Congress and federal agencies turn attention to medication abortion

A series of recent federal actions is increasing scrutiny of medication abortion, a method now used in over half of all abortions in the United States.

In March, lawmakers introduced legislation to remove FDA approval of the abortion pill mifepristone, which would effectively ban its use nationwide. They also launched investigations into its manufacturers and are continuing a federal safety review that could change how the drug is prescribed and distributed.

None of these actions changes access right now. But taken together, they reflect a growing federal effort to challenge how medication abortion is regulated—one that could reshape access nationwide depending on how these efforts unfold.

Why It Matters

• If federal approval is revoked or restricted, access will change nationwide
  Medication abortion is currently available across the U.S. under FDA approval. Removing or altering that approval would directly limit how the medication can be prescribed, dispensed, or used in every state.
• People would face fewer options for abortion care
  Medication abortion is often the most accessible option, especially early in pregnancy. If access is restricted, some people would need to seek in-clinic procedures instead—requiring more time, travel, and coordination.
• Telehealth access could be eliminated
  Many people currently receive abortion pills through telehealth and mail delivery. Reinstating in-person requirements or restricting distribution would remove that option, particularly affecting people in rural areas or states with limited (or no) providers.
• Delays in care can have real consequences
  Barriers to timely access can push care later into pregnancy, limit available options, or make it harder for people to get care at all.

Background

Medication abortion typically involves a two-drug regimen, including mifepristone, and has been approved by the U.S. Food and Drug Administration for more than 25 years. It has been used by millions of patients and is supported as safe and effective by major medical organizations, including the American College of Obstetricians and Gynecologists.

Despite this long-standing approval and body of research, the medication has become a central focus of recent political, legal, and regulatory efforts.

In recent weeks, several federal actions have brought renewed attention to the medication:

• New legislation (S4066) introduced by Senator Josh Hawley and Representative Diana Harshbarger would revoke FDA approval of mifepristone, prohibit its use for abortion, and allow individuals to sue manufacturers.
• Congressional investigations, led by Josh Hawley and Bill Cassidy, are seeking records from abortion pill manufacturers related to safety, marketing, and adverse event reporting, with responses requested by April 24, 2026.
• An FDA review of mifepristone’s safety is ongoing but remains unresolved, with no clear timeline for completion or indication of what changes could result.

In the meantime, new state laws and related court challenges continue to shape how medication abortion is accessed, particularly through telehealth and mail distribution.

Resources

Center for Reproductive Rights - Threats to Abortion Pill Access in the United States
NPR - Over-the-counter medication abortion? These researchers say it would be safe
Families USA - The Battle Over Mifepristone Access in 2026