Houston Chronicle Sunday

Why does 1870s law affect abortion pills?

- By Matthew Perrone

WASHINGTON — A 19thcentur­y “anti-vice” law is at the center of a new court ruling that threatens access to the leading abortion drug in the U.S.

Dormant for a half-century, the Comstock Act has been revived by anti-abortion groups and conservati­ve states seeking to block the mailing of mifepristo­ne, the pill used in more than half of U.S. abortions.

On Friday, a federal judge in Texas sided with Christian conservati­ves in ruling that the Comstock Act prohibits sending the long-used drug through the mail.

Here’s at look at the case and the law:

What happened?

In a sweeping ruling, U.S. District Judge Matthew J. Kacsmaryk said that the Food and Drug Administra­tion’s approval of mifepristo­ne more than two decades ago violated federal rules. Despite overwhelmi­ng evidence to the contrary, the Donald Trump appointee said the FDA overlooked “legitimate safety concerns,” with the pill, which has been available since 2000.

The Biden administra­tion and mifepristo­ne’s main drugmaker filed appeals notices within hours of the decision.

The Texas ruling came almost simultaneo­usly with an order from a judge in Washington state, who said the FDA must maintain access to the drug in Democratic-led states that filed their own lawsuit. The dueling opinions are expected to send the matter quickly to the Supreme Court.

A former lawyer for the conservati­ve First Liberty Institute, Kacsmaryk used the terminolog­y of anti-abortion advocates throughout his opinion, referring to doctors who prescribe mifepristo­ne as “abortionis­ts,” fetuses as “unborn humans” and medication abortions as “chemical” abortions.

If upheld, Kacsmaryk’s 67page decision would also dismantle recent FDA changes designed to ease access to mifepristo­ne, particular­ly a 2021 switch that allowed the drug to be sent through the mail.

What is the Comstock Act?

Originally passed in 1873 and named for an anti-vice crusader, the Comstock Act was intended to prohibit the mailing of contracept­ives, “lewd” writings and any “instrument, substance, drug, medicine, or thing” that could be used in an abortion.

The law’s scope has been repeatedly narrowed by federal courts and Congress, which eliminated the reference to contracept­ives in the 1970s.

And the federal government hasn’t enforced the law since the 1930s, according to legal experts.

Kacsmaryk, though, agreed with plaintiffs that the law — as literally interprete­d — prohibits mailing mifepristo­ne.

The FDA’s decision allowing the “dispensing of chemical abortion drugs through mail violates unambiguou­s federal criminal law,” he concluded.

Why is the Comstock Act in play now?

The law was essentiall­y dormant in the 50 years after Roe v. Wade establishe­d a federal right to abortion. And until the FDA loosened its requiremen­ts on mifepristo­ne in 2021, there was no real way to enable abortion through the mail.

But Rachel Rebouché of Temple University’s law school says anti-abortion groups — emboldened by the Supreme Court decision overturnin­g of Roe — have seized on Comstock to try to shut off the flow of abortion drugs.

“The fact that pills can be mailed is an existentia­l crisis for the anti-abortion movement — it’s hard to police, it’s hard to track, it’s difficult to enforce,” said Rebouché. “If courts are willing to breathe new life into Comstock, it has the potential to shut down the uptake of medication abortion across the country.”

How have courts treated the Comstock Act in the past?

Beginning in the 1930s, federal courts issued rulings drasticall­y narrowing how the law could be applied. Read literally, the law could be interprete­d to outlaw almost any medical item that could be used in an abortion.

“The interpreta­tion being advanced would apply to all kinds of articles — like surgical gloves — that are just basic equipment for health care,” Rebouché said.

A key 1936 ruling concluded that the law could only apply when the person mailing an item or drug specifical­ly intended it to be used illegally for abortion.

In December, the Biden administra­tion’s Justice Department attempted to bolster that interpreta­tion, issuing an opinion that Comstock could not be used to outlaw the mailing of abortion pills because of their many legal uses, including during miscarriag­es and under abortion-ban exceptions.

Again, Kacsmaryk, rejected that view, stating that the law “plainly does not require intent on the part of the seller.”

What happens next?

The Supreme Court has never weighed in on Comstock and — assuming the justices takes up the case— the ruling could have far-reaching consequenc­es for American women, abortion providers and their opponents.

Kacsmaryk’s order is limited to mifepristo­ne, but the same approach could potentiall­y be used for other drugs.

 ?? Allen G. Breed/Associated Press ?? Boxes of the drug mifepristo­ne sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., last year.
Allen G. Breed/Associated Press Boxes of the drug mifepristo­ne sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., last year.

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