A CITADEL OF CHOICE
The text message simply read, “Fuck Texas.” Rebecca Cohen looked up from her phone, took a sip of her chai latte, and said, “I get a lot of these in my line of work.” Still, Cohen, a Denver OB-GYN, thought this particular expletive, received in mid-February, might’ve been about more than another pregnant person being denied health care in the Lone Star State. The 42-year-old abortion clinician pulled up Google. “I wonder if maybe the mifepristone ruling came through,” she said.
Cohen searched for a breaking news story detailing whether a Donald Trump–appointed Texas judge had decided to force a major abortion drug off the market despite longtime Food and Drug Administration (FDA) approval and a 23-year safety record. “If the judge bans mifepristone,” Cohen said, “it would be baseless and inappropriate, but appeals would go to the conservative Fifth Circuit Court of Appeals and then to the Supreme Court, which is, of course, what they want.”
Her emphasis on the word “they” was a not-so-subtle reference to the American anti-abortion movement that has, over the past 22 months, made significant progress in restricting the practice across the country. That momentum includes the U.S. Supreme Court overturning Roe v. Wade, the 1973 landmark decision that, for 50 years, had protected an American’s freedom to have an abortion. The reversal of Roe in June 2022 led to trigger laws and legislative action at the state level, which resulted in a U.S. map where 14 states have banned the practice and others have enacted varying levels of restrictions.
The Texas case, Alliance for Hippocratic Medicine v. FDA, which wasn’t ruled upon until early April, did ultimately become the most consequential anti-abortion win since Roe fell. The decision, which would’ve amounted to a ban, was immediately appealed by the FDA. A subsequent ruling by the Fifth Circuit Court of Appeals did not remove mifepristone from the U.S. market, but it put into question future access to a medication used in roughly 54 percent of abortions in this country each year by rolling back policies the FDA had put in place to expand access to the drug. Also in early April, a judge in Washington state ruled in another lawsuit that the FDA must keep the drug available in certain states, including Colorado. The discordant decisions, plus the Justice Department’s distaste for the Texas ruling, sent the question of mifepristone’s availability to the U.S. Supreme Court. On April 21, SCOTUS said mifepristone could remain on the market with the FDA’s current policies in place as appeals proceed. That decision sent the question back to the Fifth Circuit, where, at press time, arguments were scheduled to have begun on May 17. Experts suggest that the losing party will undoubtedly appeal, once again sending the case to SCOTUS. Whatever happens, the banning or restriction of mifepristone could have even further-reaching consequences than the repeal of Roe—consequences that could disproportionately affect Colorado, as the need for surgical abortions would likely increase.
Colorado is one of only 15 states generally considered to be protective of reproductive rights, so rulings at the federal and state levels have had an outsize impact here. Nearly encircled by neighbors that have limited, if not outright denied, abortion, the Centennial State has not only continued its history of serving those who need care regardless of their home addresses (the state was the first to decriminalize abortion in 1967), but it has also further
