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What do dueling mifepristone rulings mean for Colorado?

By Michael Karlik April 10, 2023 | updated 2 years ago

On Friday, a federal judge in Texas issued a ruling to suspend the U.S. Food and Drug Administration’s approval of mifepristone. That same day, another federal judge in Washington released a contradictory decision in a case where Colorado is among the plaintiffs.

Here is an overview of what happened and what to expect.

Q: What is mifepristone?

A: Mifepristone is a hormone-blocking drug used to end a pregnancy up to 10 weeks. It requires a follow-up dosage of misoprostol, which is not implicated by either court ruling. The FDA approved mifepristone as safe for use more than two decades ago.

Q: How many abortions in Colorado occur through medication?

A: Planned Parenthood of the Rocky Mountains estimated that 70% of its 11,800 abortion-care patients in Colorado last year received medication abortion rather than surgical. Nationally, just over half of all abortions occur medicinally.

Q: What did the judge in Texas rule?

A: U.S. District Court Judge Matthew J. Kacsmaryk, an appointee of Donald Trump, suspended the FDA’s approval of mifepristone on the grounds that the agency violated regulations governing the accelerated approval of new drugs for “serious or life-threatening illnesses.” Kacsmaryk disputed that pregnancy was an “illness” and also believed mifepristone is dangerous.

Q: What did the judge in Washington rule?

A: In a separate lawsuit, U.S. District Court Judge Thomas O. Rice, a Barack Obama appointee, agreed the public interest in ensuring access to “safe and effective medicine” weighed in favor of maintaining the FDA’s current mifepristone program. He blocked the FDA from altering the status quo for the 18 state entities that sued the FDA.

Q: Where does Colorado fit in?

A: Colorado was one of the plaintiffs in the Washington case, along with 16 other Democratic-led states and the District of Columbia. They sought to block the FDA from implementing more restrictive record-keeping and certification requirements for dispensing mifepristone and, beyond that, from causing the drug to become “less available.”

Q: Does the Texas ruling suspending mifepristone trump the Washington ruling that freezes the status quo?

A: The Colorado Attorney General’s Office believes Rice’s preliminary injunction will legally ensure the availability of mifepristone in Colorado unless a higher court intervenes. In this instance, the higher courts would be the U.S. Court of Appeals for the Ninth Circuit or the U.S. Supreme Court.

Q: What happens for Colorado should a higher court act to suspend mifepristone nationally?

A: A spokesperson for Planned Parenthood of the Rocky Mountains said the loss of mifepristone as an option would be significant, but medical providers could still be able to guide patients through a misoprostol-only method of abortion.

Q: So, is mifepristone safe?

A: Through June 2022, an estimated 5.6 million people have taken mifepristone for medication abortion in 22 years. There have been 28 deaths. In contrast, motor vehicles, COVID-19 and guns all present a far higher risk of death than mifepristone, according to the National Safety Council.

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Michael Karlik

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