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Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
Despite RFK Jr.’s review of mifepristone, two things will remain true: Abortions pills will still be extremely safe, and abortion pills will still be available—everywhere.
In a disturbing advancement of the Project 2025 playbook for eradicating abortion, Health and Human Services Secretary Robert F. Kennedy Jr. is using the release of a new pseudo-study as a pretense for the Food and Drug Administration to review mifepristone’s safety and efficacy. The use of this widely discredited self-published report is a clear political maneuver by the Trump administration and anti-abortion extremists to curb access to telehealth abortion and end access to mifepristone more widely, against the scientific evidence and the will of the American public.
I am a public health researcher and abortion access advocate and have been tracking access to the abortion pill since it was first approved in France in 1988. I feel confident that, regardless of the outcome of this illegitimate review, two things will remain true: Abortions pills will still be extremely safe, and abortion pills will still be available—everywhere.
Abortion pills are safe. Period. The fact that Secretary Kennedy has asked the FDA to reevaluate the medications based on a single, unpublished junk science report is absurd. We have mountains of data and decades of clinical experience documenting their safety, whether provided through an in-person visit at a clinic or, since 2020, via telehealth. The World Health Organization has also said that abortion pills are safe even when taken without medical supervision, also known as self-managed abortion. Data support the safety of all of these forms of access.
As activists and clinicians expand these new routes of access to abortion pills, we are providing an immediate, practical solution for people who need abortion access, and thereby reducing the harm that abortion bans create.
Abortion pills are everywhere. As courts and legislatures have been systematically blocking access to abortion across the country, clinicians and activists—myself included—have been setting up and illuminating innovative routes of access that reach people where they are with safe abortion access, including in states with restrictions. As a result of our collective efforts, abortion pills are now readily available by mail for $150 or less—and free for those who can’t afford any amount—in all 50 states, even states with bans. Access routes currently include telehealth from U.S. providers operating from states with laws that shield them from prosecution, international telehealth services that mail pills to the U.S., community networks that send pills by mail for free, and e-commerce vendors that mail pills to all states.
An organization I co-founded, Plan C, tracks these different services to learn about their offerings, including whether they do a medical screening, what type of pills they offer, and how much they cost. Our ongoing investigations—which include mystery shopping and laboratory testing to verify that the pills are real—document a rich ecosystem of abortion pill access. These are real services providing practical, affordable, medically-safe abortion access, even in states with bans. They are all discoverable online. We index and share this information through our Guide to Pills so that people can learn about this ecosystem, and those who are seeking abortions know that they still have options.
These routes of access, combined with the clinic-based care options that exist in states that still allow it, have been so successful in reaching people that there are now even more abortions occurring in the United States than prior to the Supreme Court decision that overturned Roe v. Wade. Guttmacher, a leading abortion research organization, reports that clinician-provided abortions in the United States rose by more than 100,000 between 2020 and 2024, and that figure does not even include self-managed abortions or abortions facilitated by telehealth shield providers prescribing across state lines into states with bans. The Society of Family Planning also has been documenting abortion post-Roe and reports that these shield providers are serving approximately 10,000 people per month in states that totally or partially ban access to care.
As activists and clinicians expand these new routes of access to abortion pills, we are providing an immediate, practical solution for people who need abortion access, and thereby reducing the harm that abortion bans create, particularly for populations underserved by healthcare systems. We are also showing a new way forward for modern abortion access and laying the groundwork for eventual policy change (which will likely only be possible after our U.S. democracy is restored).
This scenario has already played out in other countries, with resulting improvements in abortion access. For instance, it was largely based on the experiences of patients in Ireland who received abortion pills by mail from Women on Web to safely terminate their pregnancies that parliament liberalized abortion access. In Mexico, the widespread grassroots sharing of information about how to use misoprostol—a widely available ulcer medication—for abortion, ultimately paved the way to policy reform, with abortion pills now officially registered in the country.
For decades, abortion pills have been so severely restricted by politics and overregulation that envisioning a radically different future in which the pills are universally available by mail—or even over the counter—is difficult for most. But this future is coming. Many would say it is largely already here. And, what is particularly notable, given the current FDA safety review based on fabricated claims about the “dangers” of abortion pills, is that these new, modern routes of access are possible precisely because abortion pills are so safe. They are safer than Tylenol, safer than Viagra, and research has demonstrated time and again that they are absolutely safe enough to put directly in the hands of the person who needs them.
A recent report on citizen-driven initiatives found that people in red and blue states vote for policies that are egalitarian and economically redistributive.
On the evening of November 5, 2024, I sat at a gathering of organizers and volunteers from the campaign to pass Proposition 139, a citizen-driven initiative in Arizona seeking to enshrine abortion access in the state constitution.
After an hour or so of waiting with bated breath, the bulk of Arizona’s ballot initiative results had been counted and posted online. Our hard work had paid off! Prop 139 had amassed 66% voter support (a number that would decrease to a still impressive 61% by the final tally.) After a significant round of applause and the shedding of a few tears, the party settled into a pleasant thrum.
At first I expected shouting, screaming, and crying—we had won a massive victory! But I quickly understood that the celebration was more subdued than expected because the results were exactly what the lead organizers of the campaign hadanticipated: a win.
Healthcare Rising and Prop 139 won because they refused to partake in party politics and instead tailored their campaign toward fighting for issues that were resonant and supported in their constituency and across the political spectrum.
Ultimately, it was unsurprising that this initiative to enshrine abortion access passed in Arizona, despite voters in the state supporting anti-abortion candidate and now U.S. President Donald Trump, because reproductive freedom itself as a policy has proven to be overwhelmingly popular when put to a vote by the electorate.
