From statute to courtroom

Since the 2022 Dobbs decision, roughly two dozen states have enacted “shield laws” intended to protect clinicians who provide reproductive care that is legal where they practice — including telehealth prescription of abortion medication to patients in states where abortion is banned. For three years those laws were largely untested. They were a legal premise, not yet a legal holding.

That has changed. The shield-law framework is now being litigated, and the first rulings are in. This brief covers the live cases. It is distinct from our earlier brief on cross-state travel and the shield-law architecture in general; here the subject is the specific litigation and where it is likely to lead.

How shield laws work

A telehealth shield law typically combines several protections:

• Non-cooperation. State courts, license boards, and law enforcement are barred from assisting out-of-state investigations, prosecutions, or civil actions against a provider for care that was lawful under the shield state’s law.
• Extradition refusal. The governor will not honor extradition requests for shield-protected conduct. New York’s governor invoked exactly this in February 2025, when Governor Hochul declined Louisiana’s extradition request for Dr. Margaret Carpenter, a New York physician indicted in West Baton Rouge Parish over abortion pills mailed to a Louisiana minor (NBC News).
• Records protection. Patient and provider information is shielded from out-of-state subpoenas and legal process.
• Counter-suit provisions. Some laws let a shielded provider sue an out-of-state actor who tries to enforce a restrictive-state law against them.

The crucial design choice is where the law treats the care as occurring. New York’s shield law protects a provider regardless of where the patient is located. Delaware’s law, strengthened in 2025 by House Bill 205, protects care delivered within Delaware — a narrower formulation that may matter when the care reaches a patient in another state.

The two cases

Texas v. Carpenter / Texas v. Bruck (New York). In December 2024, Texas Attorney General Ken Paxton sued Dr. Carpenter for prescribing mifepristone via telehealth to a patient near Dallas. Carpenter did not appear, and a Texas court entered a default judgment in February 2025 ordering her to pay roughly $113,000. Paxton then tried to collect that judgment in New York, asking an Ulster County court to compel the county clerk to file it.

On October 31, 2025, Ulster County Supreme Court Justice David Gandin dismissed the effort (JURIST). He held that the county clerk had acted lawfully in refusing the filing, because Carpenter’s conduct was legal in New York and fell “squarely within the definition of ‘legally protected health activity’” under the state’s shield law (Texas Tribune). Notably, the judge did not reach the federal constitutional question — he found Texas had not properly raised a Full Faith and Credit challenge in its petition, so that issue was, in his words, not before the court (State Court Report). The shield law survived its first test, but on narrow procedural ground. New York Attorney General Letitia James has separately defended the shield law against the Texas action (NY Attorney General).

Texas v. Lynch (Delaware). In January 2026, Paxton filed a second suit — this time against Debra Lynch, a Delaware nurse practitioner who operates an online clinic, Her Safe Harbor, serving patients in all 50 states (Texas Tribune). The complaint alleges two violations of Texas law: providing abortion-inducing medication in violation of the state’s Human Life Protection Act, and practicing medicine without a Texas license. The case was filed in Jefferson County, Texas (Bloomberg Government). As in the Carpenter matter, the likely path is a default judgment in Texas followed by an attempt to enforce it in Delaware — where the narrower 2025 shield law will face its own first test.

The Full Faith and Credit question

The U.S. Constitution’s Full Faith and Credit Clause (Article IV, Section 1) directs that each state give “Full Faith and Credit” to the “public Acts, Records, and judicial Proceedings” of every other state. In ordinary practice, this means a money judgment validly entered in one state is enforceable in the others.

Restrictive states are building their strategy around that clause. The argument runs: once Texas has a final judgment against a provider, a New York or Delaware court must honor it, and a shield law that blocks enforcement is unconstitutional. Shield-state defenders point to long-recognized limits on the clause:

• The penal-judgment exception. Courts have historically declined to enforce another state’s penal judgments — those that punish conduct to protect public order rather than compensate a private injury. Whether a civil penalty under an abortion ban counts as “penal” is contested and unsettled.
• Jurisdiction and choice of law. Whether Texas even had personal jurisdiction, and whose law governs care delivered by telehealth, both turn on the location-of-care question that the two states answer differently.

Legal scholars describe the doctrine here as genuinely uncertain — there are few modern precedents on one state punishing conduct that is lawful where it occurred (Stanford Law Review).

Why this could reach the Supreme Court

Two features make this an unusually strong candidate for eventual Supreme Court review.

1. It is a direct conflict between sovereign states. Texas asks New York and Delaware courts to enforce Texas law; those states’ legislatures have enacted statutes designed to refuse. As one Harvard Law analysis put it, this is “exactly the kind of case” that is likely to reach the Court because it pits states against each other (Harvard Law School).
2. The federal question has not yet been decided. The New York ruling sidestepped Full Faith and Credit on procedural grounds. That issue remains live and, once a restrictive state frames it cleanly — most plausibly at the enforcement stage in the Delaware case or a successor suit — it presents a clean federal question.

A ruling either way would be consequential. If the Court held that shield laws cannot block enforcement of out-of-state judgments, the telehealth model that now accounts for a large and growing share of US abortions would be exposed to restrictive-state collection actions nationwide. If it upheld the shield framework, it would entrench a durable structural divide between abortion-access and abortion-ban states.

What to watch

• The Delaware enforcement stage. Whether Texas obtains a default judgment against Lynch and how Delaware courts treat an attempt to enforce it under the narrower 2025 shield law.
• A cleanly framed Full Faith and Credit challenge. The first case in which a restrictive state properly raises and litigates the constitutional question.
• Criminal escalation. Louisiana’s criminal indictment of Dr. Carpenter, and New York’s extradition refusal, run on a separate track from the civil suits; sustained criminal cases would raise their own interstate questions.
• Copycat suits. Whether other restrictive states file parallel actions, multiplying the litigation and increasing the odds of a circuit split or a state-court conflict that draws Supreme Court review.

What to ask your representatives

• Will they support their state’s shield law, and strengthen it where the location-of-care language is narrow?
• Will they support federal codification of telehealth and medication-abortion access — for example, through the Women’s Health Protection Act — so that protection does not rest solely on state-by-state shield statutes?
• How will the state respond if a court orders enforcement of an out-of-state abortion judgment against one of its licensed providers?