Vice President JD Vance delivers remarks during the annual March for Life rally on the National Mall in Washington, D.C., on Jan. 23, 2026. (Photo by Kevin Dietsch/Getty Images)

WASHINGTON — The Trump administration plans to expand a policy that blocks foreign aid dollars from going to organizations that discuss, refer or perform abortions to also include groups that address transgender health care or have policies on diversity, equity and inclusion, Vice President JD Vance said Friday.

“We’re expanding this policy to protect life, to combat DEI and the radical gender ideologies that prey on our children. And with these additions, the rule will now cover every non-military foreign assistance that America sends,” Vance announced at the March for Life anti-abortion rally on the National Mall.  

“All in all, we have expanded the Mexico City Policy about three times as big as it was before,” he added. “And we’re proud of it, because we believe in fighting for life.”

The White House did not immediately respond to a request from States Newsroom for more details on the policy expansion or when it would be implemented. 

Defending administration’s record

Vance said during the rally he needed to “address an elephant in the room” that President Donald Trump and others in the administration have not made enough progress on anti-abortion initiatives during the first year of unified Republican control of the federal government.  

“I want you to know that I hear you and that I understand,” he said. “There will inevitably be debates within this movement. We love each other. But we’re going to have open conversations about how best to use our political system to advance life, how prudential we must be in the cause of advancing human life. I think these are good, natural and honest debates.”

Vance mentioned that Trump nominated some of the Supreme Court justices that overturned Roe v. Wade, the 1973 case that had guaranteed a constitutional right to an abortion for nearly 50 years. 

He also noted that Republicans in Congress included a provision in the “big, beautiful” law that blocks Medicaid funding from going to Planned Parenthood for one year for any type of health care. Federal law had already barred funding from going to abortions, with limited exceptions.

Vance argued that in addition to judicial rulings and federal laws, members of the anti-abortion movement must strive to change hearts and minds as well. 

“We’re not trying to argue to the Supreme Court anymore,” he said. “We’re trying to argue to our fellow citizens that we must build up that culture of life. And as you know, that effort is going to take a lot of time, it’s going to take a lot of energy and it’s going to take a little bit of money.”

Later in his speech, Vance sought to discourage people from concentrating on professional lives and instead called on them to focus more on getting married and having children. 

“You’re never going to find great meaning in a cubicle or in front of a computer screen,” he said. “But you will find great meaning if you dedicate yourself to the creation and sustenance of human life.”

Trump didn’t attend the rally in person but recorded a video message that was played just before Vance spoke, telling attendees he “was proud to be the first president in history to attend this march in person” six years ago. 

“In my first term I was honored to appoint judges and justices who believed in interpreting the Constitution as written. That was a big deal. And because of that, the pro-life movement won the greatest victory in its history,” Trump said. “Now the work to rebuild a culture that supports life continues in every state, every community and every part of our beautiful land.”

Calls for action on medication abortion

Trump and some in his administration have come under scrutiny lately for not moving faster to complete a safety review of mifepristone, one of two pharmaceuticals used in medication abortion, which is approved for up to 10 weeks gestation. 

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, and Lila Rose, founder of the anti-abortion group Live Action, both released statements in December calling on Trump to fire Food and Drug Administration Commissioner Marty Makary over the pace of that review.

Anti-abortion organizations want the administration to end the ability of doctors or other qualified health care providers to prescribe mifepristone and the second pharmaceutical used in medication abortion, misoprostol, via telehealth and have it shipped to patients. 

Several Republicans in Congress have joined their call, with Senate Health, Education, Labor and Pensions Committee Chairman Bill Cassidy, R-La., holding a hearing on mifepristone earlier this month. 

The U.S. Supreme Court rejected efforts from anti-abortion organizations to limit access to mifepristone in a June 2024 ruling, writing they never had standing to bring the lawsuit in the first place. 

Trump told House Republicans during a policy retreat at the Kennedy Center earlier this month they must be “flexible” about the Hyde Amendment, which blocks federal funding for abortion with limited exceptions, in order to broker a health care deal that can reach his desk. 

Dannenfelser rebuked Trump for the comment, writing in a statement that to “suggest Republicans should be ‘flexible’ is an abandonment of this decades-long commitment. If Republicans abandon Hyde, they are sure to lose this November.”

