Republican lawmakers call for FDA to review abortion pill restrictions at Senate hearing
The Senate’s health committee convened its first hearing of the year on the efficacy of the chemical abortion drug mifepristone, which requires a prescription, amid a growing push from conservatives to restrict abortion access across the country.
Mifepristone is an oral drug typically used in combination with another drug, misoprostol, to induce an abortion or to help manage an early miscarriage. In 2019, the Food and Drug Administration approved a generic version of the drug.
The two-hour committee hearing on Wednesday centered around measures to outlaw telehealth practices for women seeking abortions. Republican lawmakers on the committee decried the use of the drug as Democrats accused them of attempting to control women’s bodies.
“My goal of the hearing is to inform people that this is not just taking Tylenol,” Sen. Bill Cassidy, R-La., chairman of the Senate Committee on Health, Education, Labor and Pensions, told ABC News. “It's more than that, and therefore to emphasize that there should be an in-patient visit and some human contact,” he said.
Ahead of the annual National March for Life rally in Washington, D.C., Cassidy held the hearing to highlight so-called harmful abortion medications that he alleged could cause serious medical complications.
The American College of Obstetricians and Gynecologists has previously said, "Mifepristone is a safe, effective, and necessary medication that has been used by millions of patients over the course of more than two decades and should remain available nationwide without medically unnecessary and burdensome restrictions."
Ranking Member Sen. Bernie Sanders, D-Vt., slammed Cassidy and his Republican colleagues for their anti-abortion rhetoric.
“Let’s be clear about what this hearing is about. It’s not the safety of a drug. [This hearing] is about the ongoing effort of my friends in the Republican Party to deny the women of this country the basic right to control their own body,” Sanders explained.
Both Republicans and Democrats on the panel used the forum to call for health agency leaders to testify before the committee. Democrats took jabs at Health and Human Services Secretary Robert F. Kennedy Jr. for his vaccine skepticism and alleged attacks on the nation’s healthcare industry. Meanwhile, Republicans continued to press for answers from FDA Commissioner Dr. Marty Makary to testify about the mifepristone pill.
Makary has stressed that while a review of the abortion pill is ongoing, the FDA is unable to fully respond due to pending litigation. Kennedy has yet to appear before the Senate committee since being confirmed a year ago, but Cassidy claimed that Kennedy will testify this year. Timing for future hearings was not immediately available.
Mifepristone works by blocking progesterone, a hormone that the body needs to continue a pregnancy. This causes the uterine lining to stop thickening and to break down, detaching the embryo.
The second drug, misoprostol, taken 24 to 48 hours later, causes the uterus to contract and dilate the cervix, which will expel the embryo.
Dr. Nisha Verma, a double board-certified OB/GYN and complex family planning subspecialist, stressed that medication abortion is safe and effective and that she’s witnessed firsthand the threats to healthcare and health insurance for her patients. Medication abortion now accounts for more than 60% of all abortions in the U.S., according to the Guttmacher Institute, a research group focusing on sexual and reproductive health.
Sen. Jim Banks, R-Ind., said he was disappointed that the FDA under Dr. Makary’s leadership hasn't moved faster to restore the in-person dispensing requirement for mifepristone and that he was hoping to ask Makary questions directly at Wednesday’s hearing.
HHS Spokesperson Andrew Nixon told ABC News that the agency is conducting a study of reported adverse events associated with mifepristone to assess whether the FDA’s risk mitigation program continues to provide appropriate protections for women.
On the witness stand, Louisiana Attorney General Liz Murrill blasted former President Joe Biden’s efforts to expand the abortion pills, calling them dangerous and illegal.
“After Dobbs [Supreme Court decision], the Biden FDA promptly announced that it would remove the in-person dispensing requirement for abortion pills,” Murrill said, adding, “Thereby authorizing mifepristone to be shipped nationwide by mail. This was not a medically informed decision, but a purely political one; it was not even a legal one, because federal law prohibits distribution by mail.”
Murrill accused the former president of ignoring federal law to identify ways to “ensure” mifepristone is as widely accessible as possible, including through telehealth and sent by mail.
Cassidy also said there’s “no safeguards” against coercion. However, his colleagues across the aisle condemned the hearing for “gaslighting at the highest level.”
“The truth of the matter is that women have been coerced before Mifepristone and they've been coerced since Mifepristone,” said Sen. Maggie Hassan, D-N.H., who had a miscarriage while 12-weeks pregnant.
“To say that women shouldn’t be able to get this medication through the mail misses the point that abortion bans have created maternal health and reproductive health deserts in this country, so that when you say a woman should go consult with a physician, there are women who would have to wait hours in this country, miss work, find a babysitter -- if they have a car to begin with -- in order to do that because of policies that have banned abortion and have cut Medicaid in particular. That’s what we are facing,” she added.
As Cassidy touted the hearing for moving the country closer to requiring in-person patient visits, he seized on the ease of obtaining an abortion pill through telehealth methods and claimed that it's being prescribed as late as 20 weeks. The FDA authorized mifepristone -- sometimes called by the brand name Mifeprex -- for medication abortion in September 2000 for up to seven weeks' gestation, which was then extended to 10 weeks' gestation in 2016. However, the World Health Organization says the two-drug regimen can be taken up until the 12-week mark of pregnancy.
The Center for Reproductive Rights, a pro-abortion rights group, called telehealth abortion care as safe as in-clinic provision and a “lifeline” for millions of patients.
Harkening back to culture war issues around medical science practices, multiple Republican lawmakers asked Verma, the Democrats’ witness, if men could get pregnant.
“This isn't hard, doctor. Can men get pregnant? Yes or no?” Sen. Josh Hawley, R-Mo., repeatedly asked Verma.
Verma stumbled when answering because she said that yes or no questions could be skewed as polarizing language and leveraged as a political tool.
“I’m not sure of the goal of this question, so that's where I paused,” Verma said. “I take care of people with many identities (cross talk), but I take care of many women who can get pregnant. I do take care of people who don't identify as women,” she said as Hawley interrupted.
“Can men get pregnant?” Hawley reiterated. The Missouri Republican criticized Verma for her inability to answer the line of questioning. He said it’s “deeply corrosive” to science and the public’s trust if science and evidence can’t guide medical decisions.
Meanwhile, Sen. Roger Marshall (R-Kan.), an OBGYN, praised ultrasound care while downplaying telehealth practices for women’s health.
“Telehealth -- taking care of ectopic pregnancies -- threatening miscarriages, prescribing abortion pills, is below the standard of care,” Marshall said, adding, “You’re putting women’s lives in danger.”
Abortion bans and restrictions are limiting access to reproductive care, according to Verma.
“That is why we are seeing these [telehealth] cases because patients can't get that follow-up care in their communities,” Verma said, adding, “They are scared to go to the hospital if they need to because of fear of being criminalized."
In June 2024, the Supreme Court unanimously rejected a bid by a group of anti-abortion doctors that would have potentially blocked widespread access to a common abortion pill.
ABC News' Mary Kekatos contributed to this report
