Federal health officials temporarily froze Title X family-planning funds for some Planned Parenthood clinics, which provide reproductive health services ranging from birth control to STI testing, across the nation this week. (Photo by Michael M. Santiago/Getty Images) 

More than 1 million people seeking care such as contraception or testing for sexually transmitted diseases and cancer could be affected by the Trump administration withholding more than $27 million in Title X funding to Planned Parenthood clinics nationwide, according to estimates from the Guttmacher Institute.

Planned Parenthood state affiliates said they were notified that the funding they receive under the Title X family-planning program would be temporarily frozen, Politico first reported Monday night.

The U.S. Department of Health and Human Services, which is responsible for managing and distributing Title X funds, told States Newsroom via email that it is reviewing all Title X grant recipients to make sure they comply with federal law and President Donald Trump’s executive orders. The department is concerned about “the compliance of several awardees” that together receive $27.5 million, according to an HHS spokesperson, who added, “HHS expects all recipients of federal funding to comply with federal law.”

Letters received by some affiliates detailed possible violations of federal civil rights laws and executive orders recently issued by Trump, including the administration’s efforts to prohibit diversity, equity and inclusion initiatives and provide care regardless of a person’s immigration status.

“It is difficult to overstate how ridiculous it is that the administration is premising this funding freeze on a ‘DEI review,’” said Amy Friedrich-Karnik, Guttmacher’s director of federal policy, in a statement. “The entire point of the Title X program is to address disparities in access to contraception and other sexual and reproductive health care, including serving people with low incomes and those from other historically underserved communities. We need to see this for what it is — a direct attack on health equity.”

The Title X program was established in 1970 to provide reproductive health care for anyone who needs it. Federal law prohibits use of federal funds for abortion. Planned Parenthood clinics offer a broad range of non-abortion services.

No final decisions have been made regarding Title X funding for Planned Parenthood.

Affiliates in Alaska, California, Idaho, Hawaii, Maine, Mississippi, Missouri, Montana, Oklahoma, Tennessee, Utah and others reported receiving the notification, representing thousands of people served at each clinic every year and millions in funds. Guttmacher’s data shows that 83% of people who visited Title X-funded clinics in 2023 had family incomes at or below 250% of the federal poverty level.

In Missouri and Oklahoma alone, Title X funding totals nearly $8.5 million, according to a news release from Missouri Family Health Council.

“Withholding these critical funds, even temporarily, threatens the essential sexual and reproductive health care communities depend on,” said Michelle Trupiano, executive director of the council.

Kat Mavengere, spokesperson for Maine Family Planning, said the agency also received notice of a freeze affecting $1.92 million in funds. Planned Parenthood of Northern New England is a sub-grantee of Maine Family Planning. Mavengere told States Newsroom the notice from HHS identified two items on their website “related to documents that detail our commitment to health equity” as reasons for the funding review.

Nicole Clegg, CEO of the Northern New England Planned Parenthood affiliate, said it receives about $900,000 in funds between Maine and New Hampshire from the family-planning organization.

If people can’t seek basic reproductive health services at no cost, including wellness exams, Clegg said they go without.

“We’ve seen that. When Planned Parenthoods leave communities, the data just speaks to increases in STI transmission, increases in unintended pregnancy … there are very real consequences to a community when we’re no longer there,” Clegg said. 

A recent poll conducted by Perry Undem showed 77% of respondents were opposed to the idea of the Trump administration cutting funding for services like birth control for people with low incomes.

During his first term, Trump also cut Title X funds to clinics that provided abortions or referred people for abortions in 2019, causing one-third of participating providers to leave the program, according to KFF. The Biden administration reversed the policy two years later.

The U.S. Supreme Court is scheduled to hear arguments Wednesday in a case that will determine whether South Carolina government officials can remove Planned Parenthood clinics from the state’s Medicaid program because the organization provides abortions. If the court rules in South Carolina’s favor, other states that have tried to drain the organization’s funding for decades may follow suit.

Anti-abortion organizations celebrated the news of the Title X freeze for some Planned Parenthood clinics on Tuesday, including Susan B. Anthony Pro-Life America, which has been pushing efforts to “defund” Planned Parenthood in recent weeks in its fundraising emails. SBA was also involved in the drafting of the Heritage Foundation’s blueprint for the next conservative presidency, Project 2025, and identified this action as a priority.