GOP leaders tout major law

U.S. House Speaker Mike Johnson, R-La., also spoke at the March for Life rally, touting the “big, beautiful” law as “the most pro-life and pro-family legislation that has been signed into law in decades.”

“For the first time since Roe v. Wade was reversed, we have the White House, the Senate and the House all working together to deliver meaningful and historic pro-life victories,” he said. 

The law included several policies that Johnson said will aid Americans in having children, including an expansion of the child tax credit and the adoption tax credit as well as the investment accounts for babies. 

Johnson said the provision that blocks Medicaid patients from going to Planned Parenthood for non-abortion health care services, depriving the organization of that income, was a massive policy victory for Republicans. 

“We stand here today with one united voice to affirm the federal government should not be subsidizing any industry that profits from the elimination of human life,” Johnson said. 

New Jersey Republican Rep. Chris Smith, speaking just after Johnson while other GOP lawmakers stood on the stage, said eliminating access to mifepristone must be accomplished. 

“I’ve been here since Ronald Reagan’s first election, 1981,” Smith said. “And I can tell you, this leadership is the most pro-life, so committed. And behind me are just absolute heroes. Men and women who take up the fight every single day.”

Senate Majority Leader John Thune, R-S.D., didn’t attend the rally in person but submitted a video that touted the Planned Parenthood defunding provision. 

“Thanks to that landmark legislation, this year, some of the nation’s largest abortion providers, including Planned Parenthood, are prohibited from receiving Medicaid funding,” Thune said. 

Other Republicans attending the rally included Alabama Rep. Robert Aderholt, Arkansas Rep. French Hill, Florida Rep. Kat Cammack, Georgia Rep. Andrew Clyde, Maryland Rep. Andy Harris, Michigan Reps. Bill Huizenga and Tim Walberg, Minnesota Rep. Michelle Fischbach, Missouri Rep. Bob Onder, Pennsylvania Rep. Dan Meuser, South Carolina Rep. William Timmons, Texas Reps. Michael Cloud and Dan Crenshaw, Utah Rep. Mike Kennedy, Virginia Rep. John McGuire and Wisconsin Rep. Glenn Grothman.

Dr. Margaret Baum (second from left), chief medical officer for Planned Parenthood Great Rivers, stands with attorneys from the Planned Parenthood Federation of America on the steps of the Jackson County Courthouse in Kansas City, Missouri, on Jan. 12, 2026, the first day of a two-week trial over abortion restrictions. (Photo by Anna Spoerre/Missouri Independent)

The outcome of two trials in the coming weeks could shape what it will look like when voters overturn state abortion bans through future ballot initiatives.

Arizona and Missouri voters in November 2024 struck down their respective near-total abortion bans. Both states added abortion access up to fetal viability as a right in their constitutions, although Arizonans approved the amendment by a much wider margin than Missouri voters.

That was just the beginning of protracted legal battles.

Amy Myrick, senior counsel at the Center for Reproductive Rights, said ballot measures are a powerful and important step in returning abortion access to a state, but success on Election Day doesn’t mean the fight is over.

“State constitutions don’t automatically repeal laws,” Myrick said. “Sometimes, even if the state isn’t doing it, other groups or legislators will jump in to try to retain these restrictions.” 

The trial over Arizona’s abortion restrictions wrapped up this week, Arizona Mirror reported. Maricopa County Superior Court Judge Gregory Como seemed unconvinced of the argument that certain laws around how abortion medication can be prescribed, waiting periods and bans on abortions in cases of fetal abnormalities should remain enforceable.

A similar trial in Missouri will wrap up on Jan. 26 after hours of testimony about more than a dozen abortion restrictions state officials are seeking to preserve. The Republican supermajority state legislature is also putting a countermeasure to reinstate the abortion ban on the ballot in November, paired with a ban on gender-affirming care for minors. 

