The Denver Post

Long-used abortion pill under threat in lawsuit

- By Seanmurphy andmatthew­perrone

AMARILLO, TEXAS>> A federal judge in Texas raised questions Wednesday about a Christian group’s effort to overturn federal regulators’ decades- old approval of a leading abortion drug, in a case that could threaten the country’s most common method for ending pregnancie­s.

Judge Matthew Kacsmaryk heardmore than four hours of debate over the Alliance Defending Freedom’s request to revoke or suspend the Food and Drug Administra­tion’s approval of mifepristo­ne. Such a step would be an unpreceden­ted challenge to the FDA and its authority in deciding which drugs to permit on the market.

Kacsmaryk said he would rule “as soon as possible,” without giving any clear indication of how he might decide and leaving open the question of whether access to the standard regimen formedicat­ion abortionsm­ight soon be curtailed throughout the country.

Mifepristo­ne, when combined with a second pill, was approved in 2000 and is used to end pregnancie­s until their 10th week. It has been increasing­ly prescribed since last summer’s U.S. Supreme Court ruling overturnin­g Roe vs. Wade.

The Texas lawsuit has become the latest high-stakes legal battle over access to abortion since the question of its legality was returned to the states.

Kacsmaryk, who was appointed by former president Donald Trump, saved some of his most pointed questions for attorneys representi­ng the alliance, which filed the case in Amarillo in anticipati­on of getting a favorable ruling.

“Explain to me why this court has that sweeping authority?” Kacsmaryk asked, in reference to the group’s request to pull mifepristo­ne from the market.

The judge also questioned whether the group had the legal standing to obtain a pretrial ruling, grilling both sides on U. S. Supreme Court cases that set out when such extraordin­ary relief is allowed.

Still, the judge also posed questions suggesting he was considerin­g how he might draft a preliminar­y injunction in the plaintiffs’ favor, at one point asking the alliance’s lawyers if the issue of standing had been clearly addressed by appellate courts. At another point, he told them that their outline for the order of their arguments “tracks the elements for an injunction nicely.”

Lawyers representi­ng the FDA argued that pulling mifepristo­ne would disrupt reproducti­ve care for women across the U.S.

“An injunction here would interfere with the interests of every state in the country” said Julie Harris of the U.S. Justice Department, which represente­d the FDA.

Harris and her colleagues also questioned whether the alliance — which filed its case on behalf of several anti-abortion doctors — had standing to bring the lawsuit, given that none of the plaintiffs could show the type of harm typically needed for such a legal action.

One of the chief arguments leveled against the FDA in the lawsuit is that the agency misused its authority when it originally approved the abortion pill.

The FDA reviewed the drug under its so- called accelerate­d approval program, which was created in the early 1990s to speed access to the first HIV drugs. Since then, it has been used to expedite drugs for cancer and other “serious or life-threatenin­g diseases.”

“The plain text is clear it applies to illnesses,” argued Erik Baptist, the alliance’s lead attorney. “Mifepristo­ne is used to end pregnancie­s, and pregnancy isn’t an illness.”

The FDA rejected the group’s argument on multiple accounts. First, attorneys said FDA regulation­s make clear that pregnancy is considered a “medical condition” that can be serious and lifethreat­ening in some cases.

Second, government attorneys said the terms of mifepristo­ne’s usewere replacedmo­re than a decade ago by subsequent FDA programs passed by Congress, rendering the argument irrelevant.

Finally, while the FDA reviewed the drug under its accelerate­d approval regime, it didn’t expedite the drug’s review. In fact, approval came only after four years of deliberati­on. Instead, the FDA used regulatory powers under the accelerate­d program to add extra safety restrictio­ns to mifepristo­ne.

Legal experts have long been deeply skeptical of many of the arguments made by the alliance. And there is essentiall­y no precedent for a lone judge overruling an FDA drug approval decision.

At one point, Kacsmaryk asked the alliance’s attorneys about the possibilit­y of suspending mifepristo­ne’s approval, withoutwit­hdrawing it completely.

 ?? DAVID ERICKSON — THE ASSOCIATED PRESS ?? Lindsay London holds a protest sign in support of access to abortion medication outside the federal courthouse on Wednesday in Amarillo, Texas.
DAVID ERICKSON — THE ASSOCIATED PRESS Lindsay London holds a protest sign in support of access to abortion medication outside the federal courthouse on Wednesday in Amarillo, Texas.

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