After ruling, future of abortion pills depends on Biden or Trump

The Supreme Court’s decision Thursday not to impose restrictions on a key abortion drug, while being a victory for abortion rights defenders, crystallizes the stakes of the next presidential election for access to abortion nationwide.

Because a president has enormous power to influence federal agencies that oversee abortion policy, a potential Trump administration could choose unilaterally to do what the Supreme Court has not done: impose strict restrictions on mifepristone, one of two drugs used in more than 60% of abortions – or even move to remove the drug from the market completely.

“This decision means the ball is squarely in the court of the next administration,” said Roger Severino, who oversees abortion policy at the conservative Heritage Foundation and has led abortion-related initiatives within the Department of Health and Human Services under Trump. “It will be up to the next administration to restore some semblance of safety to this largely unregulated chemical abortion regime.”

While President Biden has repeatedly pledged to ensure access to abortion pills — which major medical associations agree are safe and effective — Trump has tried to distance himself from the issue. The former president, who appointed three conservative Supreme Court justices who helped lead to the overthrow Roe v. Wade, announced this spring that the issue should be left to the states — a position he reiterated Thursday morning when meeting with Republican lawmakers on Capitol Hill.

The Trump campaign sought to move quickly on Thursday’s ruling, arguing that the matter had been settled in the courts. “The Supreme Court ruled unanimously 9-0. “The matter is settled,” said Danielle Alvarez, a senior adviser to the Trump campaign. “This election is about correcting the weakness, failures and dishonesty of the Biden crime family. »

Biden administration highlighted Trump’s anti-abortion record and role in overthrow Roe deer. Biden campaign leaders quickly sounded the alarm after the Supreme Court’s ruling, emphasizing that Trump would have significant power to crack down on abortion pills if he won.

“This case, initiated by Donald Trump’s allies, was just one tactic in a larger, relentless strategy to explicitly strip away the freedom that protects people everywhere in this country,” said Julie Chavez Rodriguez, campaign manager for Biden. “If Trump returns to power in November, his allies will be ready to roll out their plans to ban abortion access across the country, without help from Congress or the courts. »

Abortion advocates said Thursday that they remained hopeful that Trump would crack down on abortion pills if he returned to office, although there was no public evidence that such a promise had been made explicitly.

“What I have heard, and what seems likely to me, is that the Trump administration would repeal the Biden regulations and revert to the Trump policies,” said James Bopp Jr., general counsel for the National Right to Life Committee .

Under the Trump administration, the Food and Drug Administration required medical abortion patients to have an in-person medical consultation before taking the pills — a policy that changed temporarily during the coronavirus pandemic and permanently in late 2021.

Abortion advocates growing frustrated with landmark 2022 ruling Dobbs v. Jackson Women’s Health Organization Abolition of abortion rights has done little to reduce the number of abortions nationwide – with more abortions than ever before in 2023. Experts say the rise of abortion pills has contributed significantly to this trend, with many women now able to access abortion by mail, including in states where the procedure is illegal.

In the case decided Thursday, the Supreme Court could have asked the FDA to reimpose old restrictions on the drugs, including the requirement for an in-person doctor’s visit. But the justices chose not to consider the merits of the case, instead issuing a unanimous ruling on procedural grounds that the plaintiffs lacked standing to challenge the case.

Abortion advocates have targeted abortion pills since Roe deer was overturned, quickly recognizing that the drugs made abortion much easier to access. Many view a Republican president as the surest way to limit the number of people who can take the pill.

A policy document released by the conservative Heritage Foundation in April 2023 calls on the next Republican administration to significantly crack down on abortion pills – urging the FDA to revise its drug policies, including the agency’s approval of mifepristone in 2000.

“The FDA should review chemical abortion — and rely on science and the law, and not take anything off the table,” said Severino, who wrote the Heritage paper’s chapter, titled “Project 2025,” which deals with abortion pills. .

Serious drug-related complications occur in less than 0.5 percent of cases, according to leading studies.

Many leaders of the anti-abortion movement ensured that Trump selected strong abortion advocates to lead several key agencies, including the FDA, the Department of Health and Human Services and the Justice Department.

“It’s the top of our agenda, the top of every letter we’ve sent to the president’s campaign: what his nominations will be at FDA, HHS and DOJ,” said Kristan Hawkins, president of Students for Life , one of the largest anti-abortion groups. groups.

Minutes before House Speaker Mike Johnson (R-La.) — a longtime anti-abortion advocate — met with Trump Thursday morning, Hawkins said she texted to the speaker to remind him to emphasize the importance of these appointments in advancing the anti-abortion agenda.

“Ask him to strike armed agencies that support abortion,” she wrote.

The leaders of these agencies may not be the only ones a potential Trump administration would choose to change.

As part of his crusade against the federal bureaucracy, Trump derides the ‘deep state’ and campaigned on plans to strip civil service protections from tens of thousands of government workers, which could include the FDA. This “Schedule F” order – which he issued at the end of his first term but never got around to fully implementing it – would mean that government employees involved in policymaking would be reclassified as political appointees who could be arbitrarily fired and replaced by loyalists.

Trump and many in the Republican Party have struggled to talk about abortion since Roe deer was canceled because abortion continues to be a mobilizing issue for Democrats.

On Capitol Hill on Thursday, Trump said Republicans need to do a better job communicating about abortion than they did ahead of the 2022 midterm elections, according to several people who met with him.

Rep. Marcus J. Molinaro (R-N.Y.) said Trump specifically mentioned that Republicans need to “be very careful” in showing “respect for women and the choices they have to make.”

Representative Matt Gaetz (R-Florida) told reporters that the former president had “a very serious discussion about how Republicans were going to talk about abortion in the next election.”

“President Trump has reiterated his view that this is a matter of state. He thought it gave members who have different views on this issue within our conference the opportunity to really localize it rather than having to talk about it in broader national terms,” he said. declared.

Greer Donley, a law professor at the University of Pittsburgh, said the mifepristone case before the Supreme Court is likely just the beginning of the anti-abortion fight against abortion pills.

If Trump wins and appoints an anti-abortion commissioner to the FDA, she said, “they can work from the inside to do what they want.” »

Beth Reinhard and Marianna Sotomayor contributed to this report.

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