“This is a big step in the right direction,” President Marjorie Dannenfelser told States Newsroom in a statement. “We thank President Trump for this bold action and urge further steps to eliminate all taxpayer funding for Planned Parenthood.”

Multiple Republican-led states have sued to rescind a federal rule keeping the records of those who sought legal reproductive care private, while a federal judge in Texas is questioning the constitutionality of the federal HIPAA law in its entirety. (Photo by Wichayada Suwanachun/Getty Images)

The decades-old federal law protecting the privacy of individual health information is threatened by multiple lawsuits that seek to throw out a rule restricting disclosure of information in criminal investigations, including for those seeking legal abortion and other reproductive health care.

In one of the cases, the Texas federal judge who has been at the center of several anti-abortion court battles appears to question the constitutionality and legality of the health privacy act in its entirety.

The Health Insurance Portability and Accountability Act — or HIPAA — established in 1996 to protect the privacy and security of patient health information, includes some exceptions under limited conditions, such as law enforcement investigations. But after the U.S. Supreme Court ended federal abortion rights in 2022 and more than a dozen states passed abortion bans, advocates worried that such records could be used by state officials and law enforcement to investigate and prosecute patients seeking an abortion and those who help them.

Health officials under former President Joe Biden’s administration enacted a HIPAA rule to keep health information private when the patient was in a state with legal access and the care was obtained legally. In order to release information related to this type of care, the entity subject to HIPAA rules must sign a document stating it is not released for one of the prohibited purposes.

“These cases may have been prompted by this newer rule, but they threaten more broadly the entire HIPAA system on which we all rely when accessing medical care,” said Carrie Flaxman, senior legal adviser for Democracy Forward, a nonprofit legal organization.

Two lawsuits seek to rescind that most recent rule, while another brought by Texas Attorney General Ken Paxton goes a step further, asking the court to remove the general rules established in 2000 about how much health information can be disclosed to law enforcement.

“The threats to the 2000 privacy rule would be a seismic shift that could erode patients’ trust entirely in their providers and dissuade them from wanting to seek out health care and be transparent about their symptoms,” said Ashley Emery, a senior policy analyst for the nonprofit Partnership for Women and Families. “A law enforcement officer could pressure a psychiatrist to share patient notes from therapy sessions without a subpoena, without a warrant, if the 2000 privacy rule is invalidated.”

The state of Missouri sued to rescind the Biden rule in January, and the state of Tennessee filed a similar action the same day that 14 other Republican attorneys general joined as plaintiffs: Alabama, Arkansas, Georgia, Idaho, Indiana, Iowa, Louisiana, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota and West Virginia. All but three of those states either heavily restrict or outright ban abortion, and if the lawsuits are successful, records kept by doctors and pharmacists in other states could be subpoenaed.

All of the lawsuits are filed against the U.S. Department of Health and Human Services, which is now under Republican President Donald Trump and HHS Secretary Robert F. Kennedy Jr. The Trump administration has so far followed the direction of the conservative Heritage Foundation’s Project 2025, which calls for the most recent HIPAA rule to be rescinded.

Amarillo judge ordered briefing on HIPAA’s constitutionality and legality

Three cases are still in motion, including one with a physician as the plaintiff. Dr. Carmen Purl, the sole owner of Dr. Purl’s Fast Care Walk In Clinic in Dumas, Texas, sued HHS because she said the rule creates a conflict with the laws requiring her to report child abuse.

“I consider both a pregnant woman and her unborn child to be human persons, and both are entitled to medical care and deserve the protection of the law,” Purl said in court documents. “I believe … that elective abortions harm patients’ health and public health.”

The location of Purl’s clinic puts her in the judicial district that has only one federal judge — U.S. District Judge Matthew Kacsmaryk, a Trump appointee. Most federal cases are assigned randomly to a group of judges in a district, but since Kacsmaryk is the only one, many advocates and attorneys have accused law firms like Alliance Defending Freedom, who is representing Purl in the case, of “judge shopping,” or finding a plaintiff in a certain area for the purpose of putting it in front of an ideologically friendly judge.

