Commonwealth Magazine | Healey warns pharmacies to keep abortion meds stocked

By Jennifer Smith
Story Originally Appeared in Commonwealth Magazine

WITH ACCESS TO a widely-used abortion medication on the line, Massachusetts is trying to walk and chew gum at the same time – warning local pharmacies that they must continue supplying the medications, while gearing up for a potentially disruptive ruling out of Texas that could throw abortion care systems into chaos.

“Clarifying guidance” from the Massachusetts Board of Registration in Pharmacy states “all pharmacies located in Massachusetts and licensed by the Board must maintain a continuous, sufficient supply of all family planning medications.” The Wednesday advisory reminds pharmacies that they must dispense the medications to patients with valid prescriptions or face state investigation.

“Here in Massachusetts, we will always protect access to reproductive care, including abortion,” Gov. Maura Healey said in a statement. “At a time when states are rushing to ban medication abortion and some pharmacies are irresponsibly restricting access to it, we are reminding Massachusetts pharmacies that they have an obligation to provide critical reproductive health medications, including Mifepristone. It’s safe, effective, and legal.”

Most abortions in the US are performed through medication rather than surgery. A two-drug combination of Mifepristone and Misoprostol has been approved by the US Food and Drug Administration since 2000 and cleared for terminating pregnancies within the first 10 weeks. 

The Healey administration move seeks to head off companies that may decide to limit access to medication in the state because of the fraught national environment. Walgreens, a major pharmacy chain in the state, last week announced plans to stop offering abortion pills in 20 states where Republican attorneys general threatened legal action against the company if it continued to provide the medication. 

Ellen Frank, interim president and CEO of Planned Parenthood League of Massachusetts, said the advisory sends “a clear message that Massachusetts will not bend to coercive pressure from anti-abortion actors coming for our reproductive rights and legally protected health care.”

Massachusetts residents largely back access to abortion care, polls consistently show. After the US Supreme Court overturned Roe v. Wade in 2022, upending 50 years of precedent, a Suffolk University/Boston Globe poll found that 78 percent of respondents said abortion should be legal in all or most cases. 

Abortion rights tends to be a bipartisan issue in the state. Former Gov. Charlie Baker issued an executive order seeking to strengthen rights to abortion just hours after Roe was overturned.

Medication like Mifepristone remains legal in Massachusetts, but reproductive health groups are still waiting anxiously for a ruling out of a Texas federal district court that could sow nationwide confusion about the drug’s legality. 

Judge Matthew Kacsmaryk, hearing a challenge questioning Mifepristone’s initial approval 20 years ago, appears to be open to a claim that the medication is unsafe. 

Legal experts say the judge does not clearly have the authority to unilaterally ban Mifepristone nationwide, as the FDA has statutory procedures to review and remove a drug from the market. Should Kacsmaryk order the FDA to pull Mifepristone or impose tighter restrictions, the agency may decide to begin the congressionally mandated public review process or decide not to enforce the ruling. 

Regardless of the outcome, parties are expected to appeal. This would send the case up through the Fifth Circuit and may land it before the US Supreme Court. 

In the meantime, “part of the point of this lawsuit is to cause confusion and chaos among patients who are seeking abortion care,” said Rebecca Hart Holder, head of Boston-based Reproductive Equity Now. It is possible to use a less-effective one-drug regimen if