A federal judge in Texas has issued an order halting the federal approval of mifepristone, a widely used abortion pill that has been on the market in the U.S. for nearly a quarter-century.
Mifepristone is one drug in the two-part sequence typically used in pill-induced abortions. About one in two abortions in the U.S. are carried out with medication.
The case has returned Texas to the center of America’s abortion debate. A strict abortion ban took effect in the state months before the Supreme Court overturned Roe v. Wade last year.
But this time, the order in Texas could influence abortion access as far away as New York, which has long had some of America’s most robust reproductive protections.
Last year, New York City moved to guarantee free medication abortion access for anyone who needs it.
Here is what New Yorkers should know about the mifepristone case.
What is mifepristone?
Mifepristone is an abortion pill that was approved by the Food and Drug Drug Administration in 2000. It is typically used with a second drug, misoprostol, to end a pregnancy within the first 10 weeks.
Under FDA rules, mifepristone can only be prescribed by certified health care providers. The hormone-blocker has been used by more than 5 million people in the U.S. since its approval.
Challengers in the Texas case claim the drug’s safety was never fully vetted. Medical groups say the pill has a strong safety record.
In New York, the City Council passed a law last year requiring city-run health clinics to offer free sequences of mifepristone and misoprostol.
Will New Yorkers lose access to mifepristone?
The ruling by Amarillo, Texas, Judge Matthew Kacsmaryk, a conservative appointee of former President Donald Trump, could push the pill off the market across the nation.
The order marks a remarkable challenge to the FDA’s authority, and promises a swift challenge from Washington.
For now, at least, abortion-seekers in New York and across the U.S. will be left to pursue other avenues if they seek to terminate their pregnancies.
“This case is outlandish and unprecedented,” Donna Lieberman, executive director of the American Civil Liberties Union, said before Kacsmaryk’s order. “It’s simply about extending the long arm of those who would ban abortion into places like New York.”
Do New Yorkers have other medication abortion options?
Yes. Misoprostol, the second drug typically used with mifepristone, could still be used. It is used on its own in other countries where mifepristone is not available. But misoprostol is not as effective when used without mifepristone.
What happens next in the case?
The order threatens the FDA’s drug approval authority and abortion access, and the federal government is expected to appeal to U.S. Court of Appeals for the Fifth Circuit, a conservative court based in New Orleans.
If the appeals court declines a request for a stay of Kacsmaryk’s injunction, the case could quickly wind up at the Supreme Court. That court, remade by Trump, has a 6-to-3 conservative majority that erased the federal right to abortion in Dobbs v. Jackson last summer.
But it is unclear the nation’s top court would handle the pill case.
“It’s difficult to predict how they would feel about this,” said Carl Tobias, a law professor at th University of Richmond. “They might be concerned about the FDA approval process and the lack of precedent.”