Developments in Abortion, Autonomy, and Access:
This week’s Digest covers the latest decision from the Supreme Court on access to medication abortion, litigation developments out of Arkansas and Indiana, a new lawsuit challenging the VA’s abortion ban, Texas’s continued legal pursuit of a New York shield provider, Iowa’s new law restricting medication abortion access, and ongoing policy developments impacting reproductive health and bodily autonomy. As always, please read on to the end for the news that you need to know.
Legislation & Litigation:
Overview:
The Supreme Court issued a ruling allowing mifepristone to continue to be available by mail while litigation challenging the removal of in-person dispensing requirements plays out in the lower courts;
A previously-dismissed challenge to Arkansas’ total abortion ban has been revived;
A veterans rights advocacy group is suing the Trump Administration over the VA’s rescission of abortion coverage;
Indiana’s total abortion ban will remain in place, following a state supreme court order;
Iowa Governor Kim Reynolds has signed a law restricting access to medication abortion;
Texas is continuing its lawsuit against New York shield provider Dr. Maggie Carpenter; it has appealed an October ruling by a New York court that affirmed protections under the state’s shield law.
Supreme Court Issues Order Allowing Mifepristone by Mail to Continue for Now:
Shortly after publication of our last Digest, the Supreme Court issued an Order allowing mifepristone to continue to be prescribed and dispensed through telehealth. As a reminder, Louisiana initiated this litigation against the FDA in order to challenge the 2023 removal of in-person dispensing requirements for the commonly used medication abortion drug. On May 1, 2026, a panel of Republican-appointed Judges from the 5th Circuit Court of Appeals granted Louisiana’s request to reinstate in-person dispensing requirements during the pendency of litigation. Danco and GenBioPro, the manufacturers of the medication, appealed the 5th Circuit’s decision to the Supreme Court. After a brief extension, Justice Alito, who oversees emergency appeals out of the Fifth Circuit, issued an Order preserving the status quo and allowing mifepristone to continue to be sent by mail while the litigation makes its way through the lower courts. Notably, Justice Thomas penned a dissent in which he called out the Comstock Act - an 1873 anti-vice law - as a legitimate basis for ruling in Louisiana’s favor on the merits of the case. Despite courts being clear that Comstock is dead law in the context of lawful abortion, anti-abortion activists have responded to the growing availability of telehealth abortion care by calling for its enforcement - a move that could lead to a de-facto nationwide abortion ban. Some legal experts have speculated that the Trump administration has made a strategic decision not to take a strong stance on the question of mifepristone until after the midterm elections.
Lawsuit Challenging Arkansas’ Abortion Ban Revived After Previous Dismissal:
As we have previously reported, a group of Arkansas women who were denied abortion care in their home and an Arkansas ob-gyn are suing to overturn the state’s total abortion ban on constitutional grounds. The ban only permits abortion in circumstances where the patient's life is at risk. On April 30th, Pulaski County Circuit Judge Cara Conners issued a decision dismissing the case pursuant to a recently-passed Arkansas law requiring certain constitutional challenges to go before the Arkansas Court of Appeals. However, shortly before Judge Conners issued her decision, the Arkansas Supreme Court found that the law that she had based her ruling on is unconstitutional. Upon the plaintiffs’ motion, Judge Conners agreed that the case should be revived in her court.
As reported by the Arkansas Advocate, five of the six women involved in the lawsuit were forced to travel to Kansas or Illinois to obtain care; of those women, three had nonviable pregnancies, one had been the victim of sexual assault, and one did not want children - the final plaintiff had to carry her pregnancy for nearly two months after learning it was nonviable as a result of the state’s abortion ban. The case is being litigated by Molly Duane of Amplify Legal, the litigation arm of Abortion in America.
Veterans Advocacy Organization Sues Trump Administration Over Rescission of Abortion Coverage:
A veterans advocacy group - Minority Veterans of America - has filed a lawsuit against the Trump Administration challenging its policy rescinding abortion coverage and counseling for service members. The memo announcing the change in policy was issued late last year and authored by anti-abortion Deputy Attorney General Joshua Craddock. It asserted that the Biden-era policy of coverage for veterans was invalid. Under the new policy, abortion coverage is only permitted when the life of the pregnant person is endangered. Reportedly, many of Minority Veterans of America’s members live in states with abortion bans, leaving them to rely on the VA for access to care. The Organization’s lawsuit argues that the VA violated the Administrative Procedure Act by enacting restrictions on abortion coverage in cases where the patient’s health is in danger or where the pregnancy resulted from rape or incest.
Indiana’s Abortion Ban Remains in Place After State Supreme Court Upholds Lower Court Decisions:
Indiana’s near-total abortion ban will remain in place following an Indiana Supreme Court Order declining to review lower court rulings. The ban prohibits abortion at all gestational ages and includes exceptions only for the life or health of the patient, and for cases involving rape or incest or fatal fetal anomalies within a certain gestational age. Following its passage, Planned Parenthood and others filed suit arguing that it violated Indiana constitutional protections. In August of last year, the Indiana Court of Appeals found that there were no circumstances identified wherein the “limited” constitutional right to an abortion to save a patient’s life or preserve their health would be implicated and the state’s abortion ban would prohibit care. The ACLU acknowledged that the Indiana Supreme Court’s decision ends the legal challenge and lamented the impact that the ban’s continued enforcement will have on patient safety. This case does not impact a separate case challenging the state’s abortion ban on religious freedom grounds.