Arizona and Missouri have what are known by abortion-rights advocates as Targeted Regulation of Abortion Providers, or TRAP, laws passed by legislatures before the U.S. Supreme Court’s Dobbs decision in 2022. Even states without bans, like Connecticut, Maryland and Rhode Island, have statutes in place that the Guttmacher Institute considers TRAP laws. Abortion providers are subject to state licensing and other medical requirements, but as of December, 25 states still have laws that impose additional regulations for clinics, according to Guttmacher, such as facility size and transfer agreement requirements, or admitting privileges at local hospitals within 30 miles.

Officials and legislators usually argue in the statehouse and in court that the extra parameters increase the safety of abortion procedures, but the safety record is strong under existing medical requirements and is safer than childbirth, according to the American College of Obstetricians and Gynecologists. Studies show the risk of maternal death associated with childbirth is about 14 times higher than the risk associated with abortion.

But there are also other laws that advocates say are meant to discourage or frustrate those seeking abortion care, such as mandatory vaginal exams, waiting periods, or a requirement that the same physician must see an abortion medication patient over two subsequent visits. Some of those laws were passed over decades and helped drive abortion providers away, including in Missouri.

As a result, even though Missourians overturned the ban, abortion care remains difficult to obtain, and many are still leaving the state to get it, according to Missouri Independent.

“Because constitutional amendments don’t overturn conflicting laws, people can still experience injuries under these laws,” said Prachi Dave, senior managing legal and policy director at If/When/How, a reproductive rights legal services and advocacy organization. “For example, if a waiting period is interfering with my ability to access the care I am guaranteed under the newly passed amendment, then I would ask a judge to affirm that the law is getting in the way of my right. In doing so, lawsuits give practical effect to constitutional amendments.”

In a Michigan lawsuit led by advocacy groups, a judge ruled in May that a mandatory waiting period was unconstitutional after voters approved an initiative codifying reproductive rights.  

Wendy Heipt, attorney for advocacy organization Legal Voice in Washington, said even if some laws were ruled unconstitutional, they may have to be litigated again because the basis for the unconstitutional argument relied on the Roe v. Wade case that the U.S. Supreme Court overturned almost four years ago.

Heipt frequently works on cases in Idaho, where many lawsuits over the state’s near-total abortion ban have taken place in the past three years. Though still in effect, there is an effort to overturn the ban via ballot in November. 

The initiative is different from those approved in Arizona and Missouri because people in Idaho cannot submit constitutional amendments — only proposed state laws — for ballot consideration directly.

Melanie Folwell, lead organizer of the reproductive rights initiative in Idaho, said even if successful, it’s only one leg of a long race in restoring access. The initiative group, Idahoans United for Women and Families, drafted a bill that would have repealed existing abortion laws, but it was too long and legally complicated for the ballot. Instead, what they’ve come up with for voters is meant to establish a right to reproductive health privacy without undue government interference and override existing laws. 

The outcome of Missouri’s trial could be instructive for Idaho abortion-rights advocates, because the political environments are similar. Idaho has a lengthy list of its own waiting periods for abortion care, mandatory counseling and ultrasound requirements, and elected officials in the Republican-led state have repeatedly signaled their opposition to abortion access, including the attorney general. The legislature also has a Republican supermajority.

And since it can’t be a constitutional amendment, any new law may be more vulnerable to legal challenges. 

“There are things to learn from every one of the states that have reproductive access on the ballot, which is 17 states at this point,” Folwell said. “It is always instructive for us to see what plays out in that state’s legislature, what plays out with their courts.”

Myrick said the legal battles can feel discouraging, but voters shouldn’t let it stop them from using their voices to make their policy preferences known.

“Ballot measures are not the silver bullet. We need a lot of follow-up to make these rights real. And the attempts to keep these restrictions after the voters have spoken are blatantly anti-democratic, but they’re still happening,” Myrick said.

Louisiana Republican U.S. Sen. Bill Cassidy speaks during a press conference on Wednesday, Jan. 14, 2026. Also pictured, from left, are Family Foundation of Virginia President Victoria Cobb, National Association of Christian Lawmakers Founder and President Jason Rapert, Family Research Council President Tony Perkins, Ohio Attorney General Dave Yost, Louisiana Attorney General Liz Murrill and Missouri Republican U.S. Sen. Josh Hawley. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — Republicans on a key U.S. Senate committee on Wednesday called on the Food and Drug Administration to wrap up its ongoing safety review of medication abortion and pressed for the Trump administration to once again require in-person dispensing.

