Good morning, rulers! Happy Yo La Tengo album release day to all who celebrate. Also: It’s Girl Scout cookie season again. If you haven’t yet been connected with a Girl Scout troop yet, consider buying some cookies from Troop 6000, made up of girls in New York City’s shelter system. Thanks to Sophie Gardner for putting together this newsletter, producing it and sometimes writing it! Any day now, a judge will issue a ruling that could ban access nationwide to abortion medication — the most common way the procedure is performed in the United States. If that happens, abortion access, in both red and blue states, will dramatically change. The backstory: In November, a group of anti-abortion organizations sued the Department of Health and Human Services and the Food and Drug Administration in a bid to reverse the FDA’s approval of mifepristone, the first of two medications which together are known as the abortion pill. Use of the abortion pill had been increasing during the pandemic, and in 2021, the FDA permitted prescribing the medication via telemedicine and sending the pills by mail. The lawsuit: In the lawsuit, the lawyers for anti-abortion groups argue that the FDA did not adequately study the effects of the drug, which was approved by the agency two decades ago. If the judge in this case, Judge Matthew Kacsmarky, rules in favor of the plaintiffs, he could block access to mifepristone in the states where abortion is legal or rescind the rule allowing doctors to prescribe it via telemedicine. POLITICO reporters Alice Miranda Ollstein and Adam Cancryn reported on the lawsuit this week. I called Ollstein to ask some of the questions this lawsuit has raised for me about possible outcomes and how this ruling could upend abortion access in the United States — again. This interview has been edited. Katie Fossett: There have been some people saying for a while, before and after Roe v. Wade was overturned, that the decision would mostly just make abortion access a red-state-blue-state issue — that the ruling mattered a lot for red states, but not Democratic-led states where abortion would still be legal. But a ruling in this abortion pill case seems like it will be huge for states even where the legislatures have decided they want to keep the procedure mostly legal. Alice Miranda Ollstein: Oh, absolutely. And I think that was never the case [that only red states would be affected by the Roe decision].I was writing before the ruling about how blue states would absolutely be affected. They’re being affected by the huge influx of patients from red states seeking abortions. And that has led to wait times going up. Fossett: And a lot of abortions are done via medication now, right? Ollstein: Yes, the majority. That was a growing trend, but it definitely accelerated due to the pandemic. People were not wanting to go into a clinic out of fear of Covid, and around the same time, the government loosened some of the restrictions on abortion pills to allow them to be sent by mail and prescribed with a telemedicine appointment with a doctor instead of an in-person appointment. Fossett: So would a ruling against the pill go into effect immediately? Would it be appealed? Ollstein: If a ruling comes out against the pill, the administration would appeal it. But, you know, in the meantime, we’re waiting for that appeal to be heard, the judge could issue a temporary ban [that would stay in place until a higher ruling] that could really cause a lot of chaos. Fossett: You note in your story that HHS Secretary Xavier Becerra has been saying that he expects the judge to rule in favor of the FDA. But why are abortion rights advocates more concerned? Ollstein: Judge Kacsmaryk is a good example of what is called “judge shopping.” You might ask: Why is the case that’s challenging the FDA’s decades-old approval of these pills happening in a random courthouse in Amarillo, Texas? And the answer is because a lot of anti-abortion advocacy groups are intentionally filing cases before judges that they think will be more sympathetic to their cause. This judge was appointed by President Donald Trump and used to work for an advocacy group that brought anti-abortion lawsuits of their own. And those anti-abortion advocates see him as more likely to rule in their favor and thus planned the case to specifically go before him. And what we explored in our piece is how the Biden administration is publicly saying they are confident about winning this case. But behind the scenes, they’re definitely worried and they’re definitely looking into what, if anything, they can do. Fossett: Is this lawsuit part of a trend? Ollstein: There has been a lot of focus from the anti-abortion side on the abortion pill specifically. Not only are they the most common method of abortion in the U.S., but they’re a lot harder to ban and crack down on. Red states have been very successful at forcing clinics to close or shut down operations, but it’s a lot harder to track when people are receiving the pill by mail to their private home, taking them in private and terminating pregnancies that way, which is what’s going on. So this is one of many different attempts that they’re putting forward to try to stop that from happening. Also, the point could be to increase the chilling effect. Short of opening everyone’s mail, banning abortion medication is a very hard thing to enforce. But if they are aiming to make people scared to use the pills, this would increase that.
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