Updated Mar 17, 2023 - Health

READ: Transcript from high-stakes hearing on abortion pills

Photo of Mifeprex pills laid out next to the brand's box

Mifepristone tablets. Photo: Stormi Greener/Star Tribune via Getty Images

Officials in Texas have released a transcript of this week's hearing in a major federal case that could limit access to abortion pills for millions of people across the country.

Why it matters: The legal challenge was brought by a coalition of anti-abortion groups that argued the FDA did not properly authorize the pill for terminating pregnancies — and a decision in their favor could reverse the agency's authority on drug regulation for the first time.

  • The groups are asking the judge to grant a preliminary injunction on the FDA's approval of mifepristone, used alongside misoprostol for medication abortion.
  • The FDA first approved mifepristone in 2000. Now, medication abortion accounts for the majority of abortions in the U.S., according to the Guttmacher Institute.

What happened: District Judge Matthew Kacsmaryk, a Trump appointee who openly opposed Roe v. Wade, asked attorneys in the case a series of questions about legal precedent and the drug approval process during the hearing Wednesday.

  • Kacsmaryk at one point asked Erik Baptist, one of the anti-abortion groups' attorneys, if he could name any other cases in which a court had intervened when a drug had already been on the market for several years.
  • Baptist responded that he could not, and proceeded to explain that his clients had been trying for years to challenge the approval through citizen petitions that they say the FDA did not respond to in time.
  • The judge also asked the defendants, represented by the Department of Justice, about the FDA's use of a specific process known as Subpart H to originally approve mifepristone, noting that it had typically been used for drugs that treat diseases such as cancer and HIV.

The big picture: While Wednesday’s court hearing was open to the public, attendance was limited. Fewer than 19 reporters and 19 members of the public were allowed in the courtroom, according to the Center for Reproductive Rights.

  • "We represent and advise clinics who provide abortion care to patients across the country, and who could be directly impacted by this lawsuit, yet we were not allowed entry to the hearing despite traveling to Amarillo at a moment’s notice and waiting in line for hours," said Elisabeth Smith, the Center's director of state advocacy.

Worth noting: Kacsmaryk had initially planned to delay telling the public about the hearing due to security concerns, per a previous court transcript.

  • After The Washington Post reported his plans and several news outlets demanded that the hearing schedule be made public, the judge announced the details on Monday evening.

What we’re watching: A decision to suspend the FDA’s authorization of mifepristone would make it unavailable nationwide, and would impact how health providers across the country offer abortion care.

  • Some abortion providers have already said they plan to switch to a misoprostol-only regimen for medication abortions, and others say they plan to solely focus clinical abortions.

State of play: Kacsmaryk said after the hearing that he would issue a ruling "as soon as possible."

Read the transcript in full.

Editor's note: This story has been updated with additional details from the transcript.

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