Major pharmacies, including Walgreens and CVS, are at the center of a heated battle over abortion pills in the U.S. ― and the latest salvo comes from 14 Democratic governors calling on pharmacies to clarify their plans to dispense mifepristone, one of the two drugs used for medication abortion.
“We write in light of recent media reports indicating that some major pharmacy retail companies, faced with political pressure, may be considering not dispensing critical abortion medication to millions of individuals, including in states where medication abortion, like Mifepristone, can be lawfully dispensed,” the governors wrote in a letter released Tuesday morning.
The letter, addressed to seven major pharmacies in the U.S., is signed by a list of governors including California Gov. Gavin Newsom, Michigan Gov. Gretchen Whitmer, North Carolina Gov. Roy Cooper and Wisconsin Gov. Tony Evers. It was written by the Reproductive Freedom Alliance, a nonpartisan coalition of 21 governors committed to protecting reproductive rights in their states.
“As companies that dispense critical, life-saving medications, we urge that your decisions continue to be guided by well-established science and medical evidence and a commitment to the health and well-being of patients ― not politics or litigation threats,” the letter says. “The impact to people’s health and lives is too great to do otherwise.” (Scroll down to read the letter in full.)
Walgreens and CVS announced in January that they would seek certification from the U.S. Food and Drug Administration to start dispensing medication abortion, in the form of the combination of the two drugs mifepristone and misoprostol. Weeks later, however, Walgreens walked back its promise to seek certification, after Republican attorneys general from 20 states sent a letter to the pharmacy threatening to sue if Walgreens attempted to mail abortion pills in their jurisdictions.
Since then, Democrats and advocates for reproductive rights across the country have been up in arms that Walgreens bowed to political pressure.
CVS, the biggest pharmacy chain in the U.S., has not commented on whether it will keep its promise to seek FDA approval to begin dispensing mifepristone. Neither Walgreens nor CVS sold abortion pills before this controversy ― they are simply in the process of obtaining certification to do so.
Medication abortion is the most common way to terminate a pregnancy in the U.S., accounting for over 60% of abortion and miscarriage care in the country. Years of research have shown that medication abortion is extremely safe and effective. When used together, mifepristone and misoprostol are more than 95% effective and safer than Tylenol. The FDA currently approves its use up until 10 weeks of pregnancy, and the World Health Organization says mifepristone can be safely used until 12 weeks.
The Supreme Court overturned federal abortion protections last year, and more than a dozen states now have near-total abortion bans on the books. The barriers to in-person abortion care in many Southern and Midwestern states have made access to medication abortion even more critical, since in many states the pills can be mailed via telehealth and taken at home.
Walgreens and CVS are among a number of parties embroiled in the right-wing war on abortion pills. Walgreens may have acquiesced to political pressure in part because of a lawsuit filed in November by a conservative Christian legal group in a federal district court in Texas. The group, Alliance Defending Freedom, claims that the FDA fast-tracked the approval of mifepristone when the department put it on the market in 2000.
Although legal experts say the arguments in the lawsuit are weak ― citing the 20-plus years that mifepristone has been used widely and safely by millions of Americans ― the lawsuit has teeth because of where it was filed. The conservative group intentionally filed it in Amarillo, Texas, because the district only has one judge: Matthew Kacsmaryk, a far-right Trump appointee with a long track record of opposing abortion rights. The next hearing in the lawsuit against the FDA is scheduled for Wednesday morning.
Read the letter from 14 Democratic governors below.