Democrats on the Health, Education, Labor and Pensions Committee argued women, not politicians, are in the best position to determine whether to ask for a prescription for mifepristone. 

Louisiana Republican Sen. Bill Cassidy, chairman of the panel, said he hopes FDA Commissioner Marty Makary will agree to testify before the committee on the process in the future, though he didn’t set a deadline.  

“At an absolute minimum, the previous in-person safeguards should be restored and it should be done immediately,” Cassidy said. 

Republicans and anti-abortion organizations have become increasingly skeptical about the FDA’s review after news broke in December that Makary wanted to delay its release until after the November midterm elections. 

Washington Democratic Sen. Patty Murray questioned Cassidy’s reasons for holding the hearing, saying more than “160 high-quality studies have been conducted and millions of women around the world use mifepristone safely every year with fewer complications, by the way, than Viagra or penicillin.” 

Supreme Court case

Access to mifepristone, one of two pharmaceuticals used in medication abortion, which is FDA-approved for up to 10 weeks gestation, surged to the forefront after the U.S. Supreme Court ended the nationwide right to abortion in 2022. 

Many Republican state legislatures have moved to bar access to mifepristone for abortions, while Democratic states have enacted shield laws to protect health care providers who prescribe and ship it to people in states with limited or no access. 

Dr. Nisha Verma, a fellow at Physicians for Reproductive Health in Atlanta, testified before the committee that “the science on mifepristone’s safety and effectiveness is long-standing and settled.”

“Over the past 25 years, medication abortion using mifepristone and misoprostol has been rigorously studied and proven safe and effective in over 100 high-quality, peer-reviewed studies,” Verma said. “Extensive data show that medication abortion through telehealth is equally safe and effective and provides vital access for those who live in rural areas and in the growing number of maternity care deserts in the country.”

Verma contended the likely reason for the hearing was not genuine concern from Republicans about the safety and efficacy of mifepristone but “because people in this room feel uncomfortable with abortion.”

“And that’s okay, and we can talk about that,” Verma said. “And we can have an honest conversation about that and complexity and the reasons that my patients need abortion care. But we should not pretend that this is an issue of the science.”

Louisiana attorney general testifies

Louisiana Attorney General Elizabeth Murrill, a Republican, criticized the FDA’s decision during the Biden administration to allow prescriptions via telehealth and for the pharmaceuticals to be shipped, sometimes into states that bar their use. 

“Shield laws in some states protect providers from liability and effectively nullify laws in other states,” Murrill said. “Their purpose is to make it more difficult to sue or prosecute individuals in those states.”

Indiana Republican Sen. Jim Banks expressed frustration that FDA Commissioner Makary was not among the witnesses testifying at the hearing and urged the agency to release the results of its review of mifepristone quickly. 

“I’m disappointed that the FDA under Dr. Makary’s leadership hasn’t moved faster to restore the in-person dispensing requirement and strengthen the (Risk Evaluation and Mitigation Strategies) program for mifepristone,” Banks said. “I hope the rumors are false, some of them are in print, that the agency is intentionally slow-walking its study on mifepristone health risks.”

Emily G. Hilliard, press secretary for the Department of Health and Human Services, which includes the FDA, wrote in a statement the department “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.”

“The FDA’s scientific review process is thorough and takes the time necessary to ensure decisions are grounded in gold-standard science,” Hilliard wrote. “Dr. Makary is upholding that standard as part of the Department’s commitment to rigorous, evidence-based review.”

Cassidy said after Banks raised his concerns that he hopes to have Makary testify “before the committee very soon and we’ve been speaking with the FDA to facilitate discussion on this and other issues.”

Cassidy added that HHS Secretary Robert F. Kennedy Jr. “did promise to come back and we have requested that he come back and testify.” 

Republicans, Family Research Council urge action by FDA

During a press conference after the hearing, Cassidy joined a handful of other GOP lawmakers and Family Research Council President Tony Perkins to further press the Trump administration to change the prescription guidelines for mifepristone. 

Perkins said the Trump administration could change FDA guidelines around how mifepristone is prescribed and distributed “overnight” if it wanted to. 

