Chapter 1: What recent legal actions have impacted access to abortion pills?
Abortion pills have been on a bit of a journey in the United States over the past few weeks. The journey begins in Louisiana, where the state sued the Food and Drug Administration to ban access to Mifepristone through telehealth pills in the mail. On May 1st, a district appeals court temporarily banned access to telehealth abortion and pills by mail nationwide.
So for a few days, a lot of people in the country were like, uh... But then the Supreme Court of the United States weighed in.
Oh, yay!
Chapter 2: How did the Supreme Court intervene regarding abortion pills?
The Supreme Court has, at least for now, restored access. But the Supreme Court wasn't finished. They said, we'll have more for you on Monday, yesterday. But then yesterday they said, actually, Thursday. And we'll see if that happens. The Supreme Court said it would get out of the business of abortion after overturning Roe v. Wade. And they were wrong.
So while we wait for them to figure this out again, we're going to talk about what's at stake on today's Explain from Box.
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Chapter 3: What are the implications of Louisiana's lawsuit against the FDA?
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Chapter 4: What arguments are being made by both sides in the abortion pill debate?
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By the end of the week, could the nature of access to abortion pills across the country change? Is that what's at stake here?
Yes, absolutely. So what Louisiana is demanding is that the Supreme Court allow restrictions to go into effect right now, even before the case is finally resolved. Louisiana says, you know, every day that patients in our state can get abortion pills online and get them shipped in in violation of our state's ban,
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Chapter 5: How have abortion pills gained popularity since the overturning of Roe v. Wade?
is a day we are being injured as a state. They're claiming sovereign injury, that they say the ability of patients around the country to access these pills by telehealth, to have them prescribed by a doctor online and sent by mail, is helping people in their state circumvent the law. And that's why they want the Supreme Court to step in and cut that off.
for everyone nationwide because it's a federal policy, while the case is still in the works. And the drug makers are the ones fighting back against that, the two companies that make this abortion pill. And they say, there's no sovereign injury. You can't just get rid of a policy for everyone because you don't like how people are using it.
Louisiana thus suffers no sovereign injury because nothing undermines Louisiana's ability to legislate and enforce abortion restrictions as it sees fit.
And they say that, you know, this policy has been in effect for several years already. There's no sudden emergency where you need it suddenly banned just now.
Chapter 6: What would happen if the Supreme Court restricts telehealth access to abortion pills?
And thus, the Supreme Court should keep everything the way it currently is while the case works its way through.
Do we have any idea where the Supreme Court stands on abortion pills at this point?
So the reading of the tea leaves is always a, you know, tricky, tricky venture with the Supreme Court. You know, people try to guess based on, you know, the questions that were asked at oral arguments. We haven't even gotten there yet in this case. But it's just very hard to know. It's very hard to know.
Politico hasn't gotten like a leak this time about the decision.
Not on this one. Not on this one. It's very possible that, you know, once again, they sort of duck the heart of the issue on abortion, on federal power versus state power. And they just say, you don't have standing. You can't prove that you, the state, are being injured by this policy.
It seems a little contradictory, right? I mean, the Supreme Court said, let the states decide. Years later, we have Louisiana saying, hey, ban abortion pills for the entire country. That's not letting the states decide at all, right? Just on its face?
So what's interesting here is you really have both sides making a state's rights argument and saying, my rights as a state are being infringed upon. So you have Louisiana saying, why should other blue states, liberal abortion policies where anybody can get pills, why should that be allowed to invade our state when we're over here trying to ban abortion?
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Chapter 7: What role do political groups play in the current abortion pill landscape?
New York and other states have also passed aggressive shield laws that, among other things, permit doctors and clinics to omit identifying information from pill bottles so that a 12-pill bottle with mifepristone can arrive in Louisiana without indicating who sent it.
And so they're basically saying that allowing this anywhere, you know, infringes on their right as a state to prohibit it. Now, of course, as you just articulated, you also have people saying, wait a minute, so that means it gets to be restricted for everybody, even people who, you know, have laws on the books in their states supporting access to abortion.
states have no sovereign interest in having other sovereigns' policies match theirs. And a divergence in abortion policy at the state level is a natural result of returning abortion policy to the states.
And so, yeah, you really have all sides of this reaching for the states' rights, you know, banner. It's one of those sort of compromises that pleases nobody because, you know, the anti-abortion folks, they are not ever going to be satisfied. They say, you know... Why should a fetus's rights, you know, end at a state border?
And of course, on the other side, you have folks saying, why should, you know, a pregnant woman's rights end at a state border?
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Chapter 8: How are public opinions influencing the future of abortion policies?
And so this is always going to be a federal fight.
How big a deal have abortion pills become since the Supreme Court overturned Roe v. Wade, since Dobbs?
Even before that, they were becoming more and more popular as a method of abortion. And especially since the COVID pandemic, they have become the predominant method that people are choosing in order to terminate their pregnancies.
Most abortions today are obtained through medication, often accessed by mail and without an in-person visit to a doctor, something opponents have tried to stop.
Medication is now used to bring about two thirds of all abortions. And more than a quarter get them by telehealth. So, you know, even if the pills aren't banned entirely, but just telehealth is restricted, that's going to be a big blow. And it's not just a big blow to people living in states like Louisiana where there's a ban locally.
and they can't go to a doctor's office and get them even if they want to. But it'll impact people in states like California, where there are these huge swaths of the state where it's very difficult to get to a clinic. We have medical deserts all around the country.
We have shortages of providers, and telehealth has really broadened access, including in states where it was already legal and technically accessible on paper, but not in practice.
Okay, so give us an idea. Let's say by the end of this week, the Supreme Court weighs in Thursday afternoon, Thursday morning, who knows. If they say no more abortion pills via telehealth, what does this look like in the United States?
Yeah, so we actually got a sneak preview of what it would look like a couple weeks ago. We had a few days between when the Fifth Circuit ruled for Louisiana and said, OK, we're going to restrict these pills, access to these pills nationwide. And it took the Supreme Court a few days after that to step in and say, whoa, let's hit pause. Let's go back to the way things were.
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