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Lawmakers Ask RFK Jr.'s Health Department to Start Watching Something New in the Assisted-Suicide Debate

Four lawmakers from both parties want federal health regulators to start monitoring hospices and insurers, in a request that lands alongside — not inside — the court fights disability advocates have waged over assisted-suicide laws in multiple lawsuits across several states.

Sen. James Lankford, R-Okla.; Rep. Greg Murphy, R-N.C.; Sen. Tim Kaine, D-Va.; and Rep. Luis Correa, D-Calif., sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. asking HHS and the Centers for Medicare & Medicaid Services to impose new monitoring requirements on hospices. The letter raises concerns about disabled and elderly patients being coerced into medically assisted suicide by healthcare professionals. Three specific asks stand out: monitoring for discrimination against people with disabilities and other vulnerable populations, tracking insurance companies that deny life-saving treatment while offering to cover physician-assisted suicide drugs instead, and ensuring hospices comply with existing federal restrictions on using government funds, directly or indirectly, for medically assisted suicide.

Medically assisted suicide is currently legal in 13 states and Washington, D.C., with eight more states considering legislation to allow it. The second target — insurers accused of steering patients toward assisted-suicide drug coverage instead of other treatment — is a different kind of scrutiny than what's been playing out in court. Disability advocates have filed multiple lawsuits in several states seeking to overturn assisted-suicide laws without exception, arguing under existing statutes that people with life-threatening disabilities who say they want to die are aided through physician-assisted suicide while non-disabled people in similar circumstances are more often directed toward alternative treatment or suicide prevention. Those cases target the laws themselves in court. The new letter, by contrast, asks a federal agency to start tracking hospice and insurer conduct under the laws as they already stand — one likely read is that this represents a second front in the same fight, opened through regulatory oversight rather than litigation, though the letter doesn't say that itself.

The organization Death With Dignity rejected the letter outright, telling Spectrum News the proposed hospice reporting rules are "cynical efforts to use the power for the federal government to pass rules imposing a specific set of religious beliefs on dying patients who seek only to control the timing and manner of their inevitable death." The group points to safeguards already written into state laws, citing Oregon's statute, which states "no person shall qualify... solely because of age or disability," and notes every state with a codified assisted-suicide law specifies that medical aid in dying is not suicide, nor a means of assisting suicide. Advocates who favor the option argue that adults with a terminal diagnosis of less than six months to live should have the autonomy to end their lives with dignity rather than endure prolonged suffering, and describe the choice as a form of empowerment for people who aren't suicidal but see their disease as leaving them with limited options.

Not Dead Yet, a group founded by Diane Coleman to oppose legalized assisted suicide, sees the pressure point differently. Ian McIntosh, the group's executive director and a plaintiff in one of the pending lawsuits, argues many disabled people would not choose medically assisted suicide if they had better support systems, and worries that Medicaid cuts in the Republicans' tax and spending bill last year could threaten funding for home and community services — pushing more disabled people toward assisted suicide instead. "Proponents will say ... this is about choice," McIntosh said. "It's not about choice when the choices available are all lesser evils. We would choose rather equity and equal access to the gold standard of healthcare." His concern about underfunded alternatives narrowing the "choice" gives some added context to the National Council on Disability's own findings: the independent federal agency reported instances of "doctor shopping," in which a patient meets with multiple doctors until finding one who believes they meet the legal criteria of a terminal illness and is willing to prescribe a lethal dose.

The court cases the new letter runs alongside are still unresolved. In California and Delaware, plaintiffs are appealing dismissals after courts suggested they couldn't prove anyone is being forced to use the law; in Illinois and New York, recently filed suits aim to block those states' laws before they take effect later this year. Neil Romano, acting chairman of the National Council on Disability, argues the conversation about dignity shouldn't only apply to the choice to die. "I think that we should be looking at issues like this more from the point of view of how we help these people want to live," Romano said. "Then, how do we make it medically effective for them to die?" With the litigation still working through appeals and new state laws not yet in force, the bipartisan letter adds a federal regulatory question to a fight that's mostly played out in statehouses and courtrooms so far: not whether assisted-suicide laws should exist, but whether hospices and insurers are steering vulnerable patients under the laws already on the books.