The confusing fate of the abortion pill

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Julie Rovner KFF Health News @jrovner

Julie Rovner is chief Washington correspondent and host of KFF Health News' weekly health policy news podcast, "What the Health?" A noted expert on health policy issues, Julie is the author of the critically praised reference book "Health Care Politics and Policy A to Z," now in its third edition.

The abortion pill mifepristone is now ground zero in the abortion debate. Late Wednesday night, the 5th Circuit Court of Appeals said the drug should remain on the market but under restrictions on distribution that were in effect before 2016, which ban prescribing by mail or by telemedicine. The restrictions would make it even more difficult for patients in states where abortion is illegal or widely unavailable.

The decision comes in response to a ruling last week out of Texas, where a federal judge, as was widely expected, found that the FDA should not have approved the drug more than 22 years ago and ordered it, effectively, unapproved.

Complicating matters further still, in a separate case filed by 18 attorneys general in states where abortion is largely legal, last week a federal district judge in Washington state ordered the FDA not to reinstate any of the old restrictions.

This week's panelists are Julie Rovner of KFF Health News, Victoria Knight of Axios, Shefali Luthra of The 19th, and Sarah Karlin-Smith of the Pink Sheet.


Among the takeaways from this week's episode:

  • A late-night decision by the appeals court preserves access to mifepristone while the legal battle continues. But it also resurrects outdated limitations on the drug, meaning mifepristone can be used only up to seven weeks into a pregnancy, among other restrictions.
  • While it is expected that the U.S. Supreme Court will ultimately decide the drug's fate, some providers and state officials are rushing to stockpile it. Cutting off access to the abortion pill puts extra pressure on clinics in states where abortion remains legal, which are also serving women from so-called prohibition states and could see an influx of patients as mifepristone becomes difficult — or impossible — to get.
  • Republicans largely have remained quiet about the ruling overturning mifepristone's FDA approval. While many in the party support banning the drug, they likely recognize the political risks of broadcasting that stance. Meanwhile, the Biden administration moved to strengthen privacy protections for patients and providers related to abortion, offering some reassurance to those who fear they could be prosecuted under their home state laws for seeking abortions elsewhere.
  • As Southern states have whittled away at abortion access, Florida, with its 15-week abortion ban, had emerged as a hub for patients across the region. This week the state moved to restrict the procedure to six weeks, a change that could send many patients scrambling north to states like Virginia and New York for care. And in Idaho, a new law makes "abortion trafficking" — or transporting a minor to have an abortion without parental consent — a crime.
  • Congress is exploring new drug pricing measures, particularly aimed at increasing transparency around pharmacy benefit managers and capping insulin costs. Lawmakers are also watching the approach of the debt ceiling threshold; in the mix of budgetary pressure valves are Medicaid and, potentially, work requirements to receive Supplemental Nutrition Assistance Program benefits.
  • Congress continues to show little appetite for addressing a different, intensifying public health crisis: gun violence. A new poll from KFF shows startlingly high numbers of Americans — especially people of color — have directly experienced gun violence and live with that threat every day.

Plus, for "extra credit," the panelists suggest health policy stories they read this week they think you should read, too:

Julie Rovner: The Washington Post's "To Comply With a New Sesame Allergy Law, Some Businesses Add — Sesame," by Karen Weese.

Shefali Luthra: KFF Health News' "For Uninsured People With Cancer, Securing Care Can Be Like Spinning a Roulette Wheel," by Charlotte Huff.

Victoria Knight: The Washington Post's "Research With Exotic Viruses Risks a Deadly Outbreak, Scientists Warn," by David Willman and Joby Warrick.

Sarah Karlin-Smith: NBC News' "Conspiracy Theorists Made Tiffany Dover Into an Anti-Vaccine Icon. She's Finally Ready to Talk About It," by Brandy Zadrozny.


Francis Ying Audio producer Emmarie Huetteman Editor

Kaiser Health NewsThis article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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