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    U.S. judge in Texas will soon rule on the abortion pill mifepristone. Here’s what could happen

    The Alliance For Hippocratic Medicine wants Judge Kacsmaryk to nullify the FDA’s medical approval of mifepristone, which would effectively ban the abortion pill across the US.

    Senate Judiciary Committee | YouTube

    A Texas judge will soon issue a pivotal ruling in a closely watched case challenging the Food and Drug Administration’s approval of the abortion pill mifepristone.

    The lawsuit filed by a group of doctors who oppose abortion, called the Alliance for Hippocratic Medicine, is an unprecedented case, and Judge Matthew Kacsmaryk of the U.S. Northern District of Texas could rule in a number of different ways.

    He could order the FDA to pull mifepristone from the U.S. market entirely. It’s also possible that Kacsmaryk could order the agency to impose tighter restrictions on access to mifepristone but stop short of completely halting sales. The judge could also rule in the FDA’s favor, but the anti-abortion groups would appeal.

    Kacsmaryk told the attorneys involved in the case during oral arguments in Amarillo on Wednesday that he will issue his decision “as soon as possible.”

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    Abortion rights groups and legal experts expect the judge will rule against the FDA in some form. Kacsmaryk joined the court in 2019 after he was appointed by former President Donald Trump. His nomination was unanimously opposed by Senate Democrats as well Republican Susan Collins of Maine over concerns about his views on abortion and LGBTQ rights.

    Wendy Davis, senior advisor at Planned Parenthood Texas Votes, told reporters at a news conference Wednesday that abortion rights activists are preparing for the worst.

    A court order that blocks sales of mifepristone would have the greatest impact in states where abortion remains legal, said Carrie Flaxman, who heads litigation at the Planned Parenthood Federation of America.

    Rachel Rebouche, an expert on reproductive health law at Temple University, said an order blocking sales would create confusion because there will be further litigation over whether such an order is legal.

    Possible injunction

    If Kacsmaryk issues an order to withdraw mifepristone from the market, there are several ways such a ruling could be drafted. The impact of his decision will depend on the language of the order and how the FDA chooses to respond.

    “There are a lot of ways the court could effectuate a decision in our favor,” said Erik Baptist, who is representing the Alliance for Hippocratic Medicine in the case and is the senior counsel at the Alliance Defending Freedom, another anti-abortion group.

    Baptist told reporters during a news conference Thursday the judge could overturn the FDA’s approval immediately or he could order the agency to initiate a process to pull mifepristone from the U.S. market.

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    “But how the court effectuates in terms of timing – does it go into effect immediately, does it go into effect in 30 days, again that’s within the court’s discretion,” Baptist said.

    Rebouche said it’s possible the judge issues a ruling that orders the FDA to start the process of withdrawing mifepristone while at the same time suspending the drug from the market as the agency conducts that process.

    Swift appeal

    FDA could drag out the process

    Mifepristone off-label

    Tougher restrictions

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