The GOP's Attack on Abortion Pills is Here

Explainer: The GOP’s New Mifepristone Lawsuit

As I reported earlier today, the Republican Attorneys General of Kansas, Missouri, and Idaho have filed an amended complaint against the FDA—a suit that seeks to significantly roll back access to mifepristone and ban the shipping of abortion medication. 

The attack on abortion medication comes just weeks before an election that’s been defined by abortion rights and Republicans’ attempts to run from voters’ post-Roe fury. (There’s a reason that the three AGs aren’t shouting the case from the rooftops!) 

The suit—which is filled with anti-abortion misinformation, scare tactics, and bizarre claims about women and girls’ health, including the idea that abortion medication “starves the baby to death in the womb”—is conservatives’ latest attempt to go after mifepristone. This summer, the Supreme Court ruled that previous plaintiffs didn’t have standing to challenge the FDA.

Anti-abortion groups are hoping that this newer complaint will have better luck. 

It’s also worth noting that the complaint was filed with Judge Matthew Kacsmaryk, the ultra-conservative asshole who ruled in favor of the previous mifepristone suit and tried to take mifepristone off the shelves. What’s interesting is that obviously none of these AGs are from Texas—so why did they get to file in Amarillo? Essentially, they were able to ensure they’d be in front of Kacsmaryk by filing their case as an “intervening” complaint—piggybacking off the old mifepristone case. Sneaky stuff.

Before I get into the nitty gritty of the complaint, a few important things to remember: While this case was brought by three specific states, a ruling would impact the entire country—even pro-choice states. And for as much as Republicans are trying to run from their anti-abortion extremism, this complaint makes crystal clear just how hyper-focused they are on banning abortion everywhere.

As law professor David S. Cohen tells me, “Believe what the Republicans do, not what they say.” He points out that the filing proves everything we’ve warned about—from Republicans trying to get abortion pills off the market to using the Comstock Act to enact a back-door ban.

“This might as well have been written by the people who wrote Project 2025,” he says.

With that, let’s get into it!

Click to skip ahead: Mifepristone for Minors, The Comstock Act, ‘Protecting’ Women’s Health, Restricting Access, Shitty Science, Criminalization & Abortion Tracking, Weird Quotes, What to Watch Out For

Mifepristone for Minors

I know everyone is hot to trot to find out more about the Comstock Act, but I need to start with what this suit says about young people, because it’s so telling.

The Republican AGs want access to abortion medication revoked entirely for people under 18 years-old, claiming that the FDA didn’t conduct proper studies into the impact mifepristone has on adolescent development. Specifically, they’re concerned with girls’ “developing reproductive systems.” Yuck. 

The suit claims that mifepristone messes with girls’ hormones and “is likely to significantly impact the developing reproductive system of the adolescent female.” Again, yuck.

And while the suit expresses significant concern for girls' reproductive organs, it shows no similar worry about the health risks they face when forced into childbirth.

What’s also interesting about this argument is how similar it sounds to attacks on gender-affirming care and birth control for minors. I’ve warned that by saying these medications harm young bodies, it could lead to restricting young people’s access to all of them. I see this as one step down that road. 

One final thing on minors: The states argue that by allowing for the mailing of abortion medication, the FDA is interfering with and bypassing parental rights. What’s more, the AGs claim that states have ‘parental’ rights over girls in foster care. In other words, how dare we interfere with their ability to control marginalized teens.

If you’ve read my book, you know there’s a chapter about young people being the canaries in the coal mine when it comes to attacks on abortion. This is exactly what I was talking about.

The Comstock Act

This suit is primarily concerned with stopping the shipping of abortion medication. Anti-abortion groups know tele-health now accounts for nearly 1 in 5 abortions, and that shield state providers sending pills to states with bans are a big reason the abortion rate hasn’t dropped since Dobbs. 

This infuriates them. 

Instead of admitting that they’re pissed off that some women are getting the care they need despite state bans, the three AGs paint a picture of devious, irresponsible doctors pushing drugs onto unsuspecting women. The goal is to demonize providers so Republicans don’t have to face the reality of desperate women seeking out safe care because their own states won’t allow it. 

The suit also claims that by removing certain restrictions on mifepristone, “the FDA fostered the creation of out-of-state abortion drug markets” and “created a 50-state abortion drug mailing economy.” Sounds metal!

In reality, it’s groups of women coming together to ship medication and support patients across state lines. But Republicans know that doesn’t sound as sinister as calling healthcare providers drug dealers.

