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Politics|Supreme Court to Decide Availability of Abortion Pill as Appeal Moves
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https://www.nytimes.com/2023/04/19/us/politics/abortion-pill-supreme-court.html
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ABORTION PILL RULINGS

 * Supreme Court to Decide
 * Texas Judge Ruling
 * Virtual Clinics at Risk
 * Misoprostol, Explained
 * Online Market for Abortion Pills

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SUPREME COURT TO DECIDE AVAILABILITY OF ABORTION PILL AS APPEAL MOVES FORWARD

Justice Samuel A. Alito Jr. had issued a stay that was set to expire at
midnight, meaning the justices are likely to act before then, although they
could extend the deadline or fail to act.

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A federal judge in Texas invalidated the F.D.A.’s approval of an abortion pill,
mifepristone.Credit...Anna Moneymaker/Getty Images


By Abbie VanSickle

April 19, 2023Updated 12:27 p.m. ET

WASHINGTON — The Supreme Court is expected on Wednesday to decide the fate of a
crucial abortion pill that is used in more than half of abortions across the
United States while an appeal moves forward.

The court is weighing an emergency application by the Biden administration to
maintain the Food and Drug Administration’s approval of the drug after an
appeals court said it would place limitations on the medication, mifepristone.

Justice Samuel A. Alito Jr. had issued a stay in the case that is set to expire
at midnight, meaning the court is likely to act before then, although it could
extend the deadline or fail to act.

The prolonged legal clash reflects a muddled and fast-moving landscape for
mifepristone, marked by conflicting Federal District Court decisions and an
appeals panel ruling that further complicated the drug’s status.



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After the Supreme Court overturned the constitutional right to an abortion last
summer, political and legal battles have centered on medications used for the
procedure. In some conservative states, lawmakers have targeted abortion pills.


THE PUSH TO RESTRICT ABORTION PILLS


THE DECISION BY A TEXAS JUDGE TO INVALIDATE THE F.D.A.’S
APPROVAL OF MIFEPRISTONE, A COMMON ABORTION PILL, HAS SET OFF A NEW CLASH
BETWEEN SUPPORTERS AND OPPONENTS OF ABORTION ACCESS IN THE UNITED STATES.

 * Under Review: After an appeals court order let stand some aspects of the
   Texas decision and the Justice Department filed an emergency request to
   preserve the F.D.A.’s approval of mifepristone, the Supreme Court is poised
   to consider whether medication abortion can be curtailed in states where
   abortion is legal.
 * Temporary Status Quo: Justice Samuel Alito issued a temporary stay ensuring
   that mifepristone would remain widely available while the Supreme Court
   decides whether to grant a formal stay.
 * A Little-Known Drug: Abortion pills have dominated headlines, but, until
   recently, relatively few Americans were familiar with mifepristone and the
   concept of medication abortions, polls show.
 * Stockpiling Pills: The Texas ruling could affect availability even where
   abortion is legal, and states led by Democrats have been scrambling to
   adjust to a possible future without mifepristone.

Mifepristone is typically used in combination with a second drug, misoprostol,
in the first 10 weeks of pregnancy. The first drug used in the regimen blocks
progesterone, a hormone that allows a pregnancy to develop, and the second,
taken one or two days later, prompts contractions and helps the uterus expel its
contents.

The dispute started in Texas in November, when an umbrella group of
anti-abortion medical organizations and several doctors sued the Food and Drug
Administration, challenging its approval more than two decades ago of the
abortion pill.

In their suit, the anti-abortion groups claimed that the F.D.A. did not follow
proper protocols when it approved the drug in 2000. The groups said that the
agency had also ignored dangers of the drug in the years since.

The F.D.A., countering the plaintiffs’ claims, has said that the drug was
properly approved more than 20 years ago and that it is safe.



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The lawsuit was filed in the Amarillo division of the U.S. District Court of the
Northern District of Texas, where a single federal judge, Matthew J. Kacsmaryk,
an appointee of President Donald J. Trump, hears cases.

Judge Kacsmaryk, a longtime opponent of abortion, is a former lawyer for First
Liberty Institute, a legal group focused on religious liberty cases that has
long backed conservative causes.


Image

The Supreme Court in Washington.Credit...Haiyun Jiang/The New York Times


This month, Judge Kacsmaryk announced a preliminary ruling that invalidated the
F.D.A.’s approval of the drug. But the judge said that the agency had a week to
seek emergency relief before his ruling would take effect.

Judge Kacsmaryk suffused his ruling with the language of the anti-abortion
movement, referring to abortion providers as “abortionists” and a fetus or
embryo as an “unborn human” or “unborn child.” He appeared to agree with
virtually all of the claims made by the anti-abortion groups.

Less than an hour later, another federal judge, Thomas O. Rice, who was
appointed by President Barack Obama, issued a contradictory ruling in Washington
State in a different lawsuit. Judge Rice blocked the F.D.A. from limiting the
availability of mifepristone in much of the country.

The Washington State lawsuit, filed by Democratic attorneys general in 17 states
and the District of Columbia, is a direct challenge to the Texas case.



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The Biden administration immediately appealed the ruling by the federal judge in
Texas, and a divided three-judge panel of the U.S. Court of Appeals for the
Fifth Circuit, based in New Orleans, announced that mifepristone could remain
legal and available while the lawsuit makes its way through the courts.

The panel rejected Judge Kacsmaryk’s finding that the F.D.A.’s approval of
mifepristone more than 20 years ago was not valid. At the same time, the judges
blocked more recent steps by the F.D.A. to make the drug more easily available,
including permissions to send the pills by mail. Experts said the consequences
could be far-reaching, creating more obstacles for a patient’s ability to secure
the drug.

The next day, Judge Rice reaffirmed his ruling, ordering the F.D.A. to maintain
the status quo in the 18 jurisdictions, sowing further confusion about the
availability of the abortion pill.

The dueling orders all but guaranteed that the case would go to the Supreme
Court.

The Biden administration, seeking emergency relief, asked the justices to pause
the appeals court ruling that sought to limit access to the pill. In its brief,
the government argued that the decision had sweeping consequences, not only for
abortion pill access but also for the broader pharmaceutical industry.

“If allowed to take effect, the lower courts’ orders would upend the regulatory
regime for mifepristone, with sweeping consequences for the pharmaceutical
industry, women who need access to the drug and F.D.A.’s ability to implement
its statutory authority,” the brief said.







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Supreme Court to Decide Availability of Abortion Pill as Appeal Moves
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