Abortion Pills Will Be the Next Battle in the 2024 Election

Published

2 years ago

February 14, 2023

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The next front is rapidly emerging in the struggle between supporters and opponents of legal abortion, and that escalating conflict is increasing the chances that the issue will shape the 2024 election as it did last Novembers midterm contest.

President Joe Biden triggered the new confrontation with a flurry of recent moves to expand access to the drugs used in medication abortions, which now account for more than half of all abortions performed in the United States. Medication abortion involves two drugs: mifepristone followed by misoprostol (which is also used to prevent stomach ulcers). Although abortion opponents question the drugs safety, multiple scientific studies have found few serious adverse effects beyond headache or cramping.

Federal regulation of the use and distribution of these drugs by agencies including the FDA and the United States Postal Service has long been overshadowed in the abortion debate by the battles over Supreme Court nominations and federal legislation to ban or authorize abortion nationwide. But with a conservative majority now entrenched in the Court, and little chance that Congress will pass national legislation in either direction any time soon, abortion supporters and opponents are focusing more attention on executive-branch actions that influence the availability of the pills.

Read: The abortion backup plan no one is talking about

The reality of abortion care has been changing very, very rapidly, and now the politics are catching up with it, Celinda Lake, a Democratic pollster who served as one of Bidens advisers in 2020, told me.

Tens of thousands of anti-abortion activists will descend on Washington today for their annual March for Lifethe first since the Supreme Court last summer overturned Roe v. Wade, the 1973 decision that established a nationwide right to abortion. The activists will cheer the swift moves by some two dozen Republican-controlled states to ban or severely restrict abortion since the Court struck down Roe.

But even as abortion opponents celebrate, they are growing more frustrated about the increased reliance on the drugs, which are now used in 54 percent of U.S. abortionsup dramatically from less than one-third less than a decade ago, according to the Guttmacher Institute, a research group that supports abortion rights. With the overturning of Roe, [with] COVID, and with President Bidens loosening of the restrictions on these [drugs] there is a new frontier that everyone is pivoting to, Rebecca Parma, the legislative director for Texas Right to Life, a prominent anti-abortion group, told me.

George W. Bush and Donald Trump, the two Republicans who have held the presidency since the drugs were first approved under Democratic President Bill Clinton, in 2000, took virtually no steps to limit their availability. But conservative activists are already signaling that they will press the Republican presidential candidates in 2024 for more forceful action.

Our job is to make sure this becomes an issue that any GOP candidate will have to answer and address, Kristan Hawkins, the president of the anti-abortion group Students for Life of America, told me. No one can be ambivalent again; it will simply not be an option.

The challenge for Republicans is that the 2022 midterm elections sent an unmistakable signal of resistance to further abortion restrictions in almost all of the key swing states that tipped the 2020 presidential election and are likely to decide the 2024 contest. Would you really want to be Ron DeSantis or Donald Trump running in a close election saying, Im going to ban all abortion pills in Michigan or Pennsylvania right now? says Mary Ziegler, a law professor at UC Davis, who has written extensively on the history of the abortion debate.

Sunday is the 50th anniversary of the original Roe decision, and the Biden administration will mark the occasion with a defiant pro-abortion-rights speech from Vice President Kamala Harris in Florida, where GOP Governor DeSantis, a likely 2024 presidential contender, signed a 15-week abortion ban last April.

White House officials see access to abortion medication as the next battlefront in the larger struggle over the procedure, Jennifer Klein, the director of the White House Gender Policy Council, told me. She said she expects Republicans to mount more sweeping efforts to restrict access to the drugs than they did during the Bush or Trump presidencies. The reason youve seen both Democratic and Republican administrations ensure access to medication abortions is because this is the FDA following their evidence-based scientific judgment, she said. So what I think is different now is you are seeing some pretty extreme actions as the next way to double down on taking away reproductive health and reproductive rights.

Federal regulation of the abortion drugs has followed a consistent pattern, with Democratic presidents moving to expand access and Republican presidents mostly accepting those actions.