On Dec. 22, Kacsmaryk granted an injunction blocking enforcement of the rule against Purl while the case proceeds, and he is still considering whether to permanently block the law.

As part of the decision, Kacsmaryk also ordered the parties to submit briefs explaining how recent U.S. Supreme Court rulings that delegate more authority to Congress over administrative agencies “affect the constitutionality or legality of HIPAA and HHS’s authority to issue the 2024 rule.”

Kacsmaryk presided over a lawsuit in 2023 brought by a group of anti-abortion doctors seeking to revoke the U.S. Food and Drug Administration’s approval of mifepristone, one of two drugs commonly used to terminate pregnancies in the first trimester and to treat miscarriages. Kacsmaryk ruled in favor of removing its approval, but the U.S. Supreme Court unanimously overruled him in 2024.

Purl added that she thinks gender-affirming care is harmful to children, never medically necessary and a matter of concern for public health, though she has never treated a child with gender dysphoria. In the process of providing routine medical care, she said she could learn that a child was being subjected to gender-affirming treatments or procedures that could constitute child abuse, and she would be obligated to report it.

Purl’s clinic has fewer than 20 employees, and she has been licensed to practice family medicine in Texas since 1986. In that time, she said she has treated many patients who have been victims of abuse and neglect, and estimates she has personally treated more than 100 pediatric patients who were victims of sexual abuse.

“I have treated hundreds of girls under the age of consent who were either pregnant or reported sexual activity. During my career, I have delivered babies from mothers as young as 12 years old,” Purl wrote.

Purl said she has responded to Child Protective Services investigations between 10 and 12 times, and she fears that providing full, unredacted patient records in response to an entity such as CPS would violate the 2024 rule and subject her and the clinic to civil and criminal penalties, which often means hefty fines.

In a response filed by HHS in December, before Trump’s second term began, the department said the rule does nothing to prevent Purl from reporting suspected child abuse, and denied the other harms Purl said she would incur.

“Given the nature of her medical practice, Dr. Purl is highly unlikely to ever encounter a conflict between her obligations under state law and under the Rule,” the department said in court documents.

AGs from ban states are testing newly enacted shield laws

The Texas case led by Paxton has been on hold since February, after the U.S. Department of Justice asked the court to delay scheduling until the new administration could determine how to proceed. U.S. District Judge James Wesley Hendrix, a Trump appointee, ordered the parties to file a status report by May 1.

Attorneys general in states with abortions bans have already attempted to prosecute providers in other states for prescribing abortion pills via telehealth and prosecute women who obtained an abortion in another state without the consent of a male partner. Louisiana Gov. Jeff Landry signed an extradition warrant for a doctor in New York for prescribing and mailing abortion pills to residents of the state.

New York is one of 17 Democratic-led states that has a shield law to protect providers and patients from out-of-state legal actions for reproductive care and gender-affirming care, and the state government has so far refused to comply with Louisiana’s law enforcement efforts.

The coalition of states that joined Tennessee’s lawsuit claim the privacy rule harms their ability to investigate cases of waste, fraud and abuse, and “sharply limits state investigative authority.”

Chad Kubis, spokesperson for Tennessee Attorney General Jonathan Skrmetti, told States Newsroom via email that the office could not comment for this story because of the ongoing litigation.

“The final rule will hamper states’ ability to gather information critical to policing serious misconduct like Medicaid billing fraud, child and elder abuse, and insurance-related malfeasance,” the complaint says.

Attorneys at Democracy Forward have asked the courts to allow the clients they are representing to intervene as defendants in all four cases, arguing that the new administration is likely to either not defend the cases at all or defend them inadequately. They are representing the cities of Columbus, Ohio, and Madison, Wisconsin, as well as Doctors for America, an activist organization of physicians and medical students. None of the judges have ruled on their motions yet.

Partnership for Women and Families filed an amicus brief with 23 other advocacy organizations to support upholding the rule.

“We can’t count on the Trump administration to defend this regulation, given its longstanding record of hostility toward reproductive health and rights,” Emery said.

