Developments in Abortion, Autonomy, and Access:
This week’s Digest discusses the federal government’s attempts to defund Planned Parenthood, the reinstatement of North Dakota’s abortion ban, continued attacks on access to medication abortion, rulings and policy decisions limiting the rights of trans people, some important flags for the 2026 elections, and more. We thank you for your patience while we took a break last week for the Thanksgiving holiday. We will publish one final 2025 Digest on December 18th, prior to our office’s winter closure, and we will back in the New Year with all of the news that you need to know.
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Reproductive Rights and Health Equity News:
This Week’s Must-Read:
This week’s must-read comes from ProPublica and details the story of 37-year old Tierra Walker – yet another Texas woman who has died as a result of being denied an abortion. When she became pregnant, Walker was dealing with multiple health conditions, including seizures, hypertension, and diabetes, that put her at an extremely high risk for severe pregnancy complications like preeclampsia. She inquired about whether it would be safe for her to continue her pregnancy, but she was repeatedly told that there was no emergency - the only circumstance under which abortion is legal in Texas. At 20-weeks pregnant, her teenage son found her lifeless in bed. She had died of preeclampsia. Had Walker been given the choice to decide what care was best for her, experts agree that she would be alive today.
Legislation & Litigation:
Overview:
A federal judge has once again ruled against the Trump Administration’s attempt to defund Planned Parenthood;
The North Dakota Supreme Court has ruled that the state can enforce its total abortion ban, reversing a lower court ruling blocking the law from taking effect.
The Supreme Court will allow the Trump Administration to enforce its new policy blocking people from changing their gender markers on their passports, even in cases where their gender markers have been legally changed on other documents;
The ACLU has filed a lawsuit seeking information about the scope of Congress’s reported review of the safety record of mifepristone, a common medication abortion drug;
A draconian South Carolina anti-abortion bill has hit a roadblock and is unlikely to pass; and
Three states have launched a challenge to the FDA’s recent approval of another generic version of mifepristone.
Federal Judge Rules Against Trump Administration’s Attempt to Defund Planned Parenthood:
The spending bill passed by Congress in July - known as the “One Big Beautiful Bill Act’ - included a provision that effectively defunded Planned Parenthood. As we have reported on previously, that provision was immediately subject to litigation and partially blocked by a federal judge on constitutional grounds.
This week, U.S. District Judge Indira Talwani once again ruled in favor of Planned Parenthood. In a lawsuit brought by 22 Democratic states, she found, among other deficiencies, that the provision attached conditions to state funding without providing clear notice of how and to whom those conditions apply. She also found that the plaintiff states could be irreparably harmed by the defund provision, as Planned Parenthood is a critical source of general healthcare in many states. The fight over Planned Parenthood’s funding is likely to be a lengthy one as multiple cases wind their way through federal courts.
North Dakota Abortion Ban Reinstated:
On November 21, the North Dakota Supreme Court issued a ruling allowing the state’s total abortion ban to take effect. Last year, a lower court had blocked the ban, finding that it was unconstitutionally vague. The State appealed that ruling. Although three of the five North Dakota Supreme Court justices agreed with the lower court that the ban is unconstitutional, North Dakota law requires a supermajority of four out of five justices in order to declare a law unconstitutional.
For the moment, the ruling does not functionally change access to abortion in the state, as the state’s only abortion clinic moved to Minnesota shortly after the Dobbs decision. However, it does not bode well for the future of reproductive rights in the state and will increase fear and uncertainty around when physicians are able to intervene to provide emergency terminations.
The Supreme Court Allows Anti-Trans Passport Policy to Take Effect:
The U.S. Supreme Court ruled in early November that the Trump Administration can enforce its discriminatory passport policy, which prohibits individuals from changing the gender marker on their passports. The policy stems from a January Executive Order that effectively denied trans existence by declaring that there are only two sexes and that they are unchangeable.
A Massachusetts federal court had previously blocked the policy, but the Supreme Court’s conservative majority overturned that order. Justices Kagan, Jackson, and Sotomayor dissented, with Justice Jackson calling out the Administration’s failure to explain how it can claim to face urgent harm when it intends to allow people whose gender markers have been changed to continue to use those documents until expiration. She described the Court’s actions as “an abdication of [its] duty to ensure that equitable standards apply equally to all litigants—to transgender people and the Government alike.” The new passport policy fails to plausibly justify itself or explain why the harm that it will cause to the dignity and privacy of Americans is somehow necessary for the wellbeing of the country. It will additionally create significant challenges for individuals who have already changed their gender markers on other legal documentation, like their drivers license and birth certificate.
The ACLU is Seeking Information About Congress’s Review of Mifepristone:
The ACLU has filed a Freedom of Information Act (FOIA) lawsuit seeking information about the FDA’s planned review of mifepristone, a medication commonly used for medication abortions. In August, the ACLU sent a FOIA request to the FDA seeking details about the scope of the intended review and communications that the agency has had with anti-abortion groups and lawmakers. The FDA failed to respond to that FOIA request. Of particular concern is the FDA’s seeming reliance on a widely criticized paper, publicized by an anti-abortion group that attempts to cast doubt on mifepristone’s well-established safety and efficacy record. This lawsuit follows on the heels of a similar case brought by the Center for Reproductive Rights. Although the case will likely take a while to yield any concrete outcomes, it will hopefully shed light on the current Administration’s decision making framework around abortion access.