Read: The other abortion pill

During the 2000 presidential campaign, for instance, George W. Bush called the Clinton administrations initial approval of mifepristone wrong and said he worried it would lead to more abortions. But over Bushs two terms, his three FDA commissioners ignored a citizen petition from conservative groups to revoke approval for the drug. Under Barack Obama, the FDA formalized relatively onerous rules for the use of mifepristone. Physicians had to obtain a special certification to prescribe the drug, women had to meet with their doctor once before receiving it and twice after, and it could be used only within the first seven weeks of pregnancy.

The FDA loosened these restrictions during Obamas final year in office. It reduced the number of physician visits required to obtain the drugs from three to one and increased to 10 the number of weeks into a pregnancy the drugs could be used. The revisions also permitted other medical professionals, such as nurses, to prescribe the drugs if they received certification, and eliminated a requirement for providers to report adverse effects other than death. Trump didnt reverse any of the Obama decisions. He did side with conservatives by fighting a lawsuit from abortion-rights advocates to lift the requirement for an in-person doctors visit to obtain the drugs during the COVID pandemic. But by the time the Supreme Court ruled for the Trump administration in January 2021, Biden was days away from taking office. Within months, women seeking an abortion could consult with a doctor via telehealth and then receive the pills via mail.

On January 3 of this year, the FDA took another major step by allowing pharmacies to dispense the drugs. In late December, the Justice Department issued a legal opinion that the Postal Service could deliver the drugs without violating the 19th-century Comstock Act, which bars use of the mail to corrupt the public morals.

The paradox is that the impact of these rules, for now, will be felt almost entirely in the states where abortion remains legal. Obtaining abortion pills there will be much more comparable to filling any other prescription. But 19 red states have passed laws that still require medical professionals to be present when the drugs are administered, which prevents pharmacies from offering them despite the FDA authorization. And although the FDA has approved use of mifepristone for the first 10 weeks of pregnancy, medical professionals cannot prescribe the drugs in violation of state time limits (or absolute bans) on abortion. In terms of anti-abortion states, the Biden administrations actions have had basically no impact, Greer Donley, a University of Pittsburgh law professor who studies abortion law, told me in an email.

Although the red states have largely walled themselves off from Bidens efforts on medication abortion, conservatives have launched a multifront attempt to roll back access to the pills nationwide. Students for Life has filed another citizen petition with the FDA, arguing that doctors who prescribe the drugs must dispose of any fetal remains as meical waste. In a joint letter released last week, 22 Republican attorneys general hinted that they may sue to overturn the new FDA rules permitting pharmacies to dispense the drugs. In November, another coalition of conservative groups filed a lawsuit before a Trump-appointed judge in Texas seeking to overturn the original certification and ban mifepristone. Jenny Ma, the senior counsel at the Center for Reproductive Rights, says that decision could ultimately have a broader effect than even the Supreme Court ruling overturning Roe: This case, she told me, could effectively ban medication abortion nationwide. It means people in every state may not be able to get abortion pills.

Republicans will also ramp up legislative action against the pills, although their proposals have no chance of becoming law while Democrats control the Senate and Biden holds the veto pen. Republican Senator Cindy Hyde-Smith of Mississippi is planning to reintroduce her SAVE Moms and Babies Act, which would restore the prohibition against dispensing abortion drugs through the mail or at pharmacies.

From the May 2022 issue: The future of abortion in a post-Roe America

However these legal and legislative challenges are resolved, its already apparent that the 2024 GOP presidential field will face more pressure than before to propose executive-branch actions against the drugs. Thats going to be our clarion call in 2024, says Kristi Hamrick, a long-term social-conservative activist, who now serves as the chief strategist for media and policy at Students for Life.

Katie Glenn, the state-policy director at Susan B. Anthony Pro-Life America, told me that, at the least, the group wants 2024 Republican presidential candidates to press for restoring the requirement to report adverse consequences from the drugs. Former Vice President Mike Pence, a likely candidate, has already suggested that he will support a ban on dispensing the pills through the mail. But the anti-abortion movements long-term goal remains the same: ban mifepristone altogether. Hawkins shows the growing fervor GOP candidates will face when she says, This pill is a cancer that has now metastasized throughout our country.

