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Republicans Are Quietly Moving to Limit Mifepristone Access Nationwide

A House panel advanced a 2024 budget bill that would block the ability to access the abortion drug via telehealth.

House Republican lawmakers, including then-Representatives-elect Keith Self, Scott Perry, Andrew Clyde, and Rep. Andy Harris, the chair of the House Agriculture, Rural Development, Food and Drug Administration Appropriations Subcommittee, huddle in a conference room Thursday, January 5, 2023.

A Republican-led House panel has advanced a 2024 budget bill that includes riders to revoke key Food and Drug Administration (FDA) approvals regarding where patients are allowed to access abortion drug mifepristone, in a quiet move aimed at limiting abortion access nationwide.

The legislation passed the House Agriculture, Rural Development, Food and Drug Administration Appropriations Subcommittee by voice vote on Thursday. It would revoke the FDA decision to nix the requirement for mifepristone to be obtained in person and allow it to be prescribed via telehealth and received by mail, which was first announced by the agency in 2021.

It would also reverse a decision to allow mifepristone to be dispensed at retail pharmacies like CVS and Walgreens, where before the drug was only allowed to be dispensed at certain mail-order pharmacies or specially certified health providers.

Together, the decisions finalized earlier this year by the FDA significantly expand access to mifepristone, one of the drugs used in medication abortions, the most common form of abortion in the U.S. It removes hurdles to abortion care for people without access to specialized health care providers, including people in rural areas and those who can’t access in-person visits; at the time, experts said that these approvals would be crucial to expanding abortion access.

Reversing those decisions, then, would restrict access, in an attack on the drug that is already under threat. It is likely no coincidence that Republicans target mifepristone in particular in the bill: the FDA’s 2000 approval of the drug is currently under legal threat, due to a concerted effort by anti-abortion activists.

Depending on whether or not courts rule to uphold the April decision by Texas Federal Judge Matthew Kacsmaryk to revoke that approval in coming months, the drug could end up being outlawed nationwide.

It’s unclear how that case, which is likely to reach the Supreme Court, will play out. But Republicans appear to be trying to score a win against the drug and restrict abortions however they can, including by attaching riders to the 2024 congressional appropriations bill; Republicans know that standalone bills restricting abortion access, like their proposal for a nationwide ban, would likely not survive the Senate or be signed by President Joe Biden.

Democrats on the committee protested the inclusion of the mifepristone restrictions. “I strongly oppose both these riders in the interest of public health,” said Rep. Rosa DeLauro, the top Democrat on the House Appropriations Committee, during subcommittee markup on the bill.

It now goes to the full appropriations committee, where it’s unclear if the mifepristone provision will stand. Democrats would likely want to strike the proposal, although currently, the congressional budget process already includes one key anti-abortion measure that passes each year despite Democratic opposition: the Hyde Amendment, which bans federal funding from being used for most abortions.

The bill also includes other “poison pills,” as the Clean Budget Coalition points out. If included in the overall budget package and passed, it would block the FDA from working with food manufacturers to implement voluntary sodium reduction efforts and block the FDA from proposing rules to reduce nicotine levels in cigarettes to help curb addiction, according to the group.