By Sami Gottsegen PZ ’25
The Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, which overturned the federal right to abortion, inspired an influx of anti-abortion legislation in states across the country. Since June, twenty-four states have banned or placed heavy restrictions on abortion, representing the broader political attack on reproductive freedom. Now, a case being heard in Northern Texas has the potential to further bar access to reproductive health care at a federal level.
The case is Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration. Filed in November 2022 by a group of anti-choice individuals and organizations represented by the Alliance for Hippocratic Medicine, it targets access to mifepristone. Mifepristone is one of two pills in a medication abortion schedule that accounts for more than half of all self-managed abortions in the country. The FDA approved mifepristone more than twenty years ago and it has been widely used and proven safe since then. The Plaintiffs suing the FDA argue that its “approval and subsequent regulation of medication abortion was in excess of the agency’s jurisdiction as well as arbitrary and capricious.” If the Judge rules in favor, mifepristone could be banned or heavily restricted across the nation. If the case does not result in the full repeal of FDA approval, the Judge could rule to undo recent court decisions that have made mifepristone more widely available in states where abortion is protected. This includes the ability for doctors to prescribe the medicine without in-person consultation and patients to receive the pill through pharmacy pick-up and mail.
The case targets FDA approval, so its results would be felt beyond states with heavy restrictions on abortion access. In California, where the right to an abortion is enshrined in the State Constitution, mifepristone would be taken off the market. This does not mean chemical abortions would be banned altogether as there are other, less common pill regimens. However, access would be impaired as demand for other abortion pills would increase. Demand for surgical abortions, which are performed at lower rates than chemical abortions, would also increase, likely flooding the capacity of reproductive clinics and medical centers. This case targets states’ ability to legislate reproductive healthcare. Conservative activists fought to overturn Roe v. Wade under the guise that abortion should be regulated at the state level without federal intervention. However, if the Judge rules in favor, states like California, New York, and other abortion safe havens will be forced to abide by a Texas ruling.
Given the efficacy, widespread usage, and safety of mifepristone, the plaintiff’s claims hold little legal ground. However, the politicization of the case is cause for concern.
U.S. District Judge Matthew Kacsmaryk was hand-selected by the Alliance for Hippocratic Medicine to rule on the case. He was appointed to his judicial position by Trump and is a political ally of the plaintiff organization. He holds strongly anti-abortion beliefs and has informally discussed his support of extreme legislation that would criminalize contraception altogether. The bias in this case is representative of the larger phenomenon of politicization in the judicial system. During his presidency, Trump essentially reshaped the federal judicial system, appointing almost as many federal appeals court judges in four years as Obama did in two presidential terms. Cases should be decided on the basis of a strong legal argument, but it is impossible to ignore the political factors that could influence Judge Kacsmaryk’s ruling.
The case is currently in review and a ruling could be announced any day. The results will likely be appealed, though, leading the case to continue beyond this upcoming ruling. If the Judge rules in favor of the Alliance for Hippocratic medicine, the question remains: will Biden take federal action to appeal the ruling? While if the Judge rules against the plaintiff, the suing organization will likely take an appeal to the U.S. Court of Appeals for the Fifth Circuit, which usually rules against abortion access. Either way, the case will have serious implications. This is a critical moment in the fight to protect reproductive healthcare and another example of the politicization of human rights.
