Dueling Court Rulings Leave Abortion Pill in Limbo

Dueling district court rulings on the legal status of mifepristone, an abortion-inducing pill, have created legal chaos as the Biden administration plans to appeal the decision.


Dueling district court rulings on the legal status of mifepristone, an abortion-inducing pill, have created legal chaos as the Biden administration plans to appeal the decision.

  • District Judge Matthew Kacsmaryk, a Texas federal judge and a Donald Trump appointee, ordered a hold on Food and Drug Administration (FDA) approval of mifepristone and gave the Biden administration seven days to appeal.
  • At nearly the same time, District Judge Thomas O. Rice, a federal judge in Washington and an Barack Obama appointee, handed down a ruling that essentially mandated the opposite. Rice ordered the federal government not to make any changes that would restrict access to mifepristone in the 17 states that sued in his court.
  • The two conflicting rulings will likely be settled at the Supreme Court.
  • Mifepristone has been approved by the FDA for over two decades and is used in most abortions that occur before the 10th week of pregnancy. Mifepristone is part of a two-drug process that stops the pregnancy, while misoprostol kills the fetus and empties the uterus.
  • President Joe Biden attacked the federal judge in a statement, denouncing the decision as a “political, ideological” attack on the FDA, an “expert agency” at drug approvals. The President vowed to appeal the ruling.
  • Health and Human Services Secretary Xavier Becerra said the Texas decision could impact the approval of other medications and vaccinations and characterized the decision as turning “upside down the entire FDA approval process.” The FDA appealed the ruling.
  • Some Democrats, including Oregon Sen. Ron Wyden and Rep. Alexandria Ocasio-Cortez of New York, have called on the Biden administration to simply ignore the ruling in a stunning attack on the rule of law. GOP Rep. Tony Gonzales of Texas warned Republicans could consider defunding the FDA should Democrats take the “very dangerous” step of attacking the separation of powers.


reporting from the left side of the aisle


  • The New York Times predicted the ruling could undermine the FDA’s regulatory authority and have ramifications for other drugs besides mifepristone. “The decision by a Texas judge appears to be the first time a court has moved toward ordering removal of an approved drug from the market over the objection of the F.D.A. If the initial ruling, a preliminary injunction issued on Friday, withstood appeals, it could open the door to lawsuits to contest approvals or regulatory decisions related to other medications.”
  • CNN argued Kacsmaryk’s ruling, which it characterized as “a judicial intervention into the health care decisions of millions of American women and could effectively make abortion unavailable in many states if it goes into force” could lead to a political backlash against Republicans in 2024.
  • Vox published an explainer about misoprostol, an alternative abortifacient that could become more commonly used should mifepristone be taken off the market.



  • According to National Review, many Democrats are joining in Ocasio-Cortez’s lawless call for the Biden administration to ignore the ruling. Ocasio-Cortez noted, “The interesting thing when it comes to a ruling is that it relies on enforcement and it is up to the Biden administration to enforce, to choose whether or not to enforce a ruling.”
  • Ocasio-Cortez doubled down on both her democracy-threatening attacks on the judiciary and her calls for Justice Clarence Thomas to face impeachment for not disclosing luxury trips, per Fox News. To justify her attacks on the judiciary, Ocasio-Cortez inaccurately compared the two incidents to how the Trump administration handled the DACA program.
  • “Abortion has been a political gift to Democrats that they want to keep giving, which explains why they sounded almost gleefully furious on Friday after a Texas federal judge overruled the Food and Drug Administration’s approval of the abortion pill mifepristone,” wrote the Wall Street Journal editorial board.


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© Dominic Moore, 2023