Senators Urge Admin to Reinstate Abortion Pill Regulations

The Senate committee overseeing health policy debated abortion pill regulation in a hearing on Wednesday, where some Republicans urged the administration to crack down on easy access to the drug mifepristone.

Sen. Bill Cassidy, R-La., who chairs the Senate Committee on Health, Labor, Education and Pensions, criticized a policy instituted under former President Joe Biden and continued under President Donald Trump, which has allowed mifepristone to be available by mail.

 “At an absolute minimum, the previous in-person safeguards [for getting the pill] should be restored, and it should be done immediately,” Cassidy said in his opening statement.

Starting in 2021, Biden’s Food and Drug Administration began to cease enforcing a longstanding in-person dispensing requirement for abortion pills.

In a significant change, the move allowed women to access mifepristone by mail. According to Guttmacher, the abortion pill accounted for 63% of abortions in the U.S. in 2023, up from 53% in 2020 and 39% in 2017.

Cassidy and other Republicans, in addition to opposing the act of abortion itself on moral grounds, argue that allowing mail-order mifepristone is irresponsible, due to the drug’s side effects.

He urged Health and Human Services Secretary Robert F. Kennedy Jr. and FDA Commissioner Marty Makary to finish a safety review of mifepristone “that they both promised us during their confirmation hearing.”

An HHS spokeswoman told The Daily Signal in a statement that the agency was still conducting a review of “reported adverse events associated with mifepristone to assess whether the FDA’s risk mitigation program continues to provide appropriate protections for women.”

“The FDA’s scientific review process is thorough and takes the time necessary to ensure decisions are grounded in gold-standard science,” the statement continued. “Dr. Makary is upholding that standard as part of the Department’s commitment to rigorous, evidence-based review.”

Throughout the hearing, senators heard from two Republican-invited witnesses. Louisiana Attorney General Liz Murrill discussed cases where abortion pills were illegaly obtained in her state by mail. Dr. Monique Chireau Wubbenhorst, an obstetrician-gynecologist based in North Carolina, argued that waiving the in-person dispensing requirement is medically irresponsible.

Sen. Bernie Sanders, I-Vt., the committee’s ranking member, joined committee Democrats in an almost wholesale rejection of those arguments.

“Let’s be clear about what this hearing is about. It’s not the safety of a drug. It’s about the ongoing effort of my friends in the Republican Party to deny the women of the country the basic right to control their own bodies,” said Sanders.

The minority-invited witness, Dr. Nisha Verma, who performs abortions, argued for the safety of mifepristone.

“We have over 100 high quality peer-reviewed studies showing mifepristone’s safety and effectiveness,” said Verma. “It may be that that we are here today because people in this room are feel uncomfortable with abortion… We should not pretend that this is an issue of the science.”

Verma also opined on a number of separate political issues, such as trends in Medicaid funding and immigration enforcement policy.

“My patients are at risk because of restrictions on abortion care and cuts to Medicaid,” she said, adding they are also at risk due to “fears about whether they can safely go to the hospital based on their immigration status.”

Sen. Jim Banks, R-Ind., joined Cassidy in urging for stronger regulations on the drugs.

“I’m disappointed that the FDA under Dr. Makary’s leadership hasn’t moved faster to restore the in-person dispensing requirement and strengthen the REMS program for mifepristone,” Banks said. 

REMS refers to risk evaluation and mitigation strategies, an FDA process under which high-risk prescription medications can be closely monitored for their safety. The drug was subjected to REMS when it was first approved for use in the U.S. in 2000.

Throughout the hearing, Democrats argued that mifepristone is safe.

“Medication abortion is safe and effective, and we have known that for a very long time,” said Sen. Patty Murray, D-Wash. “FDA had the data to show this when they first approved mifepristone 25 years ago, and its safety was reaffirmed when FDA approved a generic version this last fall.”

Banks pushed back on this argument, calling to attention the drug’s black box warning, which warns that users should be in contact with doctors about potential fever, pain, bleeding, or fainting.

He questioned Dr. Wubbenhorst on whether online telehealth services were alerting patients of these risks.

“No, they’re not,” said Wubbenhorst. “I’ve actually visited these, and they do not say anything about the black box warning or the serious side effects.”

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