Simultaneously, abortion-rights advocates are pushing the Biden administration to loosen restrictions even further. Medication abortion has been overregulated for far too long, Ma told me. Many advocates want the FDA to extend permitted use of mifepristone from 10 to 12 weeks, eliminate the requirement that the professionals prescribing the drugs receive a special certification, and begin the process toward eventually making the drug available over the counter.

The immediate question is whether the Biden administration will challenge the red-state laws that have stymied its efforts to expand access. Advocates have argued that a legal case can be made for national FDA regulations to trump state restrictions, such as the requirement for physicians to dispense the drugs. But Biden is likely to proceed cautiously.

We dont have a lot of answers because, frankly, states have not tried to do this stuff in hundreds of years, Ziegler, the author of the upcoming book Roe: The History of a National Obsession, told me. Even so, she added, its a reasonable assumption that this conservative-dominated Supreme Court would resist allowing the federal government to preempt state rules on how the drugs are dispensed.

These mirror-image pressures in each party increase the odds of a clear distinction between Biden (or another Democrat) and the 2024 GOP nominee over access to the drugs. Democrats are generally confident they will benefit from almost any contrast that keeps abortion prominent in the 2024 race. Some, like Lake, see access to the pills as a powerful lever to do that. The issue, she argues, is relevant to younger voters, who are much more familiar than older people with the growing use of medication abortion and are especially dubious that pharmacies can offer certain drugs in some states but not in others.

The impact of abortion on the 2022 election was more complex than is often discussed. As Ive written, in the red states that have banned or restricted the practice, such as Florida, Ohio, and Texas, there was no discernible backlash against the Republican governors or state legislators who passed those laws. But the story was different in the blue and purple states where abortion remains legal. In pivotal states including Arizona, Michigan, Pennsylvania, and Wisconsin, a clear majority of voters said they supported abortion rights, and, according to media exit polls, crushing majorities of them voted against Republican gubernatorial candidates who pledged to restrict abortion. Those Democratic victories in the states likely to prove decisive again in 2024 have left many Republican strategists leery of pursuing any further constraints on abortion.

Whats clear now is that even as abortion opponents gather to celebrate their long-sought toppling of Roe, many of them wont be satisfied until they have banned the procedure nationwide. It is totally unacceptable for a presidential candidate to say, Its just up to the states now, Marilyn Musgrave, the vice president for government affairs at the Susan B. Anthony group, told me. We need a federal role clearly laid out by these presidential candidates. Equally clear is that abortion opponents now view federal regulatory actions to restrict, and eventually ban, abortion drugs as a crucial interim step on that path. The U.S. may seem in some ways to be settling into an uneasy new equilibrium, with abortion banned in some states and permitted in others. But, as the escalating battle over abortion medication makes clear, access to abortion in every state will remain on the ballot in 2024.

Politics

I’ve followed the PM wherever he goes in his first year in office – here’s what I’ve observed

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2 hours ago

July 4, 2025

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I've followed the PM wherever he goes in his first year in office - here's what I've observed

July 5 2024, 1pm: I remember the moment so clearly.

Keir Starmer stepped out of his sleek black car, grasped the hand of his wife Vic, dressed in Labour red, and walked towards a jubilant crowd of Labour staffers, activists and MPs waving union jacks and cheering a Labour prime minister into Downing Street for the first time in 14 years.

Starmer and his wife took an age to get to the big black door, as they embraced those who had helped them win this election – their children hidden in the crowd to watch their dad walk into Number 10.

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Keir Starmer, not the easiest public speaker, came to the podium and told the millions watching this moment the “country has voted decisively for change, for national renewal”.

He spoke about the “weariness at the heart of the nation” and “the lack of trust” in our politicians as a “wound” that “can only be healed by actions not words”. He added: “This will take a while but the work of change begins immediately.”

A loveless landslide

That was a day in which this prime minister made history. His was a victory on a scale that comes around but one every few decades.

He won the largest majority in a quarter of a century and with it a massive opportunity to become one of the most consequential prime ministers of modern Britain – alongside the likes of Margaret Thatcher or Tony Blair.

