In March 2023 Walgreens, the nation’s second-largest pharmacy chain, released a statement confirming that it will not dispense the FDA-approved abortion pill mifepristone in 21 states. 

This decision came in response to a Feb. 1 letter in which 20 Republican State attorney generals (AG) threatened to take legal action if Walgreens followed through with their plan to obtain and sell abortion pills via mail. The 20 AGs have also written to CVS, Albertsons, Rite Aid, Costco, Walmart and Kroger, demanding they not dispense abortion pills. Since then, conservative government signatories of the letter are moving to not only ban access to the abortion pill but to further restrict abortion access overall.

Mifepristone is a two-step medication followed by misoprostol and is commonly referred to as the standard “abortion pill.” Medicated abortions account for more than half of abortions in the United States. Planned Parenthood outlines that abortion pills can be obtained through private doctors or gynecologists, family planning clinics and abortion clinics and can be mailed to or sent to your local pharmacy in specific states. 

Research provided by the FDA assures Mifeprex (the brand name of mifepristone) is safe and a highly effective method of terminating a pregnancy. The New York Times also highlighted that more than 100 scientific studies conducted over more than 30 years have examined the effectiveness and safety of concluding that the mifepristone-misoprostol pills are safe for terminating a pregnancy and that 86 of 101 studies had no serious complications.

Walgreens has confirmed to state officials that they will not be distributing mifepristone in states where abortion is banned or has restrictive laws proposed or pending, preventing pharmacists in those states from dispensing the pills. These states include Alabama, Alaska, Arkansas, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah and West Virginia. In Alaska, Iowa, Kansas and Montana, abortion and medicated abortions are legal, but laws are proposed to restrict abortion pills. 

In response to the letter written to Walgreens, the Kansas attorney general stated, “We made clear that Kansas will not hesitate to enforce the laws against mailing and dispensing abortion pills, including bringing a RICO action to enforce the federal law prohibiting the mailing of abortion pills.” Kansas Republican lawmakers are pushing for a bill that requires providers to tell patients that a medicated abortion can be reversed once it started. Even with an expected veto, absent voters can vote “Yes” for an override. According to ABC, The American College of Obstetrics and Gynecology stated that there’s no scientific evidence of the reversal method and that this would lead to providers being forced to give patients inaccurate information.

Matthew Kacsmaryk, a Texas federal judge, issued a ruling invalidating the FDA’s approval of mifepristone. Reports from Politico mentioned that the judge’s decision includes language commonly used by anti-abortion advocates to describe the intent of the pill “to kill the unborn human.” The consequences of Judge Kacsmaryk’s verdict will likely impact and prevent access to medication for people in every state. The ruling expressed that the decision for abortion pills to be prescribed via telemedicine was unlawful. Politico also reports that the conservative Christian group The Alliance Defending Freedom brought forth the case stating that the FDA went beyond its authority when approving the medication.

The New York Times quoted Ilisa Bernstein, the interim chief executive of the American Pharmacists Association, who stated that the letter sent to Walgreens is a concern for all pharmacies that are licensed under the state as they must follow state law to maintain their license. Within the letter, the attorney generals have argued that federal law prohibits using mail to send or receive “any drug that will be used or applied for producing abortion.” In addition, the letter claims that abortion pills are riskier than surgical abortions and “invite the horror of an increase in coerced abortions.” 

California Governor Gavin Newsom declared his intent to cut ties with Walgreens following their abortion policy and statement, yet this action cannot be taken as it would violate Federal Medicare restrictions and undermine access for low-income individuals as Tony Cava, spokesman for the California Department of Healthcare Services explained. Governor Newsom has made a deal to purchase abortion medication in order to form a stockpile in the event of further restrictions.

Governors from California, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Washington, Wisconsin and Illinois sent a letter to executives at CVS, Walmart, Rite Aid, Safeway, Health Mart, Kroger, Costco and Target in response to the Walgreens policy. Illinois Governor Pritzker expressed deep disappointment and urged other pharmacies to preserve access to abortion pills. 

University student Anna Dziem Tran asserted that “Walgreens’ recent decision demonstrates their willingness to dismiss and disrespect people’s reproductive rights.”

On April 3, the Florida State Senate approved the six-week abortion ban supported by Ron DeSantis and GOP lawmakers. Currently, Florida has a 15-week ban on abortion that was enacted last year following the overturning of Roe v. Wade. Idaho became the first state to make it illegal for minors to access out-of-state abortions. House Bill 242 criminalizes “abortion trafficking,” making it illegal to obtain abortion pills for minors, with any attempts at leaving the state to obtain an abortion resulting in up to five years in prison. Adults could face felony charges with two to five years in state prison and aiding the process of an abortion. Under the new law, any adult that attempts to assist in terminating a pregnancy or hide the pregnancy can also be sued by the father, grandparents, siblings, aunt or uncle of the fetus. 

“In the wake of Roe v. Wade, conservative states and anti-choice groups are incentivized to roll back access to basic forms of reproductive autonomy and bodily justice,” explained Dr. Emily Bent, Associate Professor of Women’s and Gender Studies. “We must continue to challenge and be outraged by any politic that coerces pregnancy and parenthood, threatens the lives of women, poor and otherwise marginalized people and denies us of our shared civil and reproductive rights under the law.”

Without the protection of Roe v. Wade and the statutory right for people to seek abortion care nationally, conservative-governed states will continue to restrict, ban and outlaw abortions. Whether it be medically necessary or simply exercising the right to autonomy, abortion will remain in the news with more stories of people being denied abortion care due to the state they reside in. To support the fight for reproductive justice, donate directly to abortion networks such as the National Network of Abortion Funds and Abortion Care Network.

If you or someone you know needs help to find legal abortion providers near you, turn to the National Abortion Federation, Planned Parenthood, Abortion Clinic Pages, Abortion Finder, Abortion Care Network or the National Network of Abortion Funds.