A sprawling network of antiabortion activists, judges and dark money groups is working in lockstep to erode access to abortion pills—and mifepristone is their top target.

It’s been three years since the MAGA contingent of the U.S. Supreme Court reversed Roe v. Wade, overturning federal abortion protections. Shortly after, antiabortion groups, law firms, judges and politicians shifted gears, expanding their focus on state-level efforts to ban abortion, along with a multi-layered and relentless national assault on mifepristone—one of two drugs used in medication abortions. 

Medication abortion has become the most popular form of abortion in the U.S. post-Dobbs, providing potentially lifesaving access to women residing in states with abortion bans in place. Because of this, the antiabortion right-wing machine’s dogged attacks on mifepristone should be seen for what they are—an attempt at a backdoor national abortion ban. 

It may have taken the antiabortion machine nearly 50 years to overturn Roe, but that network has since redoubled its efforts and has tallied up additional wins under a second Trump presidency. As such, the future of mifepristone access is uncertain as ever. 

Three years post-Dobbs, the majority of Americans who support reproductive justice deserve to know where this threat to their rights is coming from and how dire it is to ensure the antiabortion machine’s attacks against mifepristone don’t culminate in another Dobbs-level victory. 

2022-2023: The Antiabortion Machine’s Early Attacks Against Mifepristone

At the end of 2022, a newly formed antiabortion front group called the Alliance for Hippocratic Medicine (AHM) filed a lawsuit against the FDA and the Biden administration’s Department of Health and Human Services (HHS) challenging the FDA’s initial approval of mifepristone. AHM is composed of five antiabortion groups, including the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), a Project 2025 advisory board member notorious for peddling reproductive disinformation. AHM has ties to Leonard Leo—the antiabortion powerbroker and judicial kingmaker who engineered the MAGA faction of the Supreme Court which overturned Roe.

AHM was incorporated in Amarillo, Texas, even though the organization has a Tennessee mailing address and none of its member organizations are based in Texas. This was by design. Incorporating and filing in Amarillo, Texas, guaranteed the group would appear before the only judge assigned there, Matthew Kacsmaryk, a controversial Trump-appointed judge who failed to disclose his most recent antiabortion zealotry prior to his confirmation. Kacsmaryk overturned the FDA’s decision on the safety of mifepristone, relying heavily on two studies from researchers affiliated with the antiabortion groups Charlotte Lozier Institute (an arm of Susan B. Anthony Pro-Life America) and AAPLOG. These pseudo-studies were later retracted for their lack of “scientific rigor” and failure to disclose any conflicts of interest.

Alliance Defending Freedom (ADF), the Southern Poverty Law Center-designated hate group that orchestrated the legal strategy to challenge and successfully overturn Roe and represented the plaintiff in Alliance for Hippocratic Medicine v. FDA. More specifically, ADF’s Erin Hawley, who is married to far-right U.S. Sen. Josh Hawley (R-Mo.), coordinated the Dobbs case for ADF and helped litigate the case at every turn, including when the case made it before the Supreme Court in March 2024.

Students for Life of America (SFLA), where Leonard Leo was co-chairman in 2023, also bolstered the legal fight against the abortion pill by attempting to shape public opinion. SFLA’s tactics included polling and disinformation campaigns.

For example, these campaigns featured a docuseries attacking the medication in collaboration with ADF and APPLOG, plus a scientifically unfounded campaign that mifepristone was contaminating drinking water. The latter served as a springboard for SFLA-crafted legislation that has been introduced in multiple states, seeking to further erode access to the medication.

Texas legislators recently introduced a version of the bill baselessly arguing that birth control is also contaminating ground water.

Despite asserting that abortion medicine is affecting water, these campaigns are silent on Viagra and other pharmaceutical residues being flushed down toilets and into municipal water purification systems. Incidentally, SFLA’s head, Kristan Hawkins, also wants access to birth control pills and other birth control devices to be illegal.

2024: Attacks on Mifepristone Make It to the Supreme Court, States Get Involved, and Project 2025

The U.S. Supreme Court added Alliance for Hippocratic Medicine v. FDA to its 2023-2024 docket, after Kascmaryk ordered the medication off the market and the Fifth Circuit on appeal reversed this ruling in part. The Roberts Court heard the case in March of 2024, ultimately ruling against the plaintiffs, not because mifepristone is safe (safer than Tylenol, Viagra and penicillin) but instead on the grounds that AHM lacked standing.

The Court’s arguably most corrupt justices—Thomas and Alito—dissented. In their dissent, Thomas and Alito suggested that the Comstock Act, a discredited 1873 law that initially targeted access to contraception, abortion information and pornography, could be used to keep abortion pills from being mailed to patients. Antiabortion groups have called for the enforcement of the Comstock Act to prohibit the mailing of abortion medication. If enforced, the law could be used to derail access to abortion medication and other reproductive health supplies nationwide.

In an anticipatory move, in January 2024, two months before the Supreme Court was set to hear the case, antiabortion attorneys general from Missouri, Idaho and Kansas sought to intervene in the case should the Court determine AHM lacked standing—as critics observed that AHM obviously had insufficient grounds. AHM’s claim of abortion medication causing harm was the possibility of a small fraction of doctors possibly needing to perform a surgical abortion if a patient took mifepristone and the medication failed to terminate the pregnancy. The states filed with Judge Kacsmaryk in January and amended their complaint in October 2024, breathing life back into the case, which could again reach the far-right supermajority on the Supreme Court that Leo’s antiabortion network helped install. 

The suit seeks to roll back access to mifepristone by requiring in-person prescriptions, reducing access from 10 weeks gestation to seven (before many know they are pregnant) and banning access for young people. The almost 200-page complaint was co-authored by Missouri Solicitor General Josh Divine. Divine was recently nominated by Trump as a federal judge, but during his confirmation, the committee did little to interrogate his antiabortion extremism, which is on display in the complaint he helped co-author. For example:

• The complaint falsely claims that mifepristone “starves the baby to death” in the womb, when really the pill blocks progesterone, a pregnancy-sustaining hormone. 
• The authors invoked the antiquated Comstock Act of 1873 to falsely argue that the FDA “unlawfully removed its prohibition against mailing abortion drugs.”  
• The complaint focuses on banning access to mifepristone for anyone under 18, despite the pervasiveness of sexual assault of minors. And while this argument is made under the guise of concern for girls and their “developing reproductive systems,” the authors fail to acknowledge the considerable adverse risks of pregnancy in minors. 
• Some of the “scientific evidence” that Divine and others used comes from Charlotte Lozier Institute staffers James Studnicki and Tessa Longbons—the same “researchers” who had their 2021 and 2022 mifepristone studies retracted due to a lack of scientific rigor, problematic methodology and undisclosed bias.
• The complaint also details “reporting requirements” around mifepristone, at one point suggesting the FDA could require what are called “Elements to Assure Safe Use (ETSU)” rules. Among the ones they specify are that “each patient be subject to ‘certain monitoring’” and “each patient be enrolled in a ‘registry.’” These intrusive demands fit in with the abortion surveillance pushed in Project 2025.

Roger Severino, who served as the director of the Office of Civil Rights within the Department of Health and Human Services during Trump’s first administration, wrote the Project 2025 chapter on HHS’ radical transformation under Trump 2.0, including his vision for the FDA withdrawing approval for mifepristone and for the Department of Justice (DOJ) initiating prosecutions under the Comstock Act.

Severino formerly worked for the Leo-tied Ethics and Public Policy Center (EPPC)—the group that released a pseudo-study that served as a catalyst for the ramped up attacks against the abortion pill in 2025. His spouse is Carrie Severino, a long-time leader in groups at the forefront of Leo’s campaign to capture the Supreme Court, namely the group called the Judicial Crisis Network, which now goes by the alias JCN.

2025: Attacks Against Mifepristone Ramp Up 

In May 2025, the Trump administration’s DOJ asked a federal judge to dismiss the lawsuit challenging the FDA’s regulation of the abortion medication mifepristone. What on the surface might seem like a move in support of abortion access is more likely part of a legal strategy aimed at eliminating FDA approval of the medicine nationwide through executive fiat. 

Just one week before the DOJ filed that request, Trump’s new FDA chief Marty Makary said he’d consider restricting abortion pill access if “new data” showed it was dangerous. As if this were orchestrated, a few days later, antiabortion groups released a pseudo-study riddled with junk science. That new report was produced by the Ethics and Public Policy Center (EPPC), an antiabortion group that Leo helps steer. An additional pseudo-scientific study utilizing the same (secret) data set was issued by another antiabortion group called the Foundation for the Restoration of America, which is tied to Dick Uihlein, an antiabortion billionaire whose non-profit vehicles are the primary funder of “Women Speak Out,” an arm of Susan B. Anthony Pro-Life America. 

Reporting by Politico documented this as part of a coordinated effort by the nation’s most influential antiabortion groups to attack mifepristone. SBA-PLA, EPPC, Americans United for Life, Students for Life and Live Action discussed on Zoom how they could leverage those documents to compel potentially sympathetic members in the Trump administration and Congress to eliminate access to the abortion pill. 

Sen. Josh Hawley (R-Mo.), a staunch antiabortionist and Josh Divine’s former boss, used the EPPC report as the basis for introducing legislation that could help further eliminate abortion access for Americans, whether they live in an antiabortion state or not. He also used the paper to successfully obtain public commitments from Trump’s administration, including leveraging the junk science to get RFK Jr., head of HHS, to consider limiting mifepristone access. RFK Jr. has since ordered a review of the drug, even though it has been around since the 1980s, was approved by the FDA in 2000 and has been the subject of over 100 scientific studies. 

… likely part of a legal strategy aimed at eliminating FDA approval of the medicine nationwide through executive fiat.

In mid-February, a new antiabortion coalition calling itself the Life Leadership Conference (LLC) was infused with $30 million through its “Pro-Life Venture Fund.” The network of Leonard Leo is financially backing this new venture. The spokesperson for the Conference, long-time antiabortionist David Bereit, said the $30 million is meant to “incentivize” antiabortion groups to “work together” to produce results. Following the announcement of this “conference,” we have seen antiabortion groups come together in messaging and focusing on efforts around Trump’s IVF executive order plus the administration’s efforts to defund Planned Parenthood. This is a joint effort to lift up this paper to try and attain their ultimate goal of eliminating access to mifepristone. 

The legal future of abortion pills remains uncertain, but what is clear is that revoking access to mifepristone is key in the antiabortion machine’s fight to maintain control over pregnant Americans’ bodies and lives. As abortion opponents have gained and wielded their power, created right wing echo-chambers filled with disinformation, and supported policies that have resulted in cruel and devastating outcomes, access to mifepristone has become more than just a means of healthcare—it is a vital lifeline and crucial tool of resistance against efforts to limit our reproductive rights and control our future livelihoods.