He also said it should immediately begin enforcing The Comstock Act, an 1873 law that could block shipping medication abortion.

“This is a two-step solution. One, is the in-person requirement being reestablished, the medical examinations to ensure that the women, their lives, are not put at risk,” Perkins said. “But then also … simply enforcing the law as it pertains to Comstock.”

State and federal proposals to regulate and restrict medication abortion are expected to continue in 2026 as abortion opponents claim, without strong evidence, that abortion medication is dangerous to patients and the environment. (Getty Images)

Going into the fourth year without federal abortion rights protections, groups that helped overturn Roe v. Wade are focused on cutting off access to abortion pills. As multiple lawsuits over the abortion drug mifepristone unfold, state and federal proposals to regulate and restrict medication abortion are expected to continue in 2026. Abortion opponents argue that medication abortion, despite its strong safety record, is dangerous to patients and the environment.

Abortion bans are largely unpopular, but heading into a midterm election year, some lawmakers in states with strict abortion bans have already prefiled bills to add new restrictions. Here’s a look at early legislative trends emerging in abortion-related bills recently introduced or prefiled ahead of the new year.

Proposals to restrict abortion pill or study environmental effects

Over the last few years, the national anti-abortion group Students for Life of America has spread unfounded claims that mifepristone pollutes U.S. waterways and drinking water, drafted model legislation to regulate the disposal of medication abortions, and requested environmental studies at the federal and state level. 

In 2025, lawmakers in at least seven states introduced bills to create environmental restrictions for the abortion drug mifepristone or order environmental studies. Bills introduced this year in Texas, Wisconsin and Wyoming would have required testing community water systems for traces of mifepristone. 

Bills in Maine, Montana, Pennsylvania, West Virginia, Wisconsin and Wyoming would have required providers to give patients medical waste kits to collect and return the tissue following a medication abortion. Women commonly flush the tissue associated with medication abortion and miscarriages, which typically occur during the first trimester. 

These bills, except Pennsylvania’s, would have also mandated in-person dispensing of the medication and follow-ups, effectively banning telehealth abortion. 

None of these proposals passed, but they are likely to be reintroduced in 2026 as abortion opponents continue to push for environmental regulation of abortion pills, including at the federal level. 

In June, 25 congressional Republicans sent the U.S. Environmental Protection Agency a letter inquiring about potential avenues for regulating mifepristone, as the New York Times reported. And as Politico recently reported, Students For Life lobbied the agency to add mifepristone to its recently updated list of contaminants that utilities will have to track in drinking water. It’s too late to include a new drug on the list, which is updated every five years. 

But according to Politico, EPA staffers advised anti-abortion activists to use an upcoming public comment period to drum up requests that the agency include active metabolites in mifepristone. The EPA collects nationwide data on the chemicals on this list, which could be used to set future federal limits.  

Fetal wrongful death bills 

In Florida, where abortion is banned at six weeks’ gestation, lawmakers recently advanced HB 289 ahead of the 2026 session, which would allow parents to file wrongful death lawsuits for the loss of a developing fetus and to claim damages for mental pain and loss of support. Its companion bill, SB 164, filed for the third year in a row by Republican Sen. Erin Grall, faces an uphill battle in the Florida Senate, reported the Florida Phoenix, which noted that jurors could be asked to consider the salary the fetus could have earned over its life as part of damages to which parents could be entitled. 

Groups opposing the legislation as far-reaching and likely to increase liability exposure for OB-GYNs who specialize in high-risk pregnancies include the American Civil Liberties Union of Florida, the Florida Justice Reform Institute and the Doctors Company, the nation’s largest physician-owned medical malpractice carrier.

One of the bill’s leading champions, Andrew Shirvell, founder and executive director of Florida Voice for the Unborn, told state House Judiciary Committee members they should continue expanding “civil remedies afforded under Florida law to hold accountable those who continue to take the lives of unborn children illegally in our state.”

Another bill, HB 663, would allow a family member to sue someone for providing or attempting to provide an abortion up to two years after the fact with up to $100,000 in damages, even if the woman consented or if the abortion was performed in another state or country where the procedure is legal.