It’s possible the new leadership at HHS will rescind the 2024 rule, Emery said, but the lawsuits alone are concerning enough because of the threat posed to privacy protections. That’s part of the goal, said Emery and Flaxman — to present the threat and sow fear and intimidation in patients and providers. And the method of launching multiple lawsuits in various jurisdictions fits a pattern that has been observed in the fight for abortion rights, Emery said.

“Anti-abortion extremists’ legal campaign against HIPAA’s reproductive health privacy protections is designed to test out different legal venues and arguments to obtain the most favorable outcome possible,” she said.

Doctor who has been investigated before says intimidation tactics have an effect

Indiana OB-GYN Dr. Caitlin Bernard knows what it’s like to be the target of an investigation, and said she’s still in court fighting new attempts to instill fear in doctors and patients.

Bernard was an abortion provider in Indiana before the state enacted its ban in August 2023. She reported in 2022 that she had provided a medication abortion to a 10-year-old rape victim who traveled to Indiana from Ohio when the state briefly had a ban in place. She was accused of violating patient privacy laws and investigated by Indiana Attorney General Todd Rokita, and the state licensing board fined her $3,000 and reprimanded her for the incident after Rokita asked the board to revoke her license to practice medicine. She was found to have violated patient privacy, but the board determined the fine was sufficient and she kept her license.

“Now my case is held up as an example of what can happen to you if you speak out about abortion bans,” Bernard said. “I’ve spoken to many physicians across the country who are intimidated by that. They say, ‘Look at Dr. Bernard and what happened to her.’”

Now, Bernard is part of a lawsuit against the state to categorize terminated pregnancy records as medical records in state law that cannot be released to the public. Indiana has historically treated abortion reports as public record with certain details redacted, but Bernard said with the ban in place and so few people qualifying for its limited exceptions, that policy should change. The records include demographic information like age, ethnicity and education level, as well as information such as diagnoses and the date, location and physician who provided care.

“It also includes the county, so you could imagine in these very small counties, somebody could absolutely figure out who that person is,” Bernard said.

Ashley Emery, senior policy analyst at Partnership for Women and Families, said the lawsuits take aim at a deeply needed line of defense against abortion criminalization, and said it will disproportionately affect immigrants, people of color and low-income populations. Trust is already low between marginalized people and health care providers, Emery said, and this would further erode that trust.

“These challenges to HIPAA are designed to take protections away from patients and try to allow anti-abortion politicians to have more control, and I think that power deficit is really important to note, and it should be very chilling,” she said.

Editor’s note: This story has been corrected to say the Indiana state licensing board found Dr. Caitlin Bernard violated patient privacy laws but kept her license.

A volunteer clinic escort holds a sign outside a Planned Parenthood clinic in Columbia, South Carolina, on Friday, March 28. (Photo by Skylar Laird/SC Daily Gazette)

U.S. Supreme Court justices will hear arguments Wednesday about whether South Carolina can remove Planned Parenthood clinics from the state’s Medicaid program because they offer abortions in a case that could imperil health care options for patients with low incomes.

At the center of the lawsuit is a conflict over whether a section of the Medicaid Act gives people who use Medicaid the right to choose their providers.

“While it might be just South Carolina’s name on this court case, it will have huge impacts nationwide,” said Vicki Ringer, Planned Parenthood South Atlantic’s director of public affairs in the state. “It will allow all of these red states that have been trying so hard to close down Planned Parenthood, and it will take away medical care for so many low-income people throughout our region of the country.”

Opponents of Planned Parenthood said Republican South Carolina Gov. Henry McMaster should be able to direct Eunice Medina, the new head of the state Department of Health and Human Services, to remove the organization’s Charleston and Columbia clinics from the list of qualified Medicaid providers.

If the court rules broadly, it could allow other states to make the same move — and some already have. The case is also part of a broader strategy across the country to drain Planned Parenthood funding for all services, including reproductive health care aside from abortion. Efforts by abortion-rights opponents to do so go back decades in the United States.

Republican President Donald Trump’s administration has taken interest in the case, Medina v. Planned Parenthood South Atlantic. The acting U.S. solicitor general will argue in favor of South Carolina health officials during a portion of the Supreme Court hearing this week.  

Lawyers for Alliance Defending Freedom, a conservative advocacy firm instrumental in major anti-abortion cases that have appeared before the Supreme Court, represent South Carolina officials in the lawsuit.

