The Next Abortion Battle

If the Supreme Court reverses Roe v. Wade, the fight will shift to access to the abortion pill

- Cynthia Koons

For decades the fight to end abortion in America has been waged over Roe v. Wade. With the Supreme Court poised to overturn the landmark decision that legalized a woman’s right to choose, the fight to stop abortion is going to become a fight about a pill.

Mifepristone, originally known as RU-486, was approved in the U.S. in 2000 after being on the market overseas for more than a decade. When used in combination with another drug, misoprostol, it’s more than 95% effective in terminating a pregnancy within the first 10 weeks. Data overwhelmingly show it’s safe. Yet, as I wrote in a Bloomberg Businessweek cover story earlier this year, it’s regulated like almost no other drug in the U.S. The federal government has one set of restrictions on how the pill is used, and state governments have additional, often more onerous rules.

It’s been a cat-and-mouse game for years now. Those opposed to abortion have tried to use laws and regulations to prevent the pill from becoming the answer for women who can’t get access to a clinic. Some two-thirds of U.S. states require that doctors prescribe the pill, which is more stringent than the U.S. Food and Drug Administration’s rules, which also allow certified nurse practitioners to do so. In December, a new law went into effect in Texas that introduced penalties of jail time and a fine of as much as $10,000 for anyone who prescribes the abortion pill via telehealth. Texas is also one of seven states that have attempted to keep the drug from being mailed directly to women; three succeeded, but four such bans were blocked by courts.