards from disciplining doctors who promote, prescribe, and distribute unfounded COVID treatments that the Federal Drug Administration has said are ineffective and, in some cases, dangerous.

At least 11 state legislatures have introduced bills that limit medical licensing boards from taking action against professionals who prescribe hydroxychloroquine and ivermectin. In North Dakota and Tennessee, it’s already the law.

Abortion care aside, state legislatures have typically let the medical profession govern itself, leaving licenses to medical boards and professional organizations. But the promotion of unapproved COVID treatments and skepticism of scientific authority, fueled in part by former president Donald Trump, have created an environment where Republican-led legislatures have made an astonishing push to allow doctors to prescribe treatments that have become popular in right-wing circles.

Self-identified Republicans account for a large share of the total population of unvaccinated Americans after months of vaccine resistance and baseless skepticism amplified by right-wing politicians and media. Demand for drugs like hydroxychloroquine and ivermectin, (which are approved to treat malaria and parasites in horses, respectively) has also skyrocketed after Trump promoted hydroxychloroquine as a potential COVID cure and some Republican Congress members have continuously pushed ivermectin as a COVID treatment.

So far, Republican lawmakers in Colorado, Florida, Idaho, New Hampshire, Pennsylvania, Mississippi, Indiana, Virginia, and West Virginia have introduced bills seeking to limit medical boards’ authority as it relates to COVID treatments. It became the law in North Dakota and in Tennessee last November.

Republicans lead each of those state legislatures except for in Virginia and Colorado. Virginia is split: Democrats control the Senate, where the bill was introduced, and Republicans control the House. ​​Virginia's Senate Health Committee shot down the proposal earlier this week in what ended with rowdy protesters confronting members and threatening one.

The bills vary from state to state. Legislators in Florida and Mississippi introduced bills to limit medical boards’ authority to reprimand a doctor, dentist, or pharmacist publicly discussing COVID treatments. The remaining states go further by allowing doctors to prescribe drugs that aren’t approved by the FDA to treat COVID.

The push is the latest in a series of state and local agency power grabs by Republicans, who are looking to dominate typically quieter races from school boards to election boards ahead of the 2022 elections.

State medical boards have been around for more than a century, essentially serving as the medical profession's self-regulating arm. But they have come under fire for not disciplining doctors who overprescribe pain pills to addicted patients, for example, or doctors who commit malpractice. Critics say they are meant to stave off stricter government regulation while keeping medical scandals quiet. To have conservative lawmakers, who were once the natural allies of establishment physicians, undermine the boards illustrates the upheaval of Republican politics during the pandemic and Trump eras.

Medical boards had been slow to take action against doctors pitching bogus COVID cures — a BuzzFeed News investigation last fall found boards had been resistant to discipline. The FDA approves drugs to treat certain illnesses, and it’s standard for doctors to prescribe these drugs for other illnesses, what is called "off-label" treatment. But it is also standard for medical boards to discipline doctors who misprescribe such off-label drugs and harm patients.

Some boards have taken action against doctors during the pandemic: A medical board in Maine suspended physician Meryl Nass's medical license for spreading COVID misinformation and then ordered her to undergo a neuropsychological evaluation.

In North Dakota, where Republican legislators hold an 84% voting majority between the House and Senate, the original bill restraining medical boards received some resistance. Rep. Bill Tveit, who sponsored the bill last November, told BuzzFeed News that his original intent was to give patients who contracted COVID broad authority to experiment with alternate medications that have been FDA approved for other uses.

But pushback from the North Dakota Hospital Association, North Dakota Board of Pharmacy, doctors, and other legislators against his original bill resulted in the truncated version that ultimately passed. As of last November, doctors, nurse practitioners, and pharmacists in North Dakota cannot be penalized by state medical boards for prescribing hydroxychloroquine or ivermectin for COVID. A Buzzfeed News report showed inconsistencies in one ivermectin study supposedly conducted in Argentina, and independent experts have said the study is, at best, unreliable.

“Why not give the doctors the right to practice medicine when they know and they are convinced by other things they’ve read and studied that these drugs will cure?” Tveit told BuzzFeed News during a phone conversation. “Why are you burying? Why are you killing people and for the sake of the guidelines that are out there when there’s alternatives?"