“This case is about whether states have the flexibility to direct Medicaid monies to best benefit low-income women and families,” John Bursch, senior counsel and vice president of appellate advocacy at Alliance Defending Freedom, said in an email.

Planned Parenthood’s two South Carolina clinics offer abortion up to six weeks in compliance with state law. But staff also provide birth control, emergency contraception, prenatal and postpartum exams and STI testing and treatment, among other services. 

“Being able to deny Medicaid patients the ability to select their own qualified provider tells low-income women, especially, that once again ‘You’re not important. Your decision-making doesn’t matter. We are here to decide for you what is best,’” Ringer said.

The picture in South Carolina

McMaster’s executive order against clinics that also offer abortions — deeming them “unqualified to provide family planning services” — has been blocked by lower courts since 2018. Throughout a nearly seven-year court battle, appellate judges have repeatedly ruled in favor of Planned Parenthood South Atlantic, and the Supreme Court has rejected requests to take up the case — until now.

“South Carolina has made it clear that we value the right to life. Therefore, taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs,” McMaster said in a Feb. 10 statement.

Nearly half — 48% — of South Carolinians surveyed in May 2024 oppose the six-week ban that’s in place, while 31% support it, and the rest were not sure or refused to answer, according to a Winthrop University poll last year. 

Ringer said South Carolina lawmakers’ anti-abortion positions are at odds with residents’ views on the issue.

“It’s political pandering, but it’s to a population that doesn’t agree with them,” she said. “They think because they’re elected, then that means we’re an anti-abortion, so-called ‘pro-life’ state.”

Like many states, South Carolina only allows Medicaid coverage of abortion in cases of rape, incest or to save a patient’s life.

Julia Walker, a spokesperson for the regional affiliate, said 10% of patients who routinely visit the South Carolina clinics for family-planning services use Medicaid.

Just 0.2% — $88,464 — of the $35 million the state spent on Medicaid-covered family-planning services went to Planned Parenthood in the 2022-2023 fiscal year, SC Daily Gazette reported. Medicaid is a reimbursement program, meaning providers foot the bill and seek at least partial reimbursement for an appointment or procedure.

A case study in Texas

Arkansas, Missouri and Texas — Republican-led states — have ended some clinics’ Medicaid eligibility for reproductive health care services because they provided abortions at one time or are affiliated with Planned Parenthood.

Still, clinic doors remain open in those states, despite ongoing lawsuits and right-wing wrangling that blocked Medicaid patients.

“Let’s be clear about where Texas was even before they cut Planned Parenthood out of Medicaid,” said Melaney Linton, president and CEO of Planned Parenthood Gulf Coast, which still has six locations in the greater Houston area. “Texas already was suffering some of the nation’s worst rates of maternal and infant mortality, and highest under and uninsured populations.”

Most of Houston is in Harris County, an area that has one of the highest Black maternal death rates nationwide. Black women in the county had a pregnancy-related mortality rate of 83.4 deaths per 100,000 live births from 2016 to 2020, according to a report last year.

The maternal mortality rate in Texas from 2018 to 2021 was 28.1, compared with 23.5 nationwide, according to federal data.

Black Texans are 2.5 times more likely to die from childbirth-related issues than white Texans, according to the state’s Maternal Mortality and Morbidity Review Committee.

A judge ruled in March 2021 that Texas could stop Planned Parenthood from receiving Medicaid funds. Linton said the state’s actions cut off an estimated 8,000 Planned Parenthood patients.

Linton offered an example of a former patient who struggled to find a Medicaid provider who would accept her insurance and give her the birth control she was seeking. Only 34% of providers accepted Medicaid and had IUDs and birth control shots readily available for new patients, according to a University of Texas at Austin research brief.

“Politicians like to talk about how they care about women and infants and families,” Linton said. “If they did, they would do everything they can to make sure that women have more access to birth control, not less.”

Six months after Texas suspended Planned Parenthood’s Medicaid funds for reproductive health care services, the state enacted a six-week abortion ban. Teen birth rates skyrocketed in Harris County and across the entire Lonestar State for the first time in 15 years, data shows.

