Abortion opponents are increasingly concentrating their efforts on limiting access to abortion pills, the most common method of ending pregnancies in the United States. With lawsuits, legislative proposals, and the possibility of federal intervention under the incoming administration of President-elect Donald Trump, the debate over abortion pills is intensifying.
Pills: The Primary Method for Abortions in the U.S.
By the time the U.S. Supreme Court overturned Roe v. Wade in 2022, more than half of abortions in the U.S. were performed using medication, typically a combination of mifepristone and misoprostol. These drugs, distinct from emergency contraceptives like Plan B, are highly effective, with a success rate of over 97%.
The use of abortion pills has grown, particularly through telehealth services that mail the medications to patients. By mid-2024, prescriptions via telehealth accounted for approximately 10% of all U.S. abortions, according to the Society of Family Planning.
Texas Targets Out-of-State Telehealth Prescriptions
A groundbreaking lawsuit filed this month by Texas Attorney General Ken Paxton against New York physician Dr. Maggie Carpenter underscores the evolving legal battle over abortion pills. Texas alleges that Carpenter violated its laws by prescribing abortion pills to a Texas patient via telemedicine.
New York, where Carpenter is based, has a “shield law” designed to protect medical providers who prescribe abortion pills to patients in states where abortion is banned. However, the outcome of the Texas lawsuit could test the limits of such protections.
Legal experts suggest that even if Texas prevails, it may not deter other providers from prescribing pills across state lines. “There’s no way he plugs them all,” said Drexel University law professor David Cohen, referring to Paxton’s efforts to restrict pill access.
State Attorneys General Challenge FDA Approvals
In a separate legal effort, the attorneys general of Idaho, Kansas, and Missouri filed a lawsuit challenging the U.S. Food and Drug Administration’s (FDA) decisions that expanded the use of mifepristone. These changes, made over two decades, allowed the drug’s use up to 10 weeks of pregnancy and enabled telemedicine prescriptions.
The lawsuit, which aims to reverse these FDA approvals, could have significant implications for abortion pill access nationwide.
Federal Action Remains a Possibility
The incoming Trump administration could play a pivotal role in shaping federal policy on abortion pills. Advocates worry that the administration might enforce a long-dormant 1873 law that bans mailing abortion-related medications. Additionally, the FDA could revisit its approvals for mifepristone and misoprostol.
During his campaign, Trump delivered mixed messages on abortion policy, at times distancing himself from hardline opponents. However, since winning the election, his appointments to key administration positions have raised concerns among abortion rights advocates.
