In the ancient days of 2022, when the Supreme Court sledgehammered abortion rights with the Dobbs decision, the (Republican) party line was that the issue had returned to where it belonged: the states. |
Fast forward to 2026 and it would now seem that the antiabortion crowd, faced with the aggressive pro-choice response of states such as California and lethargy on the part of the Trump administration to do more toward implementing a national ban, is no longer satisfied with that outcome. |
They are now out to stomp on California, and a handful of other reproductive health sanctuaries, to ensure that what happens inside our borders fits their ideology. |
“It’s strategic, it’s targeted,” Mini Timmaraju, president and chief executive of Reproductive Freedom for All, told me. “Even if you’re in a ‘blue state,’ you’re not safe.” |
The U.S. Supreme Court will decide next week whether to take up the abortion issue again, in a case that could end medication-only procedures as we know them. |
That would force women into a less-safe regimen with a lower success rate that would almost certainly lead to more complications — and therefore more controversy. Even in California, which would not be spared by what the court could do, and whose policies are central to the case. |
Let’s break it down. |
Rogue California |
After the Dobbs decision, 11 states passed near-total bans on abortions. |
Six other states put early time limits on the procedures, and others passed bans in the second trimester, leaving women in much of the South and the Great Plains with no access to in-person care for hundreds or even thousands of miles. |
In many of those places, those bans include making it illegal to receive abortion-inducing medications in the mail from states such as California. But that’s a hard law to enforce unless you go around opening lady-mail. |
In recent years, the number of U.S. abortions arranged through telehealth and mailed medication has skyrocketed to more than a quarter of all procedures, though the often illegal nature of this route probably means the number is higher but underreported. |
To protect the doctors and providers who are prescribing and sending these medications, California and other states have passed numerous laws to make it easier and safer — from allowing the prescriber to remain anonymous to shield laws that ensure those providers can’t be penalized or extradited to other states for prosecution, though some states are trying. |
Earlier this year, Louisiana (a state with a full ban) tried to extradite a California doctor with no luck. Gov. Gavin Newsom gleefully denied that request, promising to “never be complicit with Trump’s war on women.” |
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Rogue Louisiana |
In the Supreme Court case, Louisiana is thinking bigger — and expressing antiabortionists’ frustration with the Trump administration. The state is suing Trump’s Food and Drug Administration because it allows mifepristone, one of two medications used in abortions, to be prescribed via telehealth. |
“Patients and these states with bans and extreme restrictions have relied on providers in blue states, abortion access states, to really help provide care,” Timmaraju said. “And this is a way to stop that.” |
Antiabortion groups had hoped (and pushed) Trump to simply have the FDA remove its approvals of mifepristone, but Trump ain’t that dumb. Despite all his promises on the campaign trail, the administration would prefer to kick the can instead of the hornet’s nest on this one, especially before the midterms — since most Americans support abortion rights. So the FDA has said it’s “studying” mifepristone, which could take awhile. |
Louisiana is claiming it had to spend $90,000 in taxpayer money to help two women who sought medical treatment after medication abortions (though it has not said they received the medication in the mail). |
That’s a real harm, it argues, and gives them standing to sue the FDA to stop mifepristone from being prescribed by telehealth at all, claiming the FDA hasn’t done its due diligence to ensure that’s safe and it makes them really sad that they can’t stop women from ordering it. |
The FDA has remained “completely silent on this point because the Trump administration doesn’t want to get involved,” said Mary Ziegler, a UC Davis law professor and expert on reproductive law. |
“It’s totally one of the signs that the antiabortion movement is in an open rebellion, and is using the federal courts to express that because the political branches have been pretty non-responsive,” she said. |
The Supreme Court lifted a stay Monday imposed by the 5th Circuit that stopped mifepristone from being tele-prescribed. So it’s available until at least May 11. |
After that, who knows. It’s up to a court that has proven it’s no friend to reproductive rights. |
It’s an issue with real consequence for Trump. If the court takes the case, the midterms must contend with abortion. If they don’t, the pressure on Trump to do so sometime intensifies. But its also an issue with real consequence for Californians. |
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Consequences in California |
In California, there are 22 counties without an abortion clinic, Ziegler points out. In the far north of the state, women without access to telehealth abortions would be little better off than those in Louisiana if mifepristone by mail is stopped. |
Instead, women would probably be forced to use the second medication, misoprostol, alone. This single-drug regimen has a lower effectiveness rate than the combined drugs, meaning more women will have to seek out secondary care — often in places where even in-person care is hard to come by. That could lead to more real harm, and therefore more high-profile cases of botched abortions to fuel a further ban on misoprostol. |
And then there’s the fact that Newsom won’t be governor for much longer, and it will be up to the next chief executive to protect in-state providers from extradition. The top Republican contender, Steve Hilton, has previously said he would allow Louisiana to grab our California doctor if he were in charge. |
Those kinds of threats have a chilling effect, both Ziegler and Timmaraju said. If enough providers are scared of the consequences of providing telehealth — or any — abortions, a ban becomes self-imposed. |
Even in California. |
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What else you should be reading |
The must-read: Immigration crackdown souring Orange County’s view of Trump, poll finds
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The L.A. Times Special: Who won the California governor debate on CNN? Here’s what our columnists say |
Stay Golden,
Anita Chabria |
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