Linton said what happens in Texas is often replicated in other parts of the country, and the same will probably hold true for the South Carolina case before the U.S. Supreme Court this week.

“Every American should be concerned about that,” she said.

Long waits and limited options

If the Supreme Court rules in South Carolina’s favor, Bursch, the Alliance Defending Freedom attorney, said Medicaid patients can instead access family-planning services at publicly funded health care clinics instead of the Planned Parenthood clinics in Charleston and Columbia. The state has 53 public health clinics that offer family-planning services, 32 federally qualified health centers and 14 Title X federally-funded family-planning clinics, including Planned Parenthood’s Columbia clinic.

But public clinics are struggling financially, said Dr. Katherine Farris, the chief medical officer at Planned Parenthood in the Carolinas and the Virginias, in a news conference Friday. A patient may have to wait three months for an intrauterine device appointment at some of them, but at Planned Parenthood, she said, the patient can walk in and get an IUD insertion the same day.

Ringer and Linton also said finding a provider that accepts Medicaid and can see a new patient promptly is not so simple. 

“Doctors who at one time did take Medicaid aren’t anymore. It is a losing prospect for many providers,” Ringer said. “I’ve seen what Medicaid reimburses, and for many of the services we provide, we lose money on them. But because we are a safety-net provider, that means we provide care to people no matter what. If you can or can’t pay, we are going to take care of you.”

South Carolina and Texas are 2 of 10 states that have not expanded Medicaid under the Affordable Care Act passed in 2010, Stateline reported.

When Planned Parenthood’s Texas affiliates were removed from Medicaid eligibility, Linton said the Gulf Coast staff tried to connect their Medicaid patients to other health care providers.

“Unfortunately, what our patients told us is that sometimes it took them three months or more calling around the 20 or 30 practices to find someone who would even take them. Many times they didn’t provide the birth control method that that patient had been accustomed to receiving,” Linton said.

Bursch and other Alliance Defending Freedom attorneys argue that if Planned Parenthood stopped providing abortions in South Carolina, Medicaid funding could be restored.

Planned Parenthood Federation of America attorney Catherine Peyton Humphreville said that South Carolina does allow some abortions to be provided in the state.

“At no point has anyone asserted that Planned Parenthood South Atlantic is not complying with South Carolina law,” Humphreville said.

No one has questioned the quality of care that the organization provides, they said, and the idea that Planned Parenthood can be punished for simply advocating abortion “has serious First Amendment issues.”

On Capitol Hill

Anti-abortion Republicans in Congress are pushing bills to “defund Planned Parenthood” and other abortion providers, including independent clinics, nationwide. Unlike previous sessions when Congress faced gridlock, legislation could advance this year given the GOP trifecta of power in Washington, D.C.

U.S. Missouri Sen. Josh Hawley filed legislation on Jan. 16 that would prohibit federal funding from going to organizations that provide abortions, referrals and the like, with the stated intention of cutting funds from “Planned Parenthood and abortion providers across the nation.” A 2019 rule passed by the Trump administration blocked $60 million in federal funds from flowing to the organization, Hawley said, before the rule was rescinded under Biden.

The Hyde Amendment, a provision approved annually by Congress since 1977, already prevents federal funds from covering the costs of abortion unless the pregnancy stemmed from rape or incest, or the patient could die in child birth.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson said the organization is prepared to defend itself from both state-level and national attacks.

“The most immediate focus is going to be on the Medicaid defund [bills] in Congress, and that has a direct tie to the Supreme Court case,” McGill Johnson said. “That fight looks like doing everything we can to defeat, delay, to litigate, to mitigate every effort that is trying to put sexual and reproductive health care out of reach.” 

Jayanta Bhattacharya, President Donald Trump's nominee to be director of the National Institutes of Health, speaks at his confirmation hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill on March 5, 2025 in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

This report was updated at 7:59 p.m. EDT.

WASHINGTON — The U.S. Senate confirmed President Donald Trump’s nominees to lead the Food and Drug Administration and the National Institutes of Health.

Senators voted 53-47 along party lines Tuesday evening to confirm Jayanta Bhattacharya as director of the NIH before voting 56-44 to approve Martin Makary as FDA commissioner.