But within the win was a real challenge too.

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Starmer’s was a loveless landslide, won on a lower share of the vote than Blair in all of his three victories and 6 percentage points lower than the 40% Jeremy Corbyn secured in the 2017 general election.

It was the lowest vote share than any party forming a post-war majority government. Support for Labour was as shallow as it was wide.

In many ways then, it was a landslide built on shaky foundations: low public support, deep mistrust of politicians, unhappiness with the state of public services, squeezed living standards and public finances in a fragile state after the huge cost of the pandemic and persistent anaemic growth.

Put another way, the fundamentals of this Labour government, whatever Keir Starmer did, or didn’t do, were terrible. Blair came in on a new dawn. This Labour government, in many ways, inherited the scorched earth.

The one flash of anger I’ve seen

For the past year, I have followed Keir Starmer around wherever he goes. We have been to New York, Washington (twice), Germany (twice), Brazil, Samoa, Canada, Ukraine, the Netherlands and Brussels. I can’t even reel off the places we’ve been to around the UK – but suffice to say we’ve gone to all the nations and regions.

What I have witnessed in the past year is a prime minister who works relentlessly hard. When we flew for 27 hours non-stop to Samoa last autumn to the Commonwealth Heads of Government Meeting (CHOGM) summit, every time I looked up at the plane, I saw a solitary PM, his headlight shining on his hair, working away as the rest of us slept or watched films.

He also seems almost entirely unflappable. He rarely expresses emotion. The only time I have seen a flash of anger was when I questioned him about accepting freebies in a conversation that ended up involving his family, and when Elon Musk attacked Jess Phillips.

I have also witnessed him being buffeted by events in a way that he would not have foreseen. The arrival of Donald Trump into the White House has sucked the prime minister into a whirlwind of foreign crises that has distracted him from domestic events.

When he said over the weekend, as a way of explanation not an excuse, that he had been caught up in other matters and taken his eye off the ball when it came to the difficulties of welfare reform, much of Westminster scoffed, but I didn’t.

I had followed him around in the weeks leading up to that vote. We went from the G7 in Canada, to the Iran-Israel 12-day war, to the NATO summit in the Hague, as the prime minister dealt with, in turn, the grooming gangs inquiry decision, the US-UK trade deal, Donald Trump, de-escalation in the Middle East and a tricky G7 summit, the assisted dying vote, the Iran-Israel missile crisis.

He was taking so many phone calls on Sunday morning from Chequers, that he couldn’t get back to London for COBRA [national emergency meeting] because he couldn’t afford to not have a secure phone line for the hour-long drive back to Downing Street.

He travelled to NATO, launched the National Security Review and agreed to the defence alliance’s commitment to spend 5% of GDP on defence by 2035. So when he came back from the Hague into a full-blown welfare rebellion, I did have some sympathy for him – he simply hadn’t had the bandwidth to deal with the rebellion as it began to really gather steam.

Dealing with rebellion

Where I have less sympathy with the prime minister and his wider team is how they let it get to that point in the first place.

Keir Starmer wasn’t able to manage the latter stages of the rebellion, but the decisions made months earlier set it up in all its glory, while Downing Street’s refusal to heed the concerns of MPs gave it momentum to spiral into a full-blown crisis.

The whips gave warning after 120 MPs signed a letter complaining about the measures, the Work and Pensions Secretary Liz Kendall had done the same, but Starmer and Reeves were, in the words of one minister, “absolutist”.

“They assumed people complaining about stuff do it because they are weak, rather than because they are strong,” said the minister, who added that following the climbdown, figures in Number 10 “just seemed completely without knowledge of the gravity of it”.

That he marks his first anniversary with the humiliation of having to abandon his flagship welfare reforms or face defeat in the Commons – something that should be unfathomable in the first year of power with a majority that size – is disappointing.

To have got it that wrong, that quickly with your parliamentary party, is a clear blow to his authority and is potentially more chronic. I am not sure yet how he recovers.

