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Washington state stockpiles thousands of abortion pills

Mifepristone is one of two pills used in medication abortions and is used in the vast majority of such abortions in the United State.
Allen G. Breed
Mifepristone is one of two pills used in medication abortions and is used in the vast majority of such abortions in the United State.

Updated April 4, 2023 at 5:13 PM ET

Washington state officials have stocked up on a key abortion drug in preparation for the possibility that it could become much more difficult to access nationwide, pending the outcome of a federal lawsuitbrought by anti-abortion-rights groups.

Gov. Jay Inslee, a Democrat, says he ordered the Washington Department of Corrections to use its pharmacy license to buy 30,000 doses of mifepristone, an estimated three-year supply for patients in Washington state. The pills were received on March 31.

Inslee says the University of Washington has obtained an additional 10,000 doses, or about enough for a fourth year.

Noting that Washington is the first state to take such an action, Inslee called the purchase "an insurance policy" in case the drug becomes unavailable.

Inslee's office says about 800 abortions per month, or 60% of abortions in the state, take place using pills. State officials say they anticipate increasing demand for abortion pills as a result of restrictions that have taken effect in other states in response to last summer's Dobbs v. Jackson Women's Health Organization Supreme Court decision.

In a lawsuit filed in federal court in Texas last year, a coalition of anti-abortion health care providers and medical groups asks a judge to overturn the Food and Drug Administration's approval of mifepristone and remove it from the market. Mifepristone was first approved in 2000 for use in combination with another medication, misoprostol, to induce some first-trimester abortions. It's also used to treat miscarriages and for other gynecological purposes.

The federal judge in charge of the abortion pill case, Matthew Kacsmaryk, is expected to rule any day. Kacsmaryk was appointed by former President Donald Trump and has a history of issuing rulings favorable to conservative causes. In a hearing held in Amarillo on March 15, he asked several questions of lawyers on both sides of the case related to how, in practical terms, a nationwide injunction against mifepristone might be written.

"This Texas lawsuit is a clear and present danger to patients and providers all across the country. Washington will not sit by idly and risk the devastating consequences of inaction," Inslee said in a statement. "We are not afraid to take action to protect our rights. Washington is a pro-choice state and no Texas judge will order us otherwise."

Inslee said the state spent $42.50 per pill, at a total cost of $1,275,000 for 30,000 pills.

A lawyer representing the anti-abortion groups behind the mifepristone lawsuit criticized the purchase.

"Gov. Inslee could have used his state's resources to support pregnant mothers through childbirth and beyond," Erik Baptist, senior counsel with Alliance Defending Freedom, said in a statement.

A bill being introduced by Democratic state lawmakers in Washington would give the Department of Corrections the authority to dispense mifepristone to public and private health clinics in the state.

During a press conference on Tuesday announcing the effort, one of the bill's sponsors, State Sen. Karen Keiser, said she's concerned about the power of judges to make decisions affecting patients even in states where abortion remains legal.

"How these federal judges get to the point where they can rule for the nation is beyond me, but we can take creative solutions," Keiser said.

Nationwide, at least half of abortions are now done with medication as opposed to surgical procedures, according to the Guttmacher Institute, a research group that supports abortion rights. Mifepristone is used in the vast majority of medication abortions in the United States, according to data from Guttmacher.

Some abortion providers around the country say they're preparing to switch to an alternative medication abortion protocol, which relies on misoprostol alone. That regimen is not FDA-approved but is used widely around the world.

But the actions being taken in Washington could help preserve some access — at least for patients living in or visiting that state — to mifepristone. Medical experts say that protocol for medication abortion is considered the gold standard, because it's more predictable and often less painful for patients.

A competing federal lawsuit filed by a dozen Democratic attorneys general, including Washington's Bob Ferguson, seeks to remove some restrictions on the drug and to prevent the FDA from removing it from the market.

Ferguson told reporters on Tuesday that he sees his lawsuit as "the opposite of what's going on in Texas," and that he filed it because he believes "anti-abortion activists...will stop at nothing until they have removed every last vestige of reproductive freedom for Americans across the country, including individuals who live in states where abortion is safe and legal."

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Sarah McCammon
Sarah McCammon is a National Correspondent covering the Mid-Atlantic and Southeast for NPR. Her work focuses on political, social and cultural divides in America, including abortion and reproductive rights, and the intersections of politics and religion. She's also a frequent guest host for NPR news magazines, podcasts and special coverage.