The U.S. Food and Drug Administration is reviewing Obama- and Biden-era rules around a common abortion-inducing drug, after attorneys general of 22 states, including Wyoming, urged the nation’s top health officials to take a closer look at adverse events linked to the drug.
U.S. Health and Human Services Secretary Robert F. Kennedy and FDA Commissioner Dr. Marty Makary responded to the Republican AGs’ July 31 letter with their own, which surfaced publicly this week.
“The concerns you have raised in your letter merit close examination,” says Kennedy and Makary’s Sept. 19 response. “This Administration will ensure that women’s health is properly protected by thoroughly investigating the circumstances under which mifepristone can be safely dispensed.”
Why I Signed It
Wyoming Attorney General Keith Kautz told Cowboy State Daily on Thursday that he signed onto the July 31 letter because he reviewed the study it featured and the policy issues around it. And he determined the science around the drug merits scrutiny, and such scrutiny is in line with Wyoming’s posture on the matter.
“When my office gets requests to participate in letters like this,” began Kautz, “the first step I do is, I try to determine if Wyoming has an interest in this.”
Signing this letter did seem “to be consistent with the policies” Wyoming advances, he said.
Wyoming has passed multiple, varying abortion bans and restrictions since the U.S. Supreme Court overturned Roe vs. Wade in 2022.
All of those have been paused or blocked via court orders, as Teton County District Court Judge Melissa Owens ruled last November that abortion is a health care right under the Wyoming Constitution.
Her ruling is under review in the Wyoming Supreme Court.
The health issues referenced in the study underpinning the letter “seemed to be of significant enough interest to say, ‘Somebody should take a look at this,’” said Kautz. “That’s really what I think the letter does.”
This Study
The AGs’ letter had highlighted a study by the Ethics and Public Policy Center, which sourced all-payer insurance claims across 865,000 mifepristone abortions to conclude that mifepristone abortions result in serious adverse events at 22 times the rate that appears currently on the drug’s label, and has a failure rate double the rate on the label.
The group touts itself as a political and religious advocate, saying it works to build “a consensus for conservatives” and shape “the future of Jewish and Christian public witness.”
But, Kennedy and Makary added, “FDA’s own data collected between 2000 to 2012 indicated 2,740 adverse events, including 416 events involving blood loss requiring transfusions.”
Since then, the approved safeguards around the drug have been “significantly reduced,” the letter adds.
Mifepristone is commonly used alongside misoprostol to induce abortions.
The FDA approved mifepristone in 2000 – for use up to the seventh week of a woman’s pregnancy.
In 2016, the FDA extended that window to 10 weeks’ gestation.
In 2023, the FDA changed the drug’s safeguards once again, to remove a requirement that the drug be dispensed in-person.
Currently a woman can obtain a mifepristone abortion by having one telehealth visit with an approved health care provider – not necessarily a physician – ordering the drugs through mail and self-administering them, says the AGs’ letter.
“The FDA’s removal of these crucial safety protocols,” the letter continues, “begs the question of whether the removal was motivated by considerations other than the safety of patients.”
A Few Figures
Medication abortion accounted for 63% of all U.S. abortions in 2023 — an increase from 53% in 2020, the Guttmacher Institute reported.
The share of abortions in states without total bans that were provided via online-only clinics rose to 14% in 2024 from 10% in 2023 – a difference of about 40,000 abortions, said the institute.
There were more than 1 million abortions in U.S. states in 2024.
Wyoming’s ban on chemically-induced abortions – like its ban on most abortions generally — remains blocked via court order. Another law requiring pre-abortion ultrasounds is paused while a case against it continues in Natrona County District Court.
The Pro-Choicer
Kennedy is pro-choice, media reports indicate.
He weathered scrutiny in May 2024 while running as an independent candidate against President Donald Trump, for switching from a stance against government restrictions on abortion, to saying government restrictions should defer to a phase of viability outside the womb.
During his Senate Finance Committee confirmation hearing in January, Kennedy said he’d do what Trump wanted on the matter.
“President Trump has told me that he wants to end late-term abortions, he wants to protect conscientious exemptions and that he wants to end federal funding for abortions abroad,” said Kennedy at the time. “I serve at the pleasure of the president. I’m going to implement his policies.”
Trump also blurred the policy lines during his campaign, at times painting it as a states-rights issue; at times taking credit for the overturn of Roe vs. Wade, which his three conservative high court nominations likely enabled.
Clair McFarland can be reached at clair@cowboystatedaily.com.