Keir Starmer said he wanted to rule country first, party second, but finds himself pinned by a party refusing to accept his centrist approach. Now, ministers tell MPs that there will be a financial consequence of the government’s decision to delay tightening the rules on claiming disability benefits beyond the end of 2026.

A shattered Rachel Reeves now has to find the £5bn she’d hoped to save another way. She will defend her fiscal rules, which leaves her the invidious choice of tax rises or spending cuts. Sit back and watch for the growing chorus of MPs that will argue Starmer needs to raise more taxes and pivot to the left.

That borrowing costs of UK debt spiked on Wednesday amid speculation that the chancellor might resign or be sacked, is a stark reminder that Rachel Reeves, who might be unpopular with MPs, is the markets’ last line of defence against spending-hungry Labour MPs. The party might not like her fiscal rules, but the markets do.

What’s on the horizon for year two?

The past week has set the tone now for the prime minister’s second year in office. Those around him admit that the parliamentary party is going to be harder to govern. For all talk of hard choices, they have forced the PM to back down from what were cast as essential welfare cuts and will probably calculate that they can move him again if they apply enough pressure.

There is also the financial fall-out, with recent days setting the scene for what is now shaping up to be another definitive budget for a chancellor who now has to fill a multi-billion black hole in the public finances.

But I would argue that the prime minister has misjudged the tone as he marks that first year. Faced with a clear crisis and blow to his leadership, instead of tackling that head on the prime minister sought to ignore it and try to plough on, embarking on his long-planned launch of the 10-year NHS plan to mark his year in office, as if the chancellor’s tears and massive Labour rebellions over the past 48 hours were mere trifles.

It was inevitable that this NHS launch would be overshadowed by the self-inflicted shambles over welfare and the chancellor’s distress, given this was the first public appearance of both of them since it had all blown up.

But when I asked the prime minister to explain how it had gone so wrong on welfare and how he intended to rebuild your trust and authority in your party, he completely ignored my question. Instead, he launched into a long list of Labour’s achievements in his first year: 4 million extra NHS appointments; free school meals to half a million more children; more free childcare; the biggest upgrade in employment rights for a generation; and the US, EU and India free trade deals.

I can understand the point he was making and his frustration that his achievements are being lost in the maelstrom of the political drama. But equally, this is politics, and he is the prime minister. This is his story to tell, and blowing up your welfare reform on the anniversary week of your government is not the way to do it.

Is Starmer failing to articulate his mission?

For Starmer himself, he will do what I have seen him do before when he’s been on the ropes, dig in, learn from the errors and try to come back stronger. I have heard him in recent days talk about how he has always been underestimated and then proved he can do it – he is approaching this first term with the same grit.

If you ask his team, they will tell you that the prime minister and this government is still suffering from the unending pessimism that has pervaded our national consciousness; the sense politics doesn’t work for working people and the government is not on their side.

Starmer knows what he needs to do: restore the social contract, so if you work hard you should get on in life. The spending review and its massive capital investment, the industrial strategy and strategic defence review – three pieces of work dedicated to investment and job creation – are all geared to trying to rebuild the country and give people a brighter future.

But equally, government has been, admit insiders, harder than they thought as they grapple with multiple crises facing the country – be that public services, prisons, welfare.

It has also lacked direction. Sir Keir would do well to focus on following his Northern Star. I think he has one – to give working people a better life and ordinary people the chance to fulfil their potential.

But somehow, the prime minister is failing to articulate his mission, and he knows that. When I asked him at the G7 summit in Canada what his biggest mistake of the first year was, he told me: “We haven’t always told our story as well as we should.”

I go back to the Keir Starmer of July 5 2024. He came in on a landslide, he promised to change the country, he spoke of the lack of trust and the need to prove to the public that the government could make their lives better through actions not words.

In this second year, he is betting that the legislation he has passed and strategies he has launched will drive that process of change, and in doing so, build back belief.

But it is equally true that his task has become harder these past few weeks. He has spilled so much blood over welfare for so little gain, his first task is to reset the operation to better manage the party and rebuild support.

But bigger than that, he needs to find a way to not just tell his government’s story but sell his government’s story. He has four years left.

