Blue states are buying up abortion medication amid legal uncertainty

SACRAMENTO, Calif. — California and other blue states are rushing to stockpile abortion medication amid uncertainty at the federal level about the status of the drugs.

Gov. Gavin Newsom said Monday that California had secured 250,000 misoprostol pills and negotiated the purchase of up to 2 million — the latest move by a state that has repeatedly tried to shore up abortion access in the face of restrictive laws elsewhere. The announcement follows a Texas judge's decision to invalidate the Food and Drug Administration’s approval for mifepristone, another medication commonly used in the procedure.

“We will not cave to extremists who are trying to outlaw these critical abortion services,” the Democratic governor said in a statement. “Medication abortion remains legal in California.”

California contracted with ANI Pharmaceuticals through the state's drug affordability initiative to pay a little over $100,000 for the first 250,000 doses on hand, with an option to purchase more at the same price of around 43 cents per pill, according to Deputy Legal Affairs Secretary Julia Spiegel. Pharmacies who cannot find the drug on their own can request some from the state's supply.

The details have been shared with other states who may want to take advantage of the same deal. "We wanted to be very mindful about not creating any kind of run on the market or uncertainty in other states," Spiegel said.

Newsom is not the only Democratic governor buying abortion medication in bulk. Massachusetts Gov. Maura Healey also announced Monday that her state would be purchasing 15,000 doses of mifepristone through the state university system. Last week, Washington Gov. Jay Inslee announced his state had purchased 30,000 doses of mifepristone through the correctional system and 10,000 doses through the university system.

New York Gov. Kathy Hochul on Saturday told CNN she would push legislation that would require insurance companies to cover misoprostol. "We're trying to figure out all the different ways we can get ahead of this," she said.

Newsom and fellow Democrats have long proclaimed California to be a “reproductive freedom state,” launching a website to connect abortion seekers with services, appropriating money to help people with the costs of getting an abortion and teaming up with other states to secure abortion access.

Misoprostol works by causing contractions, so the uterus expels any products of conception and passes a pregnancy. It’s usually taken 24-48 hours after mifepristone, a drug that blocks the hormone progesterone and terminates a pregnancy.

Mifepristone was the subject of two federal court rulings on Friday that could complicate patients’ access. A judge in Texas ruled that the FDA’s 20-year-old approval of the drug should be blocked — a decision the Justice Department immediately vowed to appeal. Secretary of Health and Human Services Xavier Becerra said the Biden administration may simply ignore the decision. But on the same day, a federal judge in Washington ruled in a separate case against blocking mifepristone.

Misoprostol can also be used by itself to end a pregnancy, which could provide a backstop if mifepristone suddenly becomes unobtainable.

"Given the uncertainty and fear with the ongoing litigation and conflicting court opinions, it's hard enough for those in the weeds of it to follow what's happening," Speigel said. "We purchased this stockpile to ensure Californians know that they have ongoing access to medication abortion no matter what is happening in the courts."