At the heart of this is the Comstock Act. The AGs argue that the FDA should reverse rulings that allow the shipping of abortion medication because it violates Comstock. Tellingly, they don’t mention the 150-year-old law by name, just its U.S. code number. It’s almost like they know Americans will be furious when they find out Republicans want to enforce this old-ass obscenity law!

One of their biggest arguments, though, is that the shipping of abortion medication makes it unsafe for women—who suddenly they’re pretending to care about.

‘Protecting’ Women’s Health

There is something particularly infuriating about reading through a document that claims to be looking out for women’s health when the men behind it are happy to watch women die as a result of their laws. 

Take Idaho AG Raúl Labrador—he went all the way to the Supreme Court to defend denying women life-saving care in emergency rooms. But now he cares about our health?

Still, over and over, the suit argues that abortion medication puts women’s health and lives in danger. (Here’s the truth about the drugs’ safety.) Specifically, they claim mailing abortion medication prevents women from getting “continuous in-person care,” and that such care is frequently necessary. (It’s not.)

“Removing the in-person dispensing protections enabled a 50-state mail order abortion drug economy—a world where countless women in Plaintiff States receive abortion drugs by mail later in pregnancy with no in-person care and go [to] the emergency room in Plaintiffs’ States.”

This is all about making abortion pills seem as dangerous as possible, despite overwhelming evidence to the contrary. They even quote articles about shield state providers in ways meant to sound shady—like mentioning that one Aid Access provider works from “a basement in upstate New York.” Which is probably lovely, if you know upstate New York. But the hope is to make doctors seem as sketchy as possible.

It’s a tough argument to make when women are going septic and dying because of abortion bans. But Republicans need to make some kind of claim about why they want to limit access to this safe medication.

Restricting Access

In addition to stopping the mailing of abortion medication, the three Republican AGs want the courts to restore the FDA’s pre-2016 rules for mifepristone.

This would mean abortion medication could only be used up to 7 weeks of pregnancy instead of 10. The old rules would also require in-person visits to obtain the medication, and would mandate that only doctors prescribe mifepristone (as opposed to other providers like nurse practitioners or physician assistants).

The Republicans and anti-abortion groups behind the suit claim this is about protecting women’s health; in reality, they just want to make the pills as hard to get as possible. After all, they’re well aware that doctors are overwhelmed with patients from abortion ban states, and that one of the ways providers have been able to keep up is by having PAs or nurse practitioners prescribe abortion medication.

If they can impose those restrictions, it would mean throwing a huge wrench in access. And as is often the case, these restrictions would overwhelmingly impact marginalized communities—especially those in rural areas and folks who can’t afford to take time off work or get child care for in-person visits.

Shitty Science

One of the most striking things about this suit is the anti-abortion ‘science.’ It’s complete bunk—no surprise there. One quick example: The three states say that “one in 25 women who take abortion drugs will visit the emergency room.” What they don’t elaborate on, however, is that a visit to the emergency room doesn’t mean that someone was treated at the emergency room.

Most amazing is the fact that the Republican AGs are using data from studies that were retracted! You may remember that in February 2024, Sage Publications pulled three major anti-abortion studies for using misleading data and claims, and for failing to disclose ties to anti-abortion groups. Yet the same researchers and their bogus data show up all over this filing. In fact, they republished the same debunked data into a ‘new’ study that’s also cited in the case.

In other words, anti-abortion groups recycled their bad data, drew the same debunked conclusions, and repackaged it to look like fresh research.

To claim abortion medication harms women’s mental health, the complaint also cites a ‘study’ that’s really just data from 98 blog posts on a site funded by Life Perspectives. That’s a group that provides materials to Heartbeat International, the largest network of anti-abortion crisis pregnancy centers. So yeah, not exactly an objective bit of research.

It’s also worth noting that the other experts the AGs cite are extremist groups like Students for Life (which wants to ban birth control) and the American Association of Pro-Life OBGYNs (AAPLOG) (which says abortion is never necessary to save someone’s life). Even the images of embryos and fetuses from the complaint are pulled from Live Action’s ‘Baby Olivia’ video—propaganda designed by the radical anti-abortion group to indoctrinate school children.

Criminalization & Abortion Tracking

You all know that one of the tactics I’m obsessed with is conservative attempts to criminalize pregnancy and track abortion data. While those aren’t the primary focus of this complaint, there are some interesting breadcrumbs that are worth noting here. 

First, on tracking and data: You may remember my investigation into abortion ‘complication’ reporting laws; essentially conservatives are trying to drum up false reports on so-called abortion complications in order to prove abortion is dangerous despite all credible evidence to the contrary. They’re also pushing to track abortions—down to making abortion reports public records—in order to create a chilling effect. After all, they know women are far less likely to seek care if they think their names will end up in a state database.

