Clinics make backup plans as Supreme Court decision looms

U.S. abortion pill providers are scrambling to make backup plans because the Supreme Court decides whether to maintain restrictions on the important thing drug mifepristone. 

Some in-person clinics in Latest York, California and Kansas will offer mifepristone for now, but are preparing to supply an alternate abortion pill if a subsequent decision essentially bans the drug. Several in-person providers in Ohio could stop offering mifepristone altogether. One telehealth provider has plans to shut down for as much as two weeks to pivot to recent operations.

All of those efforts aim to preserve access to the most typical type of abortion within the U.S., whilst a bigger legal fight over mifepristone escalates.

Access to mifepristone is hanging within the balance and will quickly change depending on what the nation’s highest court decides as early as next week. Justice Samuel Alito on Friday temporarily suspended lower court rulings that imposed limits on access to mifepristone so the justices have more time to review the case.

But for now, telehealth and in-person clinics could also be forced to grapple with significant restrictions on the drug that would go into effect after Alito’s order expires on Wednesday at 11:59 p.m. ET.

The fifth U.S. Circuit Court of Appeals late Wednesday froze a part of Judge Matthew Kacsmaryk’s order suspending the Food and Drug Administration’s approval of mifepristone. However the court temporarily blocked mail delivery of the pill, re-imposed doctor visits on abortion patients and shortened the length of time patients can take the pill to the seventh week of pregnancy, which is down from the previous 10 weeks.

Those restrictions will limit access to mifepristone even in states where abortion is legal. However the appeals court ruling doesn’t restrict abortion pill access in 17 states and Washington D.C. that were subject to a separate court decision issued last week, a federal judge in Washington said Thursday. 

Some in-person abortion clinics in states where the procedure is legal told CNBC that operations will remain largely the identical. But in addition they highlighted their contingency plans if the court fight results in tighter restrictions on the pill. 

Trust Women, a clinic in Wichita, Kansas, will proceed to supply mifepristone even when the restrictions go into effect, in accordance with Zack Gingrich-Gaylord, the clinic’s communications director. 

“We’re not very impacted by this ruling,” Gingrich-Gaylord told CNBC, referring to the appeals court decision. “But we’re still able to pivot if there are more restrictions. Now we have the alternate protocol ready.” 

The clinic is ready to supply misoprostol as a standalone treatment if a subsequent decision tosses out the FDA’s approval of mifepristone, Gingrich-Gaylord said. The drug is often used together with mifepristone for abortion patients within the U.S.

Misoprostol by itself is endorsed world wide as a secure and effective treatment for ladies who wish to end their pregnancies. The appeals court decision doesn’t affect access to the drug. 

The Decisions Women’s Medical Center in Queens, Latest York, and the University of California San Francisco Center for Pregnancy Options will similarly proceed to supply mifepristone and have the misoprostol-only regimen in place as a backup plan, in accordance with representatives from the clinics. 

But some in-person abortion clinics in Ohio could stop allotting mifepristone entirely if those restrictions go into effect, in accordance with Jessie Hill, an attorney who represents several independent providers within the state. 

Hill, who can be a law professor at Case Western Reserve University, said Ohio law requires doctors to follow federal label guidelines when prescribing mifepristone. She noted the law means clinics cannot prescribe a drug in a way that hasn’t been approved by the federal government, which is often called an “off-label” prescription. 

Other clinics in states where abortion is legal can prescribe mifepristone off-label beyond the primary seven weeks of pregnancy, in accordance with Hill. She said that enables the clinics to effectively work around a restriction within the appeals court order in a way that Ohio providers cannot. 

“The order makes it especially inconvenient for Ohio clinics to prescribe mifepristone, so that they probably won’t. We is perhaps the one state on this weird situation,” Hill said. 

She noted that some clinics could start offering the misoprostol-only regimen as soon because the restrictions go into effect since it’s “actually a greater option for many at this point.” 

U.S.-based telehealth clinics can have to make more sudden shifts than in-person providers on account of the restriction on mail delivery of mifepristone. 

Abortion Telemedicine will only offer misoprostol in states that allow it if the restrictions go into effect on Wednesday, in accordance with the provider’s founder Jayaram Brindala. The clinic serves patients throughout the primary trimester, which is 13 weeks into pregnancy.

Just The Pill can be prepared to supply “the secure and effective misoprostol-only regimen to patients if needed,” said Dr. Julie Amaon, the corporate’s medical director. Just The Pill delivers abortion medication in Wyoming, Montana, Colorado and Minnesota.

Wisp, an organization that gives telehealth medication abortions in nine states, may also switch to providing only misoprostol if those restrictions are put in place, in accordance with Monica Cepak, the corporate’s chief marketing officer. 

But that change would require the corporate to shut down for as much as two weeks starting Wednesday, she noted. 

“Immediately, we’re in our establishment mode and can stay that way until we hear further developments,” Cepak said.

She emphasized telehealth’s critical role in abortion care within the U.S., noting that increasing demand for in-person services makes it difficult for patients to schedule appointments. 

“It may well sometimes take 20 to 40 days. That is too long for most individuals to attend,” she said. “Telehealth fills that gap.”