How a GOP-led Senate hearing inflamed an abortion fight Republicans said was over
By Michael Jones
After the 2022 Dobbs decision that overturned the constitutional right to abortion care, Republicans argued that the issue should return to the states. But the subsequent fights over medication abortion and federal authority have dotted the national battlefield that they said the Court had closed.
In practice, many Republicans have since supported or tolerated actions that cut against that states-rights framing, including for legislation or interpretations of old laws that could function as de facto national abortion restrictions and opposition to shield laws in blue states that protect providers serving patients in ban states.
The anti-abortion movement has also promoted efforts to use federal courts to restrict or invalidate FDA approval of medication abortion nationwide, which has led Democrats and champions of reproductive freedom to wonder why conservative Republicans have continued to pursue national limits through courts or Congress if it’s a states’ issue.
These questions were on display this week during a GOP-led Senate Health, Education, Labor, and Pensions Committee hearing examining what Republicans described as the “risks” of medication abortion, a legal and widely used form of reproductive care.
Sources I spoke to in the week leading up to this morning’s event told me it was an obvious outcome from a pressure campaign from anti-abortion groups and activists who have intensified their advocacy for lawmakers to use oversight, messaging hearings, and legislative pressure to cast doubt on abortion pills, which broadly remain legal and widely used.
And Committee Democrats expressed frustration that a panel with broad latitude to improve health care affordability, workers’ rights, and federal education programs would rather relitigate an issue they say should already be settled.
“This has already been approved,” Sen. Angela Alsobrooks (D-Md.) told me. “I believe that women should choose—it’s just unequivocal. Women have the right to make decisions about their own bodies.”
Sen. Tammy Baldwin noted before the hearing that it would feature a Democratic witness to ensure the record includes an accurate science-based perspective and said that Congress should be addressing the economic concerns Americans are grappling with.
“I don’t feel like this should be where we spend our focus, where we should spend our attention at this particular time when people are really struggling with the cost of things,” she said.
Medication abortion is a non-surgical method of ending an early pregnancy using pills. It usually
involves two drugs taken in sequence: Mifepristone and Misoprostol. The method is distinct from in-clinic abortion and now accounts for a majority of abortions nationwide, particularly since the pandemic-era expansion of telehealth.
Telehealth has reshaped abortion access more than any other innovation in the past decade. Pills can now be prescribed after virtual visits and mailed discreetly, which is why Republicans focus heavily on “mail-order abortion” rhetoric and have ignited debates on Capitol Hill and beyond about interstate commerce, postal service authority, and federal preemption.
The FDA, which approved mifepristone in 2000, regulates abortion drugs like any other medication and has historically limited where and how they could be dispensed. The FDA removed the in-person dispensing requirement during the Biden administration, allowing certified providers and pharmacies to mail pills after a telehealth visit, prompting Republican claims that the agency improperly loosened the rules, while Democrats argued it followed evidence and science.
Speaking of, decades of research show that medication abortion is extremely safe. Serious complications are rare and comparable to or lower than many commonly prescribed drugs. Effectiveness is highest earlier in pregnancy and slightly lower with misoprostol-only regimens, though still high.
Post-Dobbs, access to medication abortion varies widely. Some states ban abortion outright, including abortion pills. Others allow abortion but restrict telehealth or mailing pills. Meanwhile, shield laws in blue states protect providers who prescribe drugs to patients in restrictive states, setting up interstate legal conflicts.
The most credible conservative argument against abortion pills isn’t really about safety or morality but about power— about who gets to decide national policy: Congress, the courts, or federal regulators like the FDA? Conservatives argue the FDA went too far by loosening restrictions on Mifepristone through agency action rather than legislation, especially once telehealth and mail delivery made abortion access harder for states to control. But the argument weakens when it drifts into claims that medication abortion is broadly unsafe or that telehealth eliminates doctors from the process—assertions contradicted by decades of medical evidence.
Ultimately, Democrats told me that the hearing was less about engaging in a good-faith debate over a hot-button issue and more about generating soundbites and clips for the midterm elections.
“It became the kind of hearing that I don’t like, which is it felt like there was a lot of things that were playing towards having your moment on social media,” Sen. Andy Kim (D-N.J.), another HELP Committee member, told me. “What it felt like to me is like, ‘Welcome to the on-year. We are firmly in election season.’”
Michael Jones is an independent Capitol Hill correspondent and contributor for COURIER. He is the author of Once Upon a Hill, a newsletter about Congressional politics.