Democratic Sens. Dick Durbin of Illinois as well as Maggie Hassan and Jeanne Shaheen of New Hampshire were the only three members of their party to vote for Makary.

Shaheen said during an interview Wednesday that while she has reservations about how the Trump administration might try to change access to medication abortion, she felt Makary was qualified to lead the FDA.

“Well, I’m very concerned about what this administration might do about mifepristone,” Shaheen said. “But, I thought it was important to have someone in that role who has the scientific background and ability to run the agency.”

Hassan declined to answer questions about her vote when asked about it Wednesday afternoon by States Newsroom. Her office declined to send a written statement from the senator, offering only a response from a spokesperson. 

“The opioid epidemic has devasted communities across New Hampshire, and the FDA has made mistakes over the years that fueled this epidemic,” the spokesperson wrote in an email. “Senator Hassan voted for Dr. Makary as Commissioner of the FDA following his clear commitment to ensuring that the agency learns from its past mistakes and acts aggressively to tackle this crisis.”

Senate confirmation came just weeks after the Health, Education, Labor and Pensions, or HELP, Committee voted to advance Makary and Bhattacharya.

Sen. John Hickenlooper, D-Colo., voted in committee to send Makary’s nomination to the floor, but switched to opposing his confirmation on Tuesday.

Hickenlooper said during a brief interview with States Newsroom on Wednesday that he ultimately couldn’t support Makary over his comments about medication abortion. But he said nothing significant happened between his yes vote in committee and his no vote on the floor.

“I agonized over it. I could have easily gone back and voted yes,” Hickenlooper said. “You know, at some point when I see him, I’ll apologize and say, ‘You know, that was a hard vote for me. But I really wish you would have been more demonstrative about specifically mifepristone, because I think that’s a big issue that the FDA is going to take on.’”

Hickenlooper said he spoke with his staff and his wife over Makary’s comments about access to medication abortion before he cast his no vote on the Senate floor.

“I realized that he serves at the pleasure of the president, so what the president says he’s probably going to have to do,” Hickenlooper said. “But for me, I just became more and more uncomfortable that he wouldn’t make a few statements to say that, you know, this is not something that is a medical reinterpretation for political purposes. He should have said something.”

Abortion pill

Makary will have considerable authority at the FDA to determine if access to medication abortion remains as it is now, if the agency changes prescribing guidelines, or even pulls its approval.

During his confirmation hearing in early March, Makary testified he hadn’t yet decided how he would approach that aspect of the job.

“I have no preconceived plans on mifepristone policy except to take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the FDA,” Makary said at the time.

Medication abortion is a two-drug regimen consisting of mifepristone and misoprostol that accounts for about 63% of all pregnancy terminations within the United States, according to research from the Guttmacher Institute.

The FDA originally approved mifepristone in 2000 and changed its prescribing guidelines in 2016 and 2021. It is currently approved for use up to 10 weeks gestation and can be prescribed via telehealth and shipped to patients.

Sixteen major medical organizations — including the American College of Obstetricians and Gynecologists, the American Medical Association and the Society for Maternal-Fetal Medicine — affirmed to the U.S. Supreme Court last year that mifepristone is safe and effective.

“The scientific evidence is overwhelming: major adverse events occur in less than 0.32% of patients,” the medical organizations wrote in a 45-page brief. “The risk of death is almost non-existent.”

Goals for NIH

Bhattacharya testified during his confirmation hearing that he has five goals for the NIH, including focusing the agency’s research on chronic diseases and funding the “most innovative biomedical research agenda possible.”

“The NIH is the crown jewel of American biomedical sciences, with a long and illustrious history of supporting breakthroughs in biology and medicine,” Bhattacharya said at the time. “I have the utmost respect for the NIH scientists and staff over the decades who have contributed to this success.”

But, he said, “American biomedical sciences are at a crossroads” following the coronavirus pandemic.

Bhattacharya said during his hearing he would ensure NIH’s scientific research is replicable, that it has a culture that respects “free speech in science and scientific dissent” and that it regulates “risky research that has the possibility of causing a pandemic.”

“While the vast majority of biomedical research poses no risk of harm to research subjects or the public, the NIH must ensure that it never supports work that might cause harm.”