Iowa Passes Restrictions on Medication Abortion:
On May 19th, Iowa Governor Kim Reynolds signed House File 2788, a bill restricting access to medication abortions through telehealth and mail-order prescription services. The bill also creates a new civil cause of action against any person who dispenses medication abortion in violation of the law. Effectively, the law reinstates in-person dispensing requirements and incentivizes lawsuits against individuals who provide or facilitate access through other methods. The law will not take effect until July 1, but it comes during a time of national conversation and scrutiny about access to medication abortion and intense pressure from anti-abortion activists to curtail telehealth abortion care.
Texas Appeals in Case Challenging New York’s Shield Law:
Texas is continuing to pursue a judgment against New York shield provider Dr. Maggie Carpenter for allegedly prescribing medication abortion into Texas. Last October, a New York judge dismissed a claim against Ulster County Clerk Taylor Bruck for refusing to file the Texas state court judgment. The court found that Bruck’s conduct was proper in light of New York’s shield law for providers and patients involved in reproductive healthcare. Earlier this month, Texas appealed the October ruling, seeking to enforce its six-figure judgment against Dr. Carpenter, alleging that she acted in violation of the state’s total abortion ban. Bruck is standing by his actions, stating that “in rejecting the Texas filing, I was simply following the law of this State,” and that “the issues in this case . . . are legal in nature; I trust the courts to decide them.” This case is one of multiple pitting state abortion bans against protective shield laws.
Trend and Policy Watch:
Texas Attorney General Requires Texas Children’s Hospital to Open a “Detransition Clinic” as Part of Settlement:
Texas Attorney General Ken Paxton and the Department of Justice have entered into a settlement agreement with Texas Children’s Hospital (TCH) that requires TCH to pay the state $10 million, terminate and revoke medical privileges for five clinicians, and establish the nation’s first “detransition clinic.” This settlement agreement followed a three-year investigation, initiated by AG Paxton’s office, into allegations related to gender-affirming care for minors. During this time, TCH was forced to turn over millions of documents. It is not yet clear what services will be provided at the so-called “detransition clinic.” As the Texas Tribune reports, experts point out that - for the small percentage of individuals who choose to detransition - the resources already exist, and it is unlikely that a clinic created out of a legal battle initiated by a viciously anti-trans politician will have the best intentions of the transgender community at heart. TCH maintains that “all reviews and investigations continue to support” that it has “been compliant with all laws;” the hospital clarified that it is “settling to protect [its] resources from endless and costly litigation,” and that it remains committed to putting its “purpose over politics.”
Research from the National Abortion Federation Shows that Violence Against Providers and Clinics is On the Rise:
Research published in the National Abortion Federation’s 2025 Violence and Disruption Report found that violence and threats against abortion clinics and providers significantly increased between 2024 and 2025. The Trump Administration has severely curtailed enforcement of the FACE act, the federal law seeking to prohibit interference with access to reproductive health clinics. The current DOJ has indicated that it won’t enforce the FACE act, except in extraordinary circumstances, and it has disparaged previous FACE Act enforcement as political weaponization. Trump has also pardoned 23 individuals convicted of FACE Act violations. The administration’s clear message that it does not take threats of anti-abortion violence seriously has clear consequences. As reported by NAF, death threats and stalking incidents against abortion providers more than doubled between 2024 and 2025, and clinic blockades rose from 1 in 2024 to 6 in 2025. Assault and battery, arson, vandalism, and theft also increased.
NAF has joined other organizations in a lawsuit challenging the Trump Administration's recently created $1.776 billion “Anti-Weaponization Fund” on the grounds that it incentivizes and facilitates continued violence against NAF members and their affiliates.
Missouri Aims to Make Citizen-Led Ballot Initiatives More Difficult to Pass:
Missouri lawmakers are attempting to make it more difficult for voters to successfully utilize the ballot initiative process. In recent years, Missourians have successfully used the process to legalize marijuana, raise the minimum wage, and reinstate abortion rights. Frustrated by these victories, Governor Mike Kehoe has placed an amendment aimed at making direct democracy more difficult on the August ballot. If passed, Amendment 4 would raise the threshold for passing a citizen-led ballot measure from a simple statewide majority to a majority in every congressional district, allowing a single district veto power. The placement of Amendment 4 on the August ballot, rather than the November ballot has also raised questions. The August ballot draws a traditionally more conservative electorate, and the top races on this August ballot are for competitive Republican primaries. Notably, Amendment 4 would only apply its more stringent passage standard to citizen-initiated measures - it would require constitutional amendments proposed by lawmakers to only receive a simple majority.
Planned Parenthood Great Northwest to Begin Providing ‘Just in Case’ Abortion Pills to Patients in Hawaii and Washington State:
Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky (PPGNHAIK) has announced that it will start offering advance provision of abortion pills to people over the age of 18 in Hawaii and Washington. The new service - called Just In Case Abortion Pills - will allow people to obtain pills before they become pregnant, giving them increased options and access. Although other organizations and providers follow a similar model and allow for advance orders of medication abortion, having a provider as established as Planned Parenthood choose to do so sends an important message about the safety of self-managing abortion and the importance of being prepared for a future where medication abortion access may be limited. According to Planned Parenthood, “medications come with clear instructions, and PPGNHAIK clinicians are available by phone every day to answer questions before and after use.