A recent report from our team at the Center for Work and Democracy uses data from citizen-driven initiatives—ballot initiatives that are drafted, petitioned, and voted on by citizens themselves—from the last 15 years to see where patterns in voting emerge. Put very briefly, we found that people vote for policies that are egalitarian and economically redistributive.
Egalitarian measures—which equalize rights, resources, and decision-making power in society—pass at a rate of 65.63% across blue and red states alike. Initiatives supporting reproductive rights, for example, are considered egalitarian and prove to be extremely successful at the polls. Despite a difficult loss in Florida in the 2024 election and a complicated voting stalemate in Nebraska, abortion access has been protected by voters in 14 out of 17 cases since the fall of Roe v. Wade.
Redistributive measures are a subsect of egalitarian initiatives that specifically focus on the redistribution of wealth from the rich to the poor, like raising the minimum wage. With an even greater passage rate than other egalitarian measures, redistributive ballot measures clock in with an impressive win rate of 75%. In red states, this number rises all the way to a whopping 92% compared to 61.29% in blue states. (We found that blue states’ averages are skewed down by California’s initiative results, which are far less progressive than the state’s image.)
When Healthcare Rising Arizona and the other co-organizers of the campaign for Prop 139 set out to get the initiative on the ballot and enshrined in the state constitution, they knew that party politics were not going to help their cause. From day one, the campaign for 139 was clear that their organizing would be strictly nonpartisan because they knew that abortion as a policy was more popular than any individual Democratic candidates, despite those Democrats being vocally pro-choice.
The strategy worked. The Arizona for Abortion Access Act passed with 417,427 more votes than former Vice President Kamala Harris received in Arizona, proving that egalitarian policies like reproductive rights are simply more popular than pro-choice candidates.
Healthcare Rising and Prop 139 won because they refused to partake in party politics and instead tailored their campaign toward fighting for issues that were resonant and supported in their constituency and across the political spectrum.
Our data tells us that egalitarian and redistributive measures are exceedingly popular with red and blue voters alike. So if Republican and Democrat voters both want many of the same things—policies that equalize rights, break down wealth inequality, and support the decision-making power of everyday people—why won’t politicians just give the people what they want?
Unified and spirited opposition to Trump's destructive rampage is exactly what's needed, but a successful movement will not grow without a vision and proposals to support it.
On Saturday, April 5th, fifty-seven years after Martin Luther King, Jr. was assassinated, hundreds of thousands of protestors gathered across the country to challenge Trump’s attack on, well, just about everything!
I went to the rally in New Jersey, where speaker after speaker had us chanting “Hands off our Social Security!” “Hands off our Medicare!” Hands off our Medicaid!” “Hands off our Abortion Rights!” and so on. This was the national theme developed by the Democratic Party.
A few protestors in the back chanted “Hands off Gaza,” which was not on the agenda. But they soon retreated into silence. One woman carrying a large Trump 2024 banner walked near the edge of the crowd of about 2,000 and took on a few angry shouts, but there was no confrontation. Tensions rose enough, however, that the chair of the gathering did feel obliged to remind us that this was a peaceful, non-violent gathering.
As I looked around at the well-healed demonstrators from our liberal town, I couldn’t help but imagine adding a few other items to the list: “Hands off our IRA’s!” “Hands off the Stock Market!” “Hands off Free Trade!” I’m sure that would have been right on the money.
But why was I raining on this parade? After all, these were my neighbors, good caring people who turned up on this rainy Saturday because they truly want to make our society a better place.
My mind went negative because it was crystal clear that the rally was the opposite of Martin Luther King Jr.’s challenge to the established order that enabled Jim Crow and persistent poverty. Dr. King asked us to envision massive changes to the status quo. Today, we were chanting to defend the status quo that Trump is surely taking a wrecking ball to.
The Democrats who put the rallies together across the country missed a moment to present an alternative vision. This was a chance to announce new proposals to tame runaway inequality, the growth of which has undermined the Democratic Party’s coalition, and to provide job insecurity, the lack of which has given MAGA a foothold in the first place.
Instead, we got pure opposition, spirited to be sure. Its only virtue was to provide collective support to those of us who have been stunned by the revanchist thrust of Trumpism. We can’t believe what is happening and we need each other to shore up our spirits. It was a chance, feeble but necessary, to show some form of communal defiance.
But a successful movement will not grow without a vision and proposals to support it. Why didn’t the Democrats do that? Because, except for a few fellow-travelers like Bernie Sanders, their vision is deeply tied the status quo BT (Before Trump).
That set of BT institutions was working well for the top 20 percent of the income distribution, especially those with college and post-graduate degrees, including just about everyone at our town’s demonstration.
It was not working for those whose jobs had been shipped abroad to China, Mexico, or elsewhere, and who watched their communities then crumble.
It also wasn’t working so well for those who lost their jobs to finance Wall Street stock buybacks and outrageous CEO salaries.
And it wasn’t working well at all for those working at poverty wages, especially immigrant workers, risking life and limb with little protection.
In short, the Democratic Party, long the party of the working class, has no compelling vision today because it has left behind a big chunk of the working-class. As analysts debate what went wrong, they should perhaps ask why the Democrats are so reluctant to support a working-class populist agenda.
The answer lies in how it became the party of the established order and therefore was unable to provide a vision that makes sense to working people who have been screwed by the established order. (Please see Wall Street’s War on Workers.)
And that’s a damn shame. Because we want and need to be inspired by a positive vision. But that will only happen when the Democrats take their hands off their imaginations and ours.
We need to return to the days when the vision was FDRs for four freedoms, not four family tax credits to support the “opportunity society.”
The Democrats still have a chance, the field is open, but really? That is not likely to happen until it is challenged by a new independent party that stands for substantive change, created by and for working people.
I’ll be demonstrating for that.