Attempts to overturn or skirt abortion rights ballot measures 

Even though Missouri voters in 2024 approved an amendment to protect abortion rights in the state constitution, broad access has not returned to the state. Between January and October, there were only 80 in-clinic abortion procedures in Missouri, according to state data, with an additional 79 abortions in hospitals and identified as medical emergencies.

A trial in January could determine whether Missouri’s anti-abortion laws violate the voter-approved amendment. Meanwhile, Republican lawmakers have put a new constitutional amendment on the 2026 ballot that would ban nearly all abortions in the state with limited exceptions.   

In 2023, Ohio voters approved a constitutional amendment protecting abortion rights through fetal viability, and prohibiting the state from interfering with or penalizing someone for exercising that right. But Republicans have been advancing anti-abortion bills to create restrictions that make accessing abortion more difficult without directly flouting the amendment. 

During this legislative session, which ends Dec. 31, state Sen. Kyle Koehler introduced SB 309, which could add steps to accessing medication abortion and would require doctors to deliver a state-mandated script about the dangers of mifepristone. It would also allow patients, their parents if they’re underage, or the father of the fetus  to sue if they feel the patient was uninformed when taking the pill.

In November, the Ohio House passed HB 485, which would require students in fifth through 12th grade to watch either a “Meet Baby Oliva” fetal development video created by the national anti-abortion group Live Action, or a similar video. Live Action’s video has been criticized by reproductive health advocates for not being fully medically accurate or comprehensive. Similar bills have been introduced in dozens of states this year, and have been enacted in Idaho, Indiana, Iowa, Kansas, North Dakota and Tennessee. 

Abortion records privacy

Privacy concerns around reproductive health in the post-Roe era persist nationally. Lawmakers in states that protect abortion rights continue to try to shore up medical and data privacy protections for abortion, which is almost completely illegal in more than a dozen states. 

In Indiana, where the legislative session began in December, Sen. La Keisha Jackson introduced SB 109. Under the measure, a health care provider’s report about an abortion submitted to the Indiana health department as a medical record would be confidential and not subject to disclosure as a public record. In a state lawsuit brought by two OB-GYNs from Indianapolis, an appeals court in December upheld the privacy of these records, known as terminated pregnancy reports.

In Washington state, Democratic lawmakers are still drafting legislation that would regulate license plate readers following reports that authorities in Texas searched thousands of cameras, as far as Washington and Illinois, to find a woman they believed had a self-administered medication abortion. 

Calling for forced vasectomies for convicted rapists

State abortion restrictions typically hold health providers liable, but women have been jailed or prosecuted for their pregnancy outcomes. One Democratic lawmaker in Alabama, where abortion is banned throughout pregnancy except to save the pregnant person’s life, has introduced legislation that comes with steep penalties for men convicted of rape or incest that resulted in pregnancy. 

Democratic Rep. Juandalynn Givan’s prefiled HB 46 would authorize abortion to preserve the health of the mother or if the pregnancy resulted from rape or incest. It would also require men convicted of rape or incest to pay for the abortion, and undergo either vasectomy or castration, as determined by the court. As the Alabama Reflector reported, the bill is unlikely to be considered, but for Givan it’s really about starting a broader conversation of bodily autonomy. 

“We have already set a double standard,” Givan said. “Have you seen a bill crafted that tells a man what he cannot … do with his body? You have not, outside of the standard laws that speaks to rape and incest, and we already know that that is definitely a crime.”

Anticipated federal policy decisions during Trump’s second year 

In his first year back in office, President Donald Trump rescinded many of the Biden-era policies intended to expand abortion access, including the previous administration’s interpretation that the Emergency Medical Treatment and Labor Act covers abortions necessary to save a pregnant person’s life even in a state that has banned abortion.

More major federal policy decisions around abortion are anticipated in 2026. The Food and Drug Administration agreed to review mifepristone’s safety, but abortion opponents recently called for FDA Commissioner Martin Makary to be fired, accusing him of slow-walking the review until after the midterm elections in November. 

Just a few months before that, in July, a controversial Medicaid policy effectively defunding Planned Parenthood clinics and other nonprofit clinics that provide abortions, is slated to expire. Whether Republicans will renew the funding restriction or let it lapse — allowing the nation’s largest network of reproductive health clinics to continue serving Medicaid patients for services unrelated to abortion — remains to be seen.