It’s a strategy they’re clearly thinking about in this complaint. For example, the AGs attack the FDA for “eliminat[ing] the safeguard under which abortion providers must report non-fatal complications.” They also call for restoring “reporting requirements” for mifepristone—not just for serious adverse reactions, but for any emergency room visits. As I’ve pointed out, an ER ‘visit’ doesn’t mean that anything has gone wrong after taking abortion medication. But by counting a mere visit as proof of the drug’s dangerousness, conservatives can falsely drive up data they think will help them continue to ban and restrict abortion. 

The AGs also mention in the suit that the FDA has the ability to require Elements to Assure Safe Use (ETASU) rules—mandates that include “each patient be subject to ‘certain monitoring,’” and that “each patient be enrolled in a ‘registry.’” Doesn’t sound ominous at all!

As for criminalization, it comes up indirectly: For example, the AGs write that “women are the direct actor when they take abortion pills, (unlike with surgical abortions, where the physician is the direct actor).” They use this as an example of why abortion medication is harmful to women—the idea is that women will be traumatized by causing their own abortion. But it’s not hard to see how characterizing women as their own abortion providers could impact potential criminalization.

The complaint also cites several examples where abortion providers tell women that if they seek out help in an emergency room, they don’t need to reveal that they’ve taken abortion medication:

“Some abortion activists encourage women to lie to emergency room staff by saying they are having a miscarriage if they suffer complications requiring urgent care…

There’s nothing in there that’s traceable back to you … As long as you don’t tell anybody.”

The AGs frame this as proof that doctors are trying to hide wrongdoing. What they don’t mention, of course, is that perhaps women don’t want to talk about having an abortion because they’re afraid of being arrested in anti-choice states! (Which is a reasonable fear.)

Weird Quotes

Because anti-abortion groups and politicians can’t help but be total fucking weirdos, here are a few of my favorite bizarre claims from the filing:

First, they claim that abortion medication is so traumatic, that bleeding into your toilet will give you PTSD:

“Women who choose chemical abortion are more likely to continue associating their homes, or the bathroom, with abortion. The home may become a trigger for uncomfortable emotions rather than a refuge.”

What’s incredible about this claim—aside from the straight-up weirdness—is that these are the same people who want to force women into c-sections rather than allow safer, easier abortions. They’re the ones who expect patients to go septic before getting care. What, I wonder, would people say is more traumatic: life-endangering risks brought on by being denied care, or self-managing your abortion at home?

The AGs also claim that abortion medication “chemically destroys the baby’s uterine environment, prevents the baby from receiving nutrition, and ultimately starves the baby to death in the womb.” These people are ghouls.

Speaking of ghoulishness, the complaint also claims that women and girls will be traumatized “upon viewing the body of her lifeless baby after taking chemical abortion drugs.” Lovely.

What to Watch Out For

I know I’ve given you plenty to think about, but I just wanted to flag a few final things that stood out to me—specifically the so-called ‘harms’ the states claim they’re suffering because of the FDA’s rules on mifepristone.

Idaho, Missouri and Kansas argue that they:

“Pay increased medical expenses for women seeking treatment for abortion complications.” Their claim is that abortion medication is so dangerous that women are flocking to ERs and costing the state all sorts of money as a result. (Not true.)

“[S]uffer injuries from the loss of fetal life and potential births, leading to a resulting reduction in the actual or potential population of each state.” This is another strange remark, a claim that women having abortions is hurting the state because they want those babies, goddamnit.

The states also claim that the decrease in population harms them by “diminishment of political representation” and “loss of federal funds,” like “losing a seat in Congress or qualifying for less federal funding if their populations are reduced.”

Something else to watch out for: The brief is heavily focused on states’ rights, arguing that the FDA’s mifepristone rules let people break anti-abortion laws by shipping abortion pills into their states. The AGs claim the FDA’s actions “rob from the people in the Plaintiff States important decisions on this vital issue [of abortion]” and undercut the will of the people. (Sound familiar?)

It’s fascinating that we’ve come all the way back to the “will of the people.” They know that Americans oppose abortion bans, but they’ve found yet another way to make it sound like people helping each other to get the care they need is somehow anti-democratic.

Abortion, Every Day will have more this week on this complaint and why it’s so important, so keep an eye out. And if you’ve made it all the way through this explainer—whew! Thanks for sticking with me. -Jessica

This explainer was compiled with the help of AED researcher Grace Haley.