Democratic AGs Fight Back Against GOP Attacks on Abortion Pill Access

Warning that Republican-led states have launched an effort to keep millions of people from accessing lifesaving medications, 23 Democratic state attorneys general on Thursday sent a letter to officials at CVS and Walgreens to assure the pharmacies that they can legally dispense and mail mifepristone and misoprostol, the pills used in medication abortions.

The attorneys general of Oregon, California, and Washington spearheaded the letter two weeks after their Republican counterparts in 20 states told the pharmacies that they could be in violation of the Comstock Act, dating back to the 1870s, if they deliver the pills to patients by mail.

"This claim is misguided and disregards over a century's worth of legal precedent," wrote the Democratic attorneys general. "As extensively detailed in the [Food and Drug Administration] Office of Legal Counsel's recent memorandum opinion, since the early 20th century, federal courts have repeatedly and consistently held that the Comstock Act does not categorically prohibit mailing items that can be used to terminate a pregnancy, and does not apply unless the sender intends the recipient to use them unlawfully."

The Republican attorneys general, led by Andrew Bailey of Missouri, issued their warning to the two largest pharmacy chains in the U.S. a month after the FDA announced that certified retail drugstores can dispense misoprostol and mifepristone, reversing longtime regulations that required patients to obtain the latter pill only at health clinics. Health professionals had long advocated for the change, saying the restrictions unnecessarily reduced access to the medications.

Both CVS and Walgreens announced shortly after the rule was changed that they intended to apply for certification to dispense the pills.

Oregon Attorney General Ellen Rosenblum denounced Republican states for attempting "to scare retail pharmacy chains away from offering these critical medications," which are used to treat miscarriages, ectopic pregnancies, and gastric ulcers as well as inducing abortions.

"Mifepristone and misoprostol are safe, effective medications that are prescribed by doctors for many purposes, including abortion," said Rosenblum. "In a time when reproductive healthcare is under attack, our group of 23 attorneys general strongly believe we should be encouraging companies and providers to offer easily accessible, safe, and confidential healthcare as broadly as possible."

In addition to highlighting the safety and effectiveness of the pills, the attorneys general emphasized that:

• Restricting access to medication abortion jeopardizes patients' health, safety, and well-being, often forcing them to delay their care or seek abortions through unsafe means;
• Having the option to use medication abortion empowers people to make the personal and confidential choice of which method of abortion is better for them based on factors including cost, accessibility, medical history, age, and a desire to avoid surgery; and
• Increased access to reproductive care is especially important for communities underserved by the healthcare system, including people of color, low-income people, people with disabilities, LGBTQ+ individuals, and people living in rural areas, who face the greatest barriers to getting the care they need in a timely and safe manner.

Medication abortions accounted for 51% of all abortions in the U.S. in 2020, according to the Centers for Disease Control and Prevention. Misoprostol and mifepristone have been approved for use in abortion care through 10 weeks of gestation since 2000.

"Increasing access to safe and affordable reproductive healthcare is critically important to the health and well-being of millions of people across the country," said New York Attorney General Letitia James. "The evidence is clear: Medication abortion is safe and effective, and decades of clinical research back that up. Pharmacies that offer this lifesaving medication have the full support of my office."

The attorneys general sent the letter as reproductive rights advocates brace for a ruling on abortion pills by U.S. District Judge Matthew Kacsmaryk in Texas. The judge, who was appointed by former Republican President Donald Trump, has given attorneys arguing a case brought by an anti-abortion group until February 24 to finish filing legal briefs, indicating that a ruling could come soon.

The plaintiffs have asked Kacsmaryk to reverse the FDA's approval of mifepristone, which would cut off access to the drug across the nation.