So Much for Leaving Abortion Up to the States

The 2022 Dobbs decision, which overturned Roe v. Wade, supposedly gave states the authority to decide for themselves whether to permit abortion. What should have been apparent then, and is obvious now, is that anti-abortion activists and their allies on the high court were never going to be satisfied with that.Since October, the state of Louisiana has been seeking to block the distribution of mifepristone, a drug used to induce abortion, through the mail—not just in Louisiana, but anywhere in the United States. The state’s lawsuit against the FDA asserts that the Comstock Act—an anti-obscenity law championed by the 19th-century book burner Anthony Comstock—bans the mailing of abortion medication, and that the federal government wrongly repealed the in-person requirement for prescribing it.“Louisiana is complaining about reported harms in Louisiana, but they would be imposing a nationwide requirement that patients pick up the pill in person from their health-care provider, even in states that protect abortion access, even in states that explicitly, in their laws, allow for telemedicine provision of mifepristone,” Andrew Beck, an attorney with the ACLU, told me. “Louisiana is really trying to impose its own policy choices on the entire country.”Medication abortion accounts for about two-thirds of all abortions in the United States, which have actually increased since Dobbs v. Jackson Women’s Health Organization made it possible to send mifepristone through the mail. Providers were first able to mail the drug during the pandemic, a temporary measure that was made permanent by the FDA in 2023. Even in Louisiana, which has a strict anti-abortion law with few exceptions, the number of abortions has risen, according to the state’s lawsuit. This was in part because Louisianans were able to access abortion drugs through providers based in states where the procedure is legal. Indeed—abortion medication has made it possible for women who live far from any clinic to end unwante