The US District Court for the Eastern District of Missouri is the new battleground for the legal fight over access to the abortion pill Mifepristone. This development comes after the Supreme Court remanded Judge Matthew Kacsmaryk’s injunction against the FDA’s current regulations on the drug last summer, ruling the case had no legal standing in Texas. Given the options to dismiss the case or transfer it to another venue, Judge Kacsmaryk announced his decision to transfer the case to the Eastern District of Missouri.
The Attorney Generals for Missouri, Idaho, and Kansas joined the plaintiff, the Alliance for Hippocratic Medicine, last October to challenge the FDA’s restrictions on Mifepristone.
Their arguments challenging the FDA’s 2000 approval of Mifepristone center around claims that the drug is unsafe, citing statistics that 3-5% of women who take Mifepristone end up hospitalized due to complications from the medication. The plaintiffs are advocating for the reinstatement of previous regulations surrounding the drug, including rolling back the Mifepristone REMS program, which allows the medication to be dispensed by mail. Additionally, they’re requesting that the FDA implement new regulations requiring three in-person doctor visits before access to Mifepristone is granted. Given that medical abortions made up 63% of all abortions in 2023, restricting access to this abortion medication would have a significant impact nationwide.
This latest development leads to new apprehensions for reproductive health advocates. One such concern is how the new Missouri venue may grant the plaintiff, specifically the Attorney General of Missouri, an advantage in the forthcoming litigation. The pool of judges is also a worry in reproductive rights groups. Among Missouri district judges who could hear this case are Zachary Blueston and Christian Stevens, who were both nominated to the court by the Trump Administration. Other potential judges include Joshua Divine and Maria Lanahan, two more Trump nominations who both represented Missouri in prior Mifepristone litigation earlier this year. The Trump Administration has been public about its pro-life views and has already taken steps to cut access to abortion. More recently, the Administration expressed skepticism about Mifepristone. These findings suggest that the judges who may potentially preside over the Mifepristone case already have anti-abortion biases that reproductive health advocates are worried will reflect in the court’s ultimate decision.
The Eastern District of Missouri has not publicly announced whether it will accept the case, nor given any statement about who the presiding judge might be. Now that this case has gone up and back down from the Supreme Court, Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration is up for a second round of litigation. It is to be seen if the battle will reach its climax in Eastern Missouri’s District Court.