Abortion-rights advocate Kristin Hady helps a car navigate past protesters toward  A Preferred Women’s Health Center of Atlanta in Forest Park, Georgia, in August 2023. Independent clinics are facing fresh challenges, and at least 23 more closed this year, bringing the total to 100 since the Dobbs decision. (Photo by Ross Williams/Georgia Recorder) 

When Wisconsin Planned Parenthood clinics temporarily paused abortion services in October because of a new law halting federal Medicaid reimbursements, patients turned to the state’s two independent clinics for care. 

Demand at Affiliated Medical Services in Milwaukee quadrupled, according to clinic director Dabbie Phonekeo. 

“It happened all of a sudden. We were all scrambling to figure out what we needed to do and how we were going to accept all patients,” Phonekeo said. 

The staff secured additional funding to meet need before Wisconsin’s Planned Parenthood clinics resumed abortions, adapting under a law that bans certain reproductive health care providers from receiving federal funding until July 2026. 

“This was a reminder of why it’s so important to have independent clinics and abortion access overall,” Phonekeo said. 

At least 23 independent clinics have closed this year, according to a report released Tuesday by Abortion Care Network, compared with 12 last year.

Most were in states with abortion-rights protections, the report found. 

Independent providers face less recognition than Planned Parenthood and ongoing barriers to funding. Donations to abortion clinics and funds have waned, leading to more out-of-pocket costs for patients, States Newsroom reported last year.  

Independent clinics provide 58% of all abortions nationwide, while Planned Parenthood provides 38%, hospitals 3%, and 1% occur at physicians’ offices, according to the latest Abortion Care Network findings. 

Medication abortion, allowed during the first 10 weeks of pregnancy, has been a focus of abortion-rights advocates and opponents this year. But independent clinics are more likely to offer legal procedural abortions after that. 

More than 60% of all U.S. clinics that offer abortion care after the first trimester are independent, 85% that provide abortion at 22 weeks or later are independent, and all clinics that perform the procedure after 26 weeks are independent, according to the report. 

“While both medication and in-clinic abortion are safe and effective, people may need or prefer one method over another,” the report states. “This is especially true for patients for whom it’s not safe or feasible to terminate outside the clinic — including those experiencing intimate partner violence, minors without support at home, people experiencing homelessness, and patients who cannot take time off from work or caretaking.” 

The latest clinic closures come more than three years after the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision forced many to cease operations: 100 independent clinics closed between 2022 and 2025. 

Affiliated Medical Services in Wisconsin is one of the few independent abortion providers that was able to reopen after closing the day the nation’s highest court overturned federal abortion rights on June 24, 2022. 

The clinic reopened in March 2024 a few months after a Wisconsin judge ruled that a 19th century abortion ban was invalid, Wisconsin Examiner reported. 

Phonekeo said people were initially hesitant to book appointments at the clinic. 

“Most of our patients that we saw had asked, ‘Is this legal? Am I going to go to jail if I have an abortion today? Can we do this in Wisconsin?’ So I think a lot of patients were still afraid to be seen,” she said. 

Independent clinics could become even more significant to reproductive health care access if lawmakers permanently bar Planned Parenthood from receiving federal resources.  

Some anti-abortion groups have urged the Trump administration to disqualify Planned Parenthood as a federal vendor, States Newsroom reported in November. 

Nearly 50 Planned Parenthood clinics closed this year due to federal health officials’ cuts to Title X and Medicaid. At least 20 closed since a federal “defunding” provision that halts Medicaid funds for reproductive health care providers that offer abortion and received more than $800,000 in fiscal year 2023 took effect, according to a tally released on Nov. 12 by the national organization. 

Some of the clinics that closed did not offer abortion. And under the law, federal funding only covers abortions in extreme circumstances, so the Medicaid reimbursement ban primarily affects patients who go to Planned Parenthood for other services, like birth control, cervical cancer screening and treatment for sexually transmitted infections. 

Some independent clinics offer non-abortion care, too, but many don’t accept Medicaid, clinic directors said at a Wednesday news briefing. 

