‘We will not cave’: governors stockpile abortion drugs as access is threatened

Several Democratic governors have moved swiftly to protect access to medication abortion in their states after a ruling by a Texas judge late last week threatened access to the widely used abortion drug mifepristone.

In an announcement on Monday, Governor Maura Healey of Massachusetts said her state had ordered about 15,000 doses of mifepristone, the first of two drugs in a medication abortion regimen that has been approved for use up to the 10th week of pregnancy.

Healey also issued an executive order that she said would help protect access to medication abortions and shield providers who perform them.

In California, Governor Gavin Newsom, also a Democrat, said his state had secured an emergency stockpile of up to 2m pills of misoprostol, the second drug in the regimen that can be used safely on its own, though is slightly less effective as a single medication. That drug, which is used to treat other medical conditions, is also being targeted by anti-abortion groups seeking to remove it from the market.

“In response to this extremist ban on a medication abortion drug, our state has secured a stockpile of an alternative medication abortion drug to ensure that Californians continue to have access to safe reproductive health treatments,” Newsom said in a statement. “We will not cave to extremists who are trying to outlaw these critical abortion services. Medication abortion remains legal in California.”

Their actions come after US district judge Matthew Kacsmaryk, an appointee of Donald Trump known for his anti-abortion views, issued a ruling late on Friday that invalidated the 23-year-old approval of mifepristone by the Food and Drug Administration (FDA). On the same night, a federal judge in Washington state issued a contradictory ruling that ordered the FDA to maintain the drug’s approval in at least 17 states where Democrats had sued.

On Monday, the US justice department appealed the Texas ruling, asking a federal appeals court to place a hold on the “extraordinary and unprecedented order”. Underscoring the legal uncertainty surrounding the dueling orders, the administration separately asked the federal court in Washington state for clarity.

With access to the drug imperiled, and Democrats stymied in Washington by the Republican majority in the House of Representatives, a handful of liberal state governors said they were taking matters into their own hands.

“A judge has made a politically motivated decision to override doctors, patients and medical experts and block access to critical medications,” Healey said on Monday, unveiling the plan at a press conference outside the Massachusetts statehouse in Boston. “Today, we collectively are saying loud and clear: not on our watch.”

In anticipation of the Texas ruling, the Democratic governor of Washington, Jay Inslee, announced last week that his state would stockpile a three-year supply of mifepristone in the event the drug became more difficult to access. Days later, Kacsmaryk issued his ruling.

Governor Jay Inslee of Washington said the state would stockpile a three-year supply of mifepristone. Photograph: Steve Bloom/AP

Several other Democratic governors and state attorneys general have condemned the ruling while seeking to make clear that, at least for now, the drug remains available. Some went further, promising to keep medication abortion legal and accessible in their states, although without providing further details.

More than half of abortions in the US rely on medication abortion, and most of those involve the two-drug protocol. If the appeals court doesn’t intervene, the Texas ruling would take effect on Friday with far-reaching implications for access.

The FDA approved mifepristone to terminate pregnancy in 2000, when used with misoprostol. Despite claims made in the Texas lawsuit, there is decades’ worth of scientific research concluding that mifepristone is safe.

States have become the epicenter of the fight over abortion rights since the supreme court’s landmark decision last June to overturn Roe v Wade. Since then, more than a dozen Republican-led states have enacted abortion bans or severely restricted access to the procedure.

​Anti-abortion groups have long targeted medication abortion, the most common method for terminating a pregnancy in the US. But it became the focus of efforts after the supreme court’s landmark decision last June to overturn Roe v Wade, allowing states to regulate abortion.

Although more than a dozen Republican-led states moved quickly to ban or severely restrict abortions​, with scores of new limits pending before state legislatures this session, Democratic-led states have pushed in the opposite direction. Yet if the Texas ruling stands, experts say it would upend access nationwide, limiting the drug even in states where abortion is legal.

Abortion opponents in blue states denounced the efforts by Democratic governors to preserve access to medication abortion.

“It is appalling that Gavin Newsom is so obsessed with ending the lives of children in the womb that he is attempting to stockpile dangerous and potentially illegal drugs,” California Family Council president Jonathan Keller wrote on Twitter. “California again proves the only ‘choice’ they care about is abortion.”

Newsom said the judge’s ruling “ignores facts, science and the law” in a way that puts “the health of millions of women and girls at risk”.

“Abortion is still legal and accessible here in California and we won’t stand by as fundamental freedoms are stripped away,” he said.

Other supporters of abortion rights similarly denounced the conservative judge’s decision on abortion as “unprincipled” and out of step with the American public. In states where the issue has been put on the ballot, from right-leaning Kansas to battleground Michigan and liberal Vermont, voters have opted to preserve or expand access.

“I’ve fought like hell to protect abortion access and I’m not backing down,” Michigan’s governor, Gretchen Whitmer, said on Friday. “I will keep taking steps to expand access to reproductive healthcare and fight against anyone threatening our rights.”

Whitmer recently signed legislation repealing the state’s nearly century-old abortion ban, after Michigan voters overwhelmingly approved a ballot initiative in November to enshrine abortion protections into the state constitution.

Democrats and reproductive rights advocates believe the issue will continue to motivate voters in the coming election cycles after lifting them to victories across the country in the 2022 midterms. Last week’s election of a liberal judge to serve on the Wisconsin supreme court brought fresh evidence of the enduring potency of abortion politics.

“This decision will only enrage Americans further and move them to more action,” Mini Timmaraju, president of the Naral Pro-Choice America advocacy group, said on a call with reporters on Monday. “Our eyes are on 2023 and 2024 – 2022 was just the beginning.”