Politics

Did Keir Starmer screw up his own anniversary?

Published

2 hours ago

July 4, 2025

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Did Keir Starmer screw up his own anniversary?

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Sir Keir Starmer wanted to be talking about what he sees as Labour’s achievements after 12 months in government and his 10-year plan for the NHS.

But, after another dramatic policy U-turn and the sight of his own chancellor crying at PMQs, when he kept his support for her slightly vague, Beth Rigby, Harriet Harman and Ruth Davidson discuss if his start in office has been shattered by this week.

They also wonder if the solution to make relations with his own MPs a bit easier would be to make better use of Angela Rayner.

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World

Gaza aid group reacts to claims American contractors fired at starving Palestinians

Published

2 hours ago

July 4, 2025

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Gaza aid group reacts to claims American contractors fired at starving Palestinians

Israeli-backed American contractors guarding aid centres in Gaza are using live ammunition and stun grenades as starving Palestinians scramble for food, an investigation has claimed.

The Associated Press has reported the accounts by two contractors from the Gaza Humanitarian Foundation (GHF), although the organisation has strongly denied the allegations, describing them as “categorically false”.

GHF was established in February to deliver desperately needed aid to people in the besieged enclave, but its work has been heavily criticised by international aid groups.

It has also been subject to intense scrutiny about its operations, which Sky News previously reported are associated with a significant increase in deaths.

AP’s claims, which have not been independently verified by Sky News, came from GHF contractors who spoke on condition of anonymity as they were revealing their employer’s internal operations.

They said they were motivated to speak out as they were disturbed by what they considered dangerous practices by security staff who were often heavily armed.

AP reported the contractors had claimed “their colleagues regularly lobbed stun grenades and pepper spray in the direction of the Palestinians” and “bullets were fired in all directions – in the air, into the ground and at times toward the Palestinians, recalling at least one instance where he thought someone had been hit”.

Contractor: ‘Innocent people being hurt’

“There are innocent people being hurt. Badly. Needlessly,” the contractor told AP.

Videos reportedly provided by one contractor show aid sites, located in Israeli military-controlled zones, with hundreds of Palestinians crammed between metal gates, scrambling to reach aid.

In the background, gunfire can be heard, and stun grenades are allegedly fired into crowds.

The footage does not show who was shooting or what was being shot at, but another video shows contractors in a compound, when bursts of gunfire can be heard. One man is then heard shouting in celebration: “Whoo! Whoo!”.

“I think you hit one,” another says, followed by the comment: “Hell, yeah, boy!”

The contractor who took the video told AP that colleagues were shooting in the direction of Palestinians.

According to the Hamas-run Gaza Health Ministry and witnesses, several hundred people have been killed and hundreds more wounded since the GHF sites started operating more than a month ago, amid claims by Palestinians of Israeli troops opening fire almost every day at crowds seeking to reach the aid.

In response, Israel’s military says it fires only warning shots and is investigating reports of civilian harm. It denies deliberately shooting at any innocent civilians and says it’s examining how to reduce “friction with the population” in the areas surrounding the distribution centres.

GHF attacks ‘false claims’

GHF has vehemently denied the accusations, adding that it has investigated AP’s allegations.

In a statement on X, GHF wrote: “Based on time-stamped video footage and sworn witness statements, we have concluded that the claims in the AP’s story are categorically false. At no point were civilians under fire at a GHF distribution site.

“The gunfire heard in the video was confirmed to have originated from the IDF, who was outside the immediate vicinity of the GHF distribution site.

“It was not directed at individuals, and no one was shot or injured. What is most troubling is that the AP refused to share the full video with us prior to publication, despite the seriousness of the allegations.”

Safe Reach Solutions, the logistics company subcontracted by GHF, told the AP there have been no serious injuries at any of their sites to date.

But the organisation admitted that, in isolated incidents, security professionals fired live rounds into the ground and away from civilians to get their attention.

A Safe Reach Solutions spokesperson told AP this happened at the start of their operations at “the height of desperation where crowd control measures were necessary for the safety and security of civilians”.