Texas abortion pill ruling may impact reproductive rights nationwide

A debate over the drug mifepristone is happening in federal court in a case known as Alliance for Hippocratic Medicine vs. FDA.
Posted at 1:08 PM, Feb 16, 2023

The legal battle over abortion rights did not end with the Supreme Court's ruling last year that overturned Roe v. Wade.

All eyes are now on the state of Texas, where a federal district judge's opinion is expected soon in another case that could impact reproductive rights.

The case is known as Alliance for Hippocratic Medicine vs. FDA. A ruling could come as early as Feb. 24.

The case centers around the drug mifepristone, which was approved by the FDA in 2000.

Mifepristone and the drug misoprostol are used by many physicians to terminate pregnancies before 10 weeks in the U.S.

The lawsuit is alleging mifepristone, which often goes by the name Mifeprex, is unsafe and that the FDA didn't properly study the pill before approving it.

Judge Matthew Kacsmaryk is presiding over the case. He was nominated by former President Donald Trump.

Even though this case is taking place in Amarillo, Texas, a ruling could ban the drug everywhere since Kacsmaryk has the authority to if he believes the pill is unsafe.

Post-Roe's impact on abortion medicine via telehealth

Post-Roe's impact on abortion medicine via telehealth

Roe's reversal could mean patients have to go to another state for a virtual appointment or have the pills mailed to a P.O. box.


Response expected

Right now, the question is how Washington will respond to this ruling and how President Joe Biden will respond.

Many reproductive rights organizations are vowing to keep mailing the drug to potential users even if physicians and facilities can no longer prescribe it.

One thing is clear: Pressure will be on the White House to act — even though, publicly, officials say they believe the U.S. Food and Drug Administration (FDA) will win the case.

According to the Guttmacher Institute — which advocates for abortion rights — in 2017, 39% of all abortions were performed using pills.

In 2020, more than 50% are believed to have been conducted that way.

Ninety-eight percent of medication abortions in the United States in 2020 used a regimen that included mifepristone.

The Guttmacher Institute points out, though, that other drugs do exist that can end a pregnancy.

Unlike the abortion ruling by the Supreme Court last year — which impacted conservative states and liberal-leaning states differently — this pending court ruling has the potential to impact every state in the same way.

Supreme Court overturns Roe V. Wade; States can ban abortion

Supreme Court overturns Roe V. Wade; States can ban abortion

The ruling puts the court at odds with a majority of Americans who favored preserving Roe, according to opinion polls.


Following the Dobbs decision at the Supreme Court, some conservative states swiftly passed new restrictions, while many liberal-leaning states kept the status quo.

This Texas case could block the drug everywhere.

As for what happens after the ruling, the White House is expected to appeal to the 5th Circuit of Appeals — and then, eventually, to the Supreme Court: a process that will take time.

If you are wondering if this drug is safe, which is the heart of the case, a Scripps News investigation last year found that for every 1 million patients who used the drug, 6.5 patients died.

The investigation pointed out that the number is lower than the death rate for penicillin, according to some studies.