Left: A picture of what is described as a “pill packing party” in a filing by Missouri, Kansas and Idaho looking to ban mifepristone, a pill used in medication abortions (court filing). Right: In this image from video from the Senate Judiciary Committee, Matthew Kacsmaryk listens during his confirmation hearing before the Senate Judiciary Committee on Capitol Hill in Washington, on Dec. 13, 2017 (Senate Judiciary Committee via AP).
Three states have joined anti-abortion group Alliance for Hippocratic Medicine (AHM) in its attack on mifepristone — and the case is before the same Texas judge whose unprecedented 2023 decision ordered the U.S. Food and Drug Administration (FDA) to revoke its approval of the abortion drug.
Missouri, Kansas, and Idaho filed an amended complaint as intervenor plaintiffs against the FDA Friday alleging that the agency has put women at risk by allowing drugs to be mailed to women with “no doctor care, no exam, and no in-person follow-up care.”
The FDA approved mifepristone in 2000; the drug is one part of a two-drug combination used in the U.S. for medication abortions. Misoprostol, the second drug used as part of the regimen, also has uses unrelated to the termination of pregnancy. In 2021, the FDA announced it would no longer force patients to appear in person to get a prescription for mifepristone after it reviewed safety data from pregnant women who used it during the COVID-19 pandemic. The policy was formalized in 2023.
After AHM challenged the FDA’s new rules, a three-judge panel of the U.S. Circuit Court of Appeals for the Fifth Circuit upheld a portion of an unprecedented decision by Donald Trump-appointed U.S. District Judge Matthew J. Kacsmaryk that ordered the FDA to revoke approval of mifepristone. Kacsmaryk’s order launched a nationwide debate over the consequences of allowing a federal judge to second-guess the FDA’s scientific judgment regarding a medical regulations.
Ultimately, the U.S. Supreme Court unanimously reversed the Fifth Circuit’s ruling. As expected, the Supreme Court’s ruling turned on the issue of standing. The plaintiffs in the underlying lawsuit were a group of doctors who were found not to have suffered any injury in their own right.
In an amended complaint, however, the plaintiffs states now allege that “These dangerous drugs are now flooding states like Missouri and Idaho and sending women in these States to the emergency room.” They argue that the FDA’s regulatory change is illegal and that the use of abortion drugs poses a heightened risk of both physical and emotional damage to women who use them. Their argument also maintains that the FDA’s permission that mifepristone may be dispensed without an in-person medical visit “leads to abortions with no follow-up care.”
Per the plaintiffs, the FDA policy on abortion drugs has “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 the emergency room in Plaintiffs’ States.”
Over the course of the 199-page complaint, the plaintiffs listed multiple studies and statistics about patients who allegedly have suffered or would suffer adverse affects after an abortion.
The complaint also alleged that some abortion providers are hosting “pill-packing parties to help strangers in faraway states circumvent strict laws.”
The filing detailed the events as follows:
At these pill-packing parties, volunteers help “mail abortion medication to women in states with strict limits.” For example, on “a recent Monday evening, the group filled 350 boxes — in-home abortion kits ready for mailing to women in states such as Texas and Florida with near-total or six-week abortion bans ….Retirees and professionals ate pizza, sipped Chardonnay in red plastic cups and chatted while working purposefully ….Nearby, a [Massachusetts Abortion Project] staffer printed address labels for 45 boxes of pills before packing them into tote bags for the trip to the post office. They were bound for 19 states, including Texas, Georgia and Florida … The gatherings jumped from monthly to twice-monthly in July, the MAP’s busiest month with 560 boxes shipped, and are set to go weekly this fall.”
The challenge, like that which precipitated the unprecedented order, is again before Kacsmaryk.
You can read the full amended complaint here.
Representatives for the parties did not respond to request for comment.
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