When asked about the Centers for Disease Control and Prevention findings that vaccines protect against hospitalization and death, Tveit was dubious.

“What is the proof that I’m less likely to die?” Tveit said. He responded to data showing that unvaccinated people die at a higher rate with his own data: screenshots of a self-reported article from doctor Stella Immanuel, who in October 2021 claimed she and her team treated more than 7,000 patients, of which “only eight precious souls,” who she wrote had advanced stages of COVID, died. Immanuel, who was briefly boosted by Donald Trump when he was president, has also contended that the US government is at least partially run by reptiles.

Two days after the interview, the CDC released a report that found vaccinated people had 6 times the protection against infection as an unvaccinated person. Immanuel did not respond to a request for comment for this article.

Some medical professionals find the legislative attempts alarming and fear they could lead to future laws curtailing state boards’ authority to discipline doctors.

Lisa Robin, the chief advocacy officer of the Federation of State Medical Boards, told BuzzFeed News that the state lawmakers’ efforts were “something unheard of” in her 25-year tenure with the board.

“It’s certainly not in the interest of the patient. They would have no recourse,” Robin said. “It may be coronavirus related today, but it could be anything.”

Other state legislators are also acting to constrain medical boards on COVID. In North Carolina, Republican lawmakers introduced legislation to prohibit medical boards from basing licensing decisions on a person’s vaccination status. And in South Carolina, the Republican legislators proposed circumventing any board oversight by allowing patients to give written consent to use investigational drugs.

This month, Indiana became one of the latest state legislatures to introduce legislation that would allow doctors to prescribe ivermectin without penalty. The bill goes further to prohibit pharmacists from disseminating information that discourages the use of ivermectin, even though the FDA has urged people not to use the drug to treat COVID, which has not been approved or authorized for use against the illness.

Ivermectin is used to treat parasites in horses and other animals; it is also approved to treat infections in humans caused by some parasitic worms, head lice, and certain skin conditions. The deworming version of the drug used to treat animals is much more powerful and can cause nausea, vomiting, neurological pain, seizures, coma, and even death, according to the FDA. Last year, ivermectin poison cases increased 212% from Jan. 1 to Sept. 21, with 1,440 cases reported, according to data from the American Association of Poison Control Centers. Last August, the CDC issued an advisory on the increased distribution of veterinary formulations of ivermectin not intended for human use.

Hydroxychloroquine is approved to treat malaria and certain autoimmune diseases. While the FDA issued an emergency use authorization in 2020 for hydroxychloroquine, it was withdrawn months later after heart problems emerged in Covid patients taking the drug. The early run on the drug in 2020 caused shortages for lupus and arthritis patients, for whom the drug works for treating their conditions.

Arthur Caplan, a bioethicist and professor at New York University, called the medical board restrictions “purely ideology masquerading as medicine.”

“Doctors, not legislators, decide what is medical misconduct,” Caplan added. “Prescribing useless or dangerous drugs or promoting them is obvious misconduct. Hopefully, courts will recognize these restrictions as fueled by nothing more than pandering to anti-vax misinformation that some politicians want to promote for political reasons."

Colorado state Rep. Stephanie Luck, a Republican who sponsored similar legislation in her state, said doctors are leaving Colorado to practice in places “that are more friendly to their ability to actually treat their patients in accordance with their conscience and with in accordance with their professional judgment.” She was unable to provide any data related to physicians leaving the state, however.

“​​We’re not encouraging doctors to have access or act outside of any normal medical standards,” Luck said. “We’re just simply saying, ‘Hey, give them the right to look at every instance and treat their patients in the way that they deem as best.’ This doesn’t, to me, seem outlandish.”

The National Institutes of Health is still recruiting the 15,000 participants needed for a clinical trial to evaluate the efficacy of ivermectin and two other drugs. The trial started last June and has a primary end date of December 2022, with final results expected in March 2023. ●

Dan Vergano contributed reporting to this story.

Correction: Republicans control the Virginia State House and Democrats control the State Senate. A previous version of this story misstated party control.

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