Amber Gavin is the vice president of advocacy of operations at A Woman’s Choice, an organization that has three clinics in North Carolina and one each in Florida and Virginia. She said staff members at the Charlotte location have seen an uptick in patients seeking STI testing and related services. 

Karishma Oza, chief of staff at DuPont Clinic in Washington, D.C., also said providers there have seen an increase in patients who are uninsured or underinsured since the Medicaid ban, which mostly affects Planned Parenthood, took effect. 

Phonekeo said the Wisconsin clinic hasn’t dealt with more demand for reproductive health care services beyond abortion. Still, Affiliated Medical Services offers birth control pills, IUDs, STI testing and treatment, miscarriage care and even follow-up care for medication abortion provided through online-only clinics such as Hey Jane. 

While all three clinic leaders said they don’t accept Medicaid, they offer sliding-scale payments for people who cannot afford the full cost of care. 

“We’re more than just abortion providers,” Phonekeo said. 

U.S. Sen. Josh Hawley, R-Mo., talks to reporters at the U.S. Capitol on Saturday, June 28, 2025. (Photo by Ashley Murray/States Newsroom)

WASHINGTON — Missouri U.S. Sen. Josh Hawley is ratcheting up pressure on the U.S. Food and Drug Administration to finish a study into medication abortion and to change its prescribing guidelines, sending a letter to Commissioner Marty Makary on Wednesday that the pace of the review is “totally unacceptable.”

The letter came just one day after leading anti-abortion groups called on President Donald Trump to fire Makary, following a report from Bloomberg Law that he planned to delay the agency’s review into mifepristone until past the November midterm elections. 

Hawley wrote in the two-page letter he posted to social media that it was “unclear” whether the FDA was actually conducting a review of the current prescribing guidelines and the safety of medication abortion. 

“There are more abortions in America now than when Roe was still law,” Hawley wrote, referring to the 1973 Roe v. Wade ruling from the Supreme Court, which established the constitutional right to an abortion. “And this is largely because of the chemical abortion drug and its generics, like the one you approved.”

Hawley asked Makary to reply to three questions before Dec. 15, including whether the FDA is “conducting a comprehensive safety review of mifepristone separate from the (Risk Evaluation and Mitigation Strategies) process,” if Makary delayed any safety reviews of mifepristone and if the FDA has plans to revert prescribing guidelines to require in-person dispensing. 

President Donald Trump, asked about the timeline during a roundtable at the White House, said he would find out whether the FDA was stalling. 

“I’ll find out. I’ll ask them,” Trump said. “I don’t think they’re slow walking anything, but I’ll find out.”

A spokesperson for the Department of Health and Human Services, which includes the FDA, said that “FDA’s comprehensive scientific reviews take the time necessary to get the science right, and that is what Dr. Makary is ensuring as part of the Department’s commitment to gold-standard science and evidence-based reviews.”

Second day of pressure on Makary

Hawley’s letter continued the public pressure campaign from anti-abortion organizations and lawmakers that began Tuesday when leaders at Susan B. Anthony Pro-Life America and Live Action called for Makary to be fired over the Bloomberg Law news story reporting he had delayed the review of mifepristone over political considerations related to the midterm elections.

Americans United for Life CEO John Mize released a statement after meeting with Makary, saying it “is glaringly obvious that flawed political calculations” have stalled the FDA’s review of mifepristone, but not calling for him to lose his job over it. 

Access to mifepristone

Mifepristone is one of two pharmaceuticals used in medication abortion. It is approved for up to 10 weeks gestation and can be prescribed via telehealth and shipped to patients. 

Reducing or eliminating access to mifepristone has become a linchpin of the anti-abortion movement since the U.S. Supreme Court overturned the nationwide right to an abortion in 2022. 

Anti-abortion medical organizations, represented by Alliance Defending Freedom senior counsel Erin Morrow Hawley, tried unsuccessfully to have the Supreme Court revert the prescribing guidelines for mifepristone in 2024. 

Josh Hawley and Erin Morrow Hawley are married. 

Numerous medical organizations, including the American College of Obstetricians and Gynecologists and the American Medical Association, filed briefs to the justices in that case attesting to the safety and efficacy of medication abortion. 

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