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A CONFUSING LANDSCAPE ON ABORTION PILLS 
By Lisa Desjardins, @LisaDNews
Correspondent
 
The past week has been a swarm of news. A former president was indicted. A mega-leak of military secrets appeared on the internet. And Tennessee’s legislature expelled two duly elected members (though one has already been reinstated).
 
No other big headlines were needed, thank you.

But the news cycle had other ideas. Two high-stakes and conflicting court decisions arrived on the most common form of abortion: medication abortion.

• Mifepristone. A drug that blocks progesterone, which is a hormone needed for a pregnancy to continue. 
• The Food and Drug Administration approved the drug for use in abortions in 2000. 
• In 2020, 98 percent of medication abortions in the U.S. used mifepristone. It’s used in conjunction with another drug, misoprostol, for medical abortions as well as for miscarriages, through 10 weeks of pregnancy. 
• Also to know: Medication abortions make up roughly half of the abortions in America, according to the Guttmacher Institute, a research group that advocates for abortion access.
• Medication abortion is possible without mifepristone. Misoprostol can be used safely for the pregnant person on its own. But that approach is not favored because it can trigger more nausea, vomiting, cramping and diarrhea.

• The ruling is this. The FDA did not properly vet the drug mifepristone and its use in abortions should be banned nationwide. This is a preliminary injunction, meaning the ban is temporary while the underlying case works through the courts.
• A little more on this case, please. The ruling sided with anti-abortion groups suing the FDA, alleging it rushed through approval of the drug.
• One specific legal theory involved. The judge espoused the idea that fetuses should be thought of as full humans. On the second page of his decision, he wrote that the drug “ultimately starves the unborn human until death.”  
• When does this go into effect? Friday, April 14. The judge delayed the effect of his ruling for one week, anticipating an appeal from the Biden administration, which happened yesterday.
• What happens next? We wait on a higher court. Yesterday, the Justice Department appealed the ruling and filed an emergency request to block it. The temporary ban is now before the 5th U.S. Circuit Court of Appeals, which oversees Texas and a few other states. That court will decide in the next two days whether to get involved.
• And then? Very possibly, the Supreme Court. If the 5th Circuit allows a temporary ban on mifepristone, we are likely to see another Biden administration appeal that insists that the drug should stay available to the public, sending the case to the Supreme Court quickly.
• Another possible effect. Per The New York Times, the judge's ruling is believed to be unprecedented in banning a drug approved by the FDA 23 years ago. If it holds up, it could open the possibility of more court involvement in drug and health policy.
• Who is the judge? U.S. District Judge Matthew Kacsmaryk is a Trump appointee. Here is his official biography.
• Key documents to read. Here is Judge Kacsmaryk’s ruling. And here is the Justice Department emergency appeal to block it.

• The ruling is this. Mifepristone is proven safe and that its current use and availability must be allowed, at least temporarily, in 17 states whose attorneys general sued to protect access to it. 
• Which states? Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine,  Maryland, Michigan, Minnesota, Nevada, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Washington state and the city of Washington, D.C.
• A little more on this case, please. Absolutely. This group of Democratic attorneys general are suing over special FDA rules that limit who can prescribe and provide mifepristone. The attorneys general argue those limitations are not appropriate and the drug should be more easily available. The judge here is not granting that yet. Instead he ordered the FDA to keep mifepristone available as it is now, in the states involved in the lawsuit.
• Timing. This ruling, though in a different court, was filed minutes after the Texas ruling above. 
• When does this one go into effect? Immediately, per the judge’s order. 
• But this directly conflicts with the other order. Yes. It is a highly unusual situation that has led to confusion and the greater potential real-world problems. More on this below.
• What happens next with this order? This order to keep status quo access in 17 states cannot be appealed by the FDA because it does not change current policy. However, the attorneys general can appeal to try to expand access and protection of the drug immediately, as they did in their initial lawsuit.
• Who is the judge? U.S. District Judge Thomas O. Rice is an Obama appointee. Here is his official biography.
• Key document. Here is Judge Rice’s ruling. 

• The first piece of news will likely be from the 5th Circuit on whether and how that court might rule on the Texas decision and possible national ban of mifepristone. We expect to know more about that in the coming days, before the Friday deadline dawns.
• But the conflicting orders and dual-track cases may be on a collision course for the Supreme Court, which may be the only entity that can issue a national decision.
• Some members of Congress have proposed legislation, but none is expected to be able to get through both the House and Senate.