Dem Governors, US Senators Call On Top Pharmacies to Clarify Medication Abortion Plans

With Walgreens under fire for its new abortion pill policy, 14 Democratic U.S. governors on Tuesday asked the corporate leaders of seven other major pharmacies to clarify their plans to lawfully distribute abortion medication like mifepristone.

The Food and Drug Administration (FDA) in January announced a regulatory change to allow retail pharmacies to dispense mifepristone, one of two medications commonly taken in tandem to induce abortion. The move came after the U.S. Supreme Court last summer reversed Roe v. Wade with its 6-3 ruling in Dobbs v. Jackson Women's Health Organization.

In the wake of the high court decision, patients have had to contend with trigger laws, new efforts to enact abortion bans, and other attempts by right-wing political leaders to cut off access to healthcare, including 20 GOP state attorneys general who last month threatened legal action against Walgreens and CVS if they dispense abortion medication by mail.

While shortly after the FDA announcement both pharmacy giants confirmed they planned to seek certification to distribute mifepristone, Walgreens later clarified it won't offer the drug in states where Republican AGs have threatened legal action—prompting California Gov. Gavin Newsom last week to not renew his state's $54 million contract with Walgreens.

Newsom is spearheading the Reproductive Freedom Alliance and on Tuesday joined the Democratic governors of Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, North Carolina, New Jersey, New Mexico, New York, Oregon, Washington, and Wisconsin in sending letters to the leaders of Costco, CVS, Health Mart, Kroger, Rite Aid, Safeway, and Walmart.

As the governors wrote:

We are deeply committed to protecting and expanding reproductive freedom and the health and well-being of all of our residents. As governors of 14 states, we not only represent over 141 million residents with a combined economy of over $11 trillion, but we are also direct customers who have partnered with many of your companies for years on a variety of issues and initiatives. We understand you are carefully reviewing the new mifepristone certification process. We look forward to receiving your plans for dispensing mifepristone in states where such care is legal, as well as any other actions you plan to take to safeguard access to reproductive healthcare.

"As companies that dispense critical, lifesaving medications, we urge that your decisions continue to be guided by well-established science and medical evidence and a commitment to the health and well-being of patients—not politics or litigation threats," the governors added.

Meanwhile, Sens. Patty Murray (D-Wash. ) and Debbie Stabenow (D-Mich.) revealed a series of letters—backed by several Senate Democrats—sent to various pharmacy leaders in recent days. They wrote to Walgreens' chief executive officer "with grave concerns about the misunderstanding and confusion your company has created with regard to patients' access to mifepristone from retail pharmacies."

Walgreens' response to Republican attorney generals' pressure "was unacceptable and appeared to yield to these threats—ignoring the critical need to ensure patients can get this essential healthcare wherever possible," the senators continued. "As you work through the FDA certification process, we urge you to fully assess the laws in each state and ensure your policies provide the strongest possible legal access to this critical patient care."

Stabenow told NBC News, which first reported on the senators' letters Tuesday, that "in no way, shape, or form should businesses deny legal healthcare to women who have the right to access this vital medication. All businesses should follow the FDA certification process and fully comply with applicable state and federal law."

The Senate Democrats wrote to the CEOs of Albertsons, Costco, Kroger, and Walmart "with great frustration" that none of them has publicly indicated whether they plan to allow customers to access mifepristone through their pharmacies across the country.

After expressing concern that GOP intimidation tactics could "lead companies like yours to continue to sit on the sidelines and undermine critical care for your customers," the senators urged those four chains "to pursue policies that provide the strongest possible access to the full range of essential healthcare they need, including mifepristone, and to communicate clearly to your customers about how they can access this care."

"We look forward to hearing back from you by March 21, 2023 about your intentions to ensure access to this critical FDA-approved product," the lawmakers added.

In letters to CVS and Rite Aid leadership, the Senate Democrats expressed appreciation for both chains' ongoing efforts to become distributors of mifepristone while also stressing that "at a time of great confusion about abortion access, it is imperative that no company adds to it."

The senators asked both companies' leaders to respond to three questions by March 21:

• If certified, how do you plan to notify current customers about access to mifepristone in any given state, where restrictions do and do not exist?
• If a new state law to restrict access to medication abortion is proposed, at what stage will you clarify to your customers whether they still have access to mifepristone?
• Will your company conduct any community outreach to ensure customers are aware of the full range of legal health services available to them?

"Medication abortion is how most women across our country get abortion care," Murray told NBC, "and it's absolutely critical patients can access this safe, FDA-approved drug without being forced to jump through medically unnecessary hoops or drain their bank accounts to travel hundreds of miles."

The questions and concerns about accessing mifepristone at retail pharmacies come as patients and providers nationwide prepare for a secretive Wednesday hearing before right-wing U.S. District Court Judge Matthew Kacsmaryk regarding an anti-choice group's effort to limit abortion access by arguing that the FDA never should have approved the drug over two decades ago.