Draconian South Carolina Anti-Abortion Bill Hits Roadblocks:
A South Carolina bill that would have outlawed nearly all abortion care has failed to advance in the state Senate. The bill, which the ACLU of South Carolina called “an egregious attack on our autonomy, privacy, speech, and safety,” would have removed exceptions for rape, incest, and fatal fetal anomalies, and punished pregnant people and anyone who helped them access abortion care with up to 30 years in prison.
The bill also appeared to ban any form of contraception that prevents a fertilized egg from implanting, which would have effectively prohibited intrauterine devices (IUDs) and could have limited access to in vitro fertilization. The proposal also included language that would have made it illegal for doctors to provide patients with information about abortion, which critics of the bill said raised significant First Amendment concerns.
After four of the six Republicans on the Senate subcommittee declined to vote on the bill, the three Democrats on the subcommittee were able to block the measure from advancing. Notably, one of the bill’s own sponsors abstained from the vote, citing his concerns about the bill penalizing mothers. Although the bill is not officially dead, it is unlikely to move forward and become law.
States Challenge FDA’s Approval of Generic Mifepristone:
A group of anti-abortion states have moved to challenge the federal government’s recent decision to approve another generic form of mifepristone. Idaho, Missouri, and Kansas have filed an amended complaint in the pre-existing case challenging the FDA’s RIsk Evaluation and Mitigation Strategies (REMS) for mifepristone.
The original lawsuit, formerly known as Alliance for Hippocratic Medicine vs. FDA, was filed in 2022 by anti-abortion doctors and organizations seeking to wholly undo the FDA’s approval of mifepristone. Following the Supreme Court’s dismissal of the case on standing grounds, the three states took up the charge, arguing that the FDA’s relaxation of conditions for mifepristone’s use was unlawful and posed a threat of harm to the states and their citizens.
The FDA has asserted that, because federal law requires approval of a generic version when it is identical to an already-approved drug, its approval of another generic version was merely a procedural matter. Medication abortion, which accounts for two thirds of all abortions in the U.S., has been under relentless attack since the Dobbs decision overturned Roe. States like Texas and Louisiana have passed laws to curtail and criminalize possession of mifepristone. Anti-abortion state lawmakers and leaders have urged Congress to reevalute mifepristone’s safety and launched multiple lawsuits challenging its approval. And, the federal government has indicated that it is reviewing mifepristone’s safety record.
Trend and Policy Watch:
Anti-Abortion Group to Invest $80 Million in 2026 Midterm:
In the runup to the 2026 midterm elections, anti-abortion groups are mobilizing to elect pro-life candidates. As reported by Politico, Susan B. Anthony Pro-Life America and its Super PAC have announced that they will invest $80 million into anti-abortion candidates in battleground states. Their multi-pronged campaign includes door-knocking, digital advertising, and extensive canvassing. This push comes after the Post-Roe success of pro-choice candidates and ballot measures highlights the salience of abortion access as an issue within the American electorate.
U.S. Bishops Vote to Ban Gender Affirming Care at Catholic Hospitals:
In another attack on access to healthcare, U.S. Catholic Bishops have voted to ban gender-affirming care at Catholic hospitals nationwide. Catholic hospitals have been expanding for years, and the Associated Press reports that more than one in seven patients treated in America every day are treated at Catholic hospitals. Although the Church had already made its stance on the issue of gender-affirming care clear, the new vote solidifies that policy at a time when both federal and state governments are taking aggressive actions to limit access to healthcare for trans people.
Wisconsin Introduces Bill that Would Require Miscarriage and Abortion ‘Catch-Kits’:
A group of Wisconsin Republicans has introduced the “Clean Water for All Life Act,” a bill that would require patients who use medication abortion drugs to be issued ‘catch kits’ to collect blood and tissue and return it to their provider for disposal. The Republicans leading the bill claim - without evidence - that it is a water safety issue and that endocrine disruptors from the medications pose a danger to public health. This echoes an argument championed by Students for Life. In addition to the obvious surveillance and privacy concerns created by this bill, it raises concerns about patients experiencing miscarriages, who often are prescribed the same medications targeted by the bill. The bill also singles out medication abortion for particular treatment while ignoring wholesale all other medications that individuals take on a daily basis that may enter the state’s wastewater.
Ballot Measure to Overturn Idaho Abortion Ban Makes Progress:
We have reported in the past on the overwhelming success of citizen-led ballot initiatives for constitutionally protecting reproductive rights at the state level. Reproductive rights have gone before voters in 16 states since the Dobbs decision, and they have succeeded in 13 of those instances. Voters in several states, including Idaho, are now gearing up for the 2026 elections. The group spearheading the efforts reports that it has amassed more than 50,000 of the 71,000 signatures needed to qualify for the ballot. If passed, the measure would override one of the strictest abortion bans in the country and enshrine pre-viability abortion rights into the state constitution.
Research Shows How Texas Abortion Ban Adversely Impacted Minors:
New research from the American Journal of Public Health shows how Texas’s abortion bans have disproportionately impacted minors. As summarized by KUT News, researchers compared statistics from the two-year period after Texas enacted its initial 6-week abortion ban to the two years prior. They found that “facility-based abortions” received by minors decreased by almost 60%. Factoring in patients traveling out of state for care, minors overall received 26% fewer abortions than during the pre-ban time period. The stark impact is likely attributable to factors like minors’ access to a car or other transportation, financial resources, ability to miss school, and the logistical challenges of making an out-of-state medical appointment. Every state bordering Texas, with the exception of New Mexico, is now enforcing a total abortion ban, compounding barriers to care.