Mar 16, 2023 - Podcasts

A momentous hearing on medication abortion

In Texas on Wednesday, U.S. District Judge Matthew Kacsmaryk said he would rule "as soon as possible" on whether to suspend the FDA's approval of mifepristone, one of two drugs involved in medication abortion.

  • Plus, the tech industry implodes and advances all at once.

Guests: Axios' Oriana González and Scott Rosenberg.

Credits: Axios Today is produced by Niala Boodhoo, Alexandra Botti, Naomi Shavin, Lydia McMullen-Laird, Fonda Mwangi and Ben O'Brien. Music is composed by Evan Viola. You can reach us at [email protected]. You can text questions, comments and story ideas to Niala as a text or voice memo to 202-918-4893.

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Transcript

NIALA: Good morning! Welcome to Axios Today!

It’s Thursday, March 16th.

I’m Niala Boodhoo.

Today on the show: the tech industry implodes and advances all at once. But first: a momentous hearing on medication abortion. That’s today’s One Big Thing.

A momentous hearing on medication abortion

NIALA: In Texas yesterday, U.S. District Judge Matthew Kacsmaryk seemed, through his line of questioning, to be open to overturning the FDA’s approval of Mifepristone, one of two drugs involved in medication abortion.

Axios’ Health Care Reporter Oriana González is covering this case, and has the latest on when we might hear a decision, and what that decision could mean for abortion access all over the country.

ORIANA GONZÁLEZ: Hi, Niala.

NIALA: First for our listeners who are unfamiliar, what do we need to know about these medications and how they work?

ORIANA: There is this misconception when talking about abortion pills that is just one drug that you take to self manage your own abortion, and that's just not true. There are two drugs involved, which are Mifepristone and Misoprostol, and there's a series of steps that a patient needs to take in order to self manage their own abortion. When it comes to this case in particular, though, they're only challenging Mifepristone, not Misoprostol. Mifepristone was approved by the FDA to be used alongside Misoprostol for terminating pregnancies.

NIALA: And what's the basis for that legal challenge?

ORIANA: So the Alliance of Hippocratic Medicine, which is a coalition of anti-abortion groups, filed a lawsuit in November, with a series of arguments, basically saying that the FDA did not properly approve Mifepristone, that it did not consider different safety measures and that it considered pregnancy to be a “disease” in order to be able to approve this drug. But I've spoken since with several lawyers that specialize in the FDA drug regulatory process, and some of them have frankly just said that they don't think that they have standing to be able to bring this lawsuit. Considering this drug was approved, Mifepristone was approved by the FDA 23 years ago in 2000. So it's been a very long period of time, and it's not common, it's not normal for challenges to be brought up this late into a drug’s approval.

NIALA: Abortion rights advocates have criticized the judge involved in this case. That's U.S. District Judge Matthew Kacsmaryk, who was appointed by former President Trump. What are those criticisms?

ORIANA: Kacsmaryk is known for his conservative use for ties that he's had with conservative groups, and something that abortion rights advocates have pointed to a lot is that he has openly opposed to Roe v. Wade. So in general, throughout his legal career, and most recently as a district judge, Kacsmaryk has issued a number of rulings that are conservative leaning.

NIALA: So practically speaking, what would the overturning of FDA approval for Mifepristone mean for abortion access across the U.S.

ORIANA: I can't say exactly what a ruling could look like, because it's unprecedented. This hasn't happened before. However, if the judge does order the FDA to suspend its approval of Mifepristone, then that would mean that distribution of Mifepristone has to stop nationwide. And that includes states like California, Michigan, uh, Vermont, uh, New York, et cetera. All of these states that guarantee abortion access, particularly since Roe v. Wade was overturned, Mifepristone would not even be available there. In general though, how exactly it would like and how exactly the FDA would need to move to withdraw its approval that's a little bit of an unknown because again, a judge has never done that before.

NIALA: So, Oriana, how are abortion clinics preparing for this ruling?

ORIANA: Some abortion providers are preparing to switch to only surgical abortions, and others are preparing to switch to what is commonly known as the, uh, Misoprostol only regimen, which is slightly less effective than the Mifepristone Misoprostol regimen, but can still be used and has been commonly used in other countries for years.

NIALA: So when do we expect the judge's ruling?

ORIANA: Kacsmaryk said yesterday that he wanted to issue a ruling and I quote “as soon as possible.” I wish I could give you a timeline for that, but at this point it could be at any minute, any hour, any day. We're, we're truly at his disposal right now.

NIALA: Regardless of what the decision is, is it safe to assume that this will be appealed, maybe even all the way to the Supreme Court?

ORIANA: Any decision in this case is likely to be appealed, and it's going to go first to the U.S. Fifth Circuit Court of Appeals, which is known for its conservative leanings. And then after that it has the potential of being appealed all the way to the Supreme Court. And so taking that into consideration, this could be, as it already is frankly, the biggest abortion case since the Dobbs decision last year.

NIALA: Oriana González covers healthcare for Axios. Thanks for being with us.

ORIANA: Thanks, Niala.

NIALA: After the break, tech’s moment of advancement and uncertainty.

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The tech industry implodes and advances all at once

NIALA: Welcome back to Axios Today! I’m Niala Boodhoo.

The tech industry right now looks something like a split screen. On one side: we have an industry that's struggling in the wake of the Silicon Valley Bank collapse, and that's staring down another massive round of layoffs this time at Meta.

But on the other side, technology itself is advancing fast, including the AI behind ChatGPT, which is a new and improved update. Axios’ Tech Managing Editor Scott Rosenberg is joining us now from Berkeley, California with the latest on what's going on in the tech industry.

Scott, let's start with the fallout from SVB. Where do things stand for the tech industry a few days out from that bank collapse and the government stepping in?

SCOTT ROSENBERG: I think there's a lot of, sort of unresolved business that the tech world will continue to process because the rescue came from the government. And the tech world has been telling us for really the last two decades that it was going to remove our needs to have a government be there for us. Tech would find ways to improve the financial system, improve local transportation systems, improve so many different parts of our lives, and so this crisis kind of left I think a lot of people, a little bit, reevaluating that whole line of argument.

NIALA: I think the other existential crisis is the constant drumbeat of layoffs in tech since last fall. Meta announced another round of 10,000 people being laid off this week. What does this tell you about the entire tech industry and workers right now?

SCOTT: The tech industry has always been this extremely cyclical entity and we had booms and busts for decades from the mid 20th century to the millennium. And then something extraordinary happened between the millennium and today, you did not have a bust. You simply had a boom and people got used to that and what is happening now is a little bit of reassertion of the reality of this cycle.

NIALA: So we have to talk about AI, and I feel like the technology itself is progressing so rapidly that headlines about generative AI seem more like a sci-fi movie than reality. How should we make sense of all the leaps and bounds that are happening in AI and it seems like it's happening within like weeks?

SCOTT: To most of us, it does feel like this is like an overnight, uh, revolution. To people in the industry who've been working on it for 15, 20 years, it's a little bit different. It's more of, uh, the culmination of a ton of research, a ton of technical work all suddenly, um, capturing the public's imagination. Because it really is kind of wildly, uh, new and strange, but also because the tech industry is really good at selling breakthroughs as vast fundamental world changing revolutionary breakthroughs.

NIALA: How do you square that with the reality of the industry right now?

SCOTT: Well, the industry's changes have always proceeded in this kind of, build in the ruins, mode. Uh, it reminds me most of 20 years ago, the dot com bubble happened. We all learned about the internet and the web and then all these companies died. And yet at that moment Google was starting. What we now think of as Web 2.0, blogging, um, the cloud, all these things that are the foundation of our world, tech world today were born then. So this, it feels like that kind of moment to me.

NIALA: Scott Rosenberg is Axios managing editor for technology. Thanks, Scott.

SCOTT: Thank you.

NIALA: That’s it for us today! You can always send us your feedback by emailing podcasts at axios dot com or you can text me. All the information is in our show notes.

I’m Niala Boodhoo - thanks for listening - stay safe and we’ll see you back here tomorrow morning.

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