Developments in Abortion, Autonomy, and Access:
As we near the close of 2025 and publish our final Digest of the year, I want to open with a sincere thank you. This has been a challenging year for everyone in our community, and your presence here and engagement with these critical issues matters. This space exists because of a shared belief in the importance of bodily autonomy, reproductive freedom, and equity and dignity for all people, and I am so grateful for the community that we have built. Thank you for sticking with us this year, and we look forward to continuing this work in 2026.
This week’s Digest discusses the new lawsuit brought by Texas and Florida challenging access to mifepristone, an update in the Trump Administration’s efforts to defund Planned Parenthood, new details about the ongoing attacks against the transgender community, ballot initiative news, and more. As always, please read on to the end for 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 Ms. Magazine and outlines the 2026 policy priorities that the Heritage Foundation – the group behind Project 2025 – released to the public this week. As Ms. Magazine reports, the new document “picks up where Project 2025 left off: banning abortion pills, weaponizing the 150-year old Comstock Act to criminalize medication by mail, embedding fetal personhood across federal agencies, and stripping every federal safeguard protecting reproductive freedom.” The Heritage Foundation has already been exceedingly successful in implementing its Project 2025 agenda, but many conservatives have been frustrated with what they perceive as a lack of effort to restrict abortion on the Trump Administration’s part. Going into 2026, it is critical that we are prepared for attacks on all aspects of reproductive freedom and autonomy to escalate.
Legislation & Litigation:
Overview:
Texas and Florida have filed a new lawsuit in the Northern District of Texas challenging the FDA’s approval of mifepristone and two subsequent generic versions and the FDA’s relaxation of certain regulations for the medication’s use, including removing in-person dispensing requirements;
A federal appeals court has sided with the Trump Administration in its ongoing efforts to defund Planned Parenthood, placing over a million Americans access to healthcare at risk;
Texas Attorney General Ken Paxton has expanded his lawsuits against Texas clinicians who he alleges violated the state’s ban on gender-affirming care for minors; and
A Missouri appeals court rewrote ballot measure language for an initiative that will go before voters next year, finding that the state’s proposed language failed to inform voters of the fact that the new initiative would put a total abortion ban back in place.
Texas and Florida File a New Lawsuit Challenging Mifepristone Access:
Florida and Texas have filed a new lawsuit in the Northern District of Texas seeking to restrict access to medication abortion. The suit challenges 1) the FDA’s original approval of mifepristone in 2000 (a claim that the Fifth Circuit has previously found to be untimely); 2) changes made in 2016 to relax mifepristone’s regulations for use; 3) the removal of in-person dispensing requirements; and 4) the FDA’s approval of generic versions of mifepristone in 2019 and 2025.
The case closely mirrors and expands upon the Alliance for Hippocratic Medicine v. FDA case that the Supreme Court dismissed for lack of standing in 2024. Following the Supreme Court’s dismissal, Missouri, Kansas and Idaho intervened in that case, and Texas and Florida attempted to do so as well. However, the case was transferred to Missouri, and Florida and Texas’s request was found to be moot. The new case is the latest in a series of aggressive attacks on access to medication abortion, including a campaign to discredit the drug’s safety record, attempts to link it to water safety issues, and calls by anti-abortion groups for FDA Commissioner Marty Makary to be fired for failing to take swift action to limit access to the drug.
Appeals Court Sides with Trump Administration in Attempt to Defund Planned Parenthood:
The First Circuit Court of Appeals has issued a ruling allowing the Trump Administration to move forward in its attempt to defund Planned Parenthood. The court found that the challenged provision does not constitute an unconstitutional bill of attainder and overturned a district court injunction temporarily blocking it. A separate lawsuit brought by 22 states and D.C. is ongoing in the district court, and the defund provision is currently blocked for those states. If the law takes full effect, entities that provide abortions and received more than $800,000 in Medicaid funds in 2023 will be stripped of Medicaid funding for a year.
Although certain states may attempt to use state funds to mitigate the harm and keep clinics open, the reality is that this is not sustainable and Americans will lose critical access to services like cancer screenings, pregnancy testing, contraception, prenatal care, and STI testing. As we have reported on before, despite the fact that federal funds are already prohibited from paying for abortion care, ‘defunding’ Planned Parenthood has long been a key part of the anti-abortion right’s strategy. Already in 2025, nearly 50 Planned Parenthood clinics have closed their doors as a result of losing Medicaid and Title X funding, and 1.1 million Planned Parenthood patients are on the brink of losing basic healthcare.
Texas Attorney General Continues to Pursue Healthcare Providers:
Texas Attorney General Ken Paxton is continuing to aggressively target gender-affirming care in the state, announcing on December 10 that his office has expanded its lawsuits against two physicians who he claims unlawfully provided care to minors after the state banned it. Initial suits were brought against the providers in October and November; however, he now claims that “[n]ew evidence gathered by the Office of the Attorney General shows that there were deliberate efforts to conceal illegal activity by falsifying records, altering diagnosis codes, and submitting deceptive billing information.” He described the defendants’ alleged conduct as “evil” and “cruel child abuse.” According to the Texas Newsroom, an attorney for one of the doctors said that Paxton’s allegations were “false in every material aspect,” and that she “did not force any treatment on any of her patients and her care complied with Texas and federal law in every respect.” Notably, Paxton’s office brought a similar lawsuit against another provider last year and ultimately dropped the case after finding no evidence of wrongdoing.
Missouri Appeals Court Rejects Biased Ballot Initiative Language
Missouri is continuing its battle to overturn a citizen-passed constitutional amendment protecting pre-viability abortion rights and reinstate a total abortion ban. Earlier this month, a Missouri appeals court found that the state’s proposed ballot language and summary statement failed to adequately inform voters of the impact of the proposed abortion ban amendment. The now-rejected language stated that the proposed amendment would “Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest.” It failed to directly inform voters that it would reinstate a near-total abortion ban and constitutionally enshrine a ban on gender-affirming care for minors. The state may appeal to the Missouri Supreme Court. The Appeals Court’s revised language now asks voters whether the Missouri Constitution should be amended to:
“Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability;
Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies;
Allow legislation regulating abortion;
Ensure parental consent for minors’ abortions;
Prohibit gender transition procedures for minors?”
Trend and Policy Watch:
Telehealth Abortions are on the Rise:
Post-Dobbs, telehealth abortion has taken on new significance, as pregnant people in ban states struggle to access care and rely on telemedicine services. New data from the Society of Family Planning shows that telehealth abortion has increased substantially – from 5% in 2022 to 27% in 2025, with more than half of those abortions provided through shield laws. The rise in telehealth abortion and the access that it allows people is exactly why anti-abortion activists are aggressively pushing to limit medication abortion access through every available avenue, including prolific litigation challenging mifepristone’s availability and the recent calls for the firing of FDA Commissioner Marty Makary, as discussed above. In 2026, it is critical that states do everything in their power to continue to protect and expand access to telehealth and medication abortion. Without it, countless people in states where abortion is banned or severely limited will be left with no viable options for care.
South Dakota Issues Cease and Desist Against Telehealth Provider:
South Dakota is also working to restrict access to information about abortion pills and telehealth. Last week, the state’s Attorney General issued a cease and desist to Mayday Health, a nonprofit that assists with the provision of contraception and abortion medications. Mayday had launched a campaign placing advertisements that read “Pregnant? Don’t want to be?” at gas stations around the state. In response, the state is threatening a lawsuit under consumer protection laws. Mayday provided the South Dakota Searchlight with the following statement: “Mayday Health spreads awareness that abortion pills are safe, effective, and have been FDA approved for over 20 years…[t]his is First-Amendment protected free speech. Mayday is an education nonprofit. We don’t sell abortion pills, we just believe people should know their options.”
Missourians Still Struggle to Access Care, Despite Passing Constitutional Protections:
Despite having passed a citizen-led ballot measure last year legalizing pre-viability abortion, Missourians are still struggling to access care. Reportedly, between January and October, only 80 procedures were performed in clinics across the state, with another 79 abortions performed in hospitals as a result of medical emergencies. Following the passage of the abortion rights amendment, the state began the process of aggressively defending remaining abortion restrictions, including a restriction on telehealth. Those battles are continuing to play out in court. Compounding challenges to access is the fact that Planned Parenthood is currently the only operating abortion provider in the state as a result of Missouri’s long track record of instituting anti-abortion policies. As discussed above, the state is now attempting to nullify abortion rights altogether once again by putting an anti-abortion ballot measure before voters in 2026.
IVF Coverage for Military Members Remains Limited:
On Wednesday, the Senate passed the 2026 National Defense Authorization Act (NDAA), which provides for $900 Billion in defense spending. IVF coverage for service members was a subject of significant debate throughout the process, with Speaker Mike Johnson reportedly working to remove coverage from the bill due to his opposition to abortion. At present, TRICARE - the military healthcare program – only covers IVF in instances where infertility was caused by an active duty injury or illness. A bipartisan provision would have expanded TRICARE’s coverage to all enrollees; however, that expansion failed to make it to the finish line, despite President Trump’s campaign promises to expand access to IVF. The bill now goes to the President’s desk for his signature.
Anti-Abortion Lawmaker Josh Hawley Starts New Dark-Money Group:
Missouri Senator Josh Hawley and his wife Erin Hawley, an attorney who argued in favor of restricting access to mifepristone at the Supreme Court, have launched a new ‘dark money’ group to fund anti-abortion campaigns, advertising, and candidates. According to reports, the group, called “Love Life Initiative” will focus both on opposing abortion and promoting families. Senator Hawley is ardently anti-abortion and has been a vocal member of the coalition calling for the FDA to review mifepristone’s safety record. Hawley’s creation of the new organization has stirred up disagreements in the Trump Administration, which has appeared reluctant to make abortion a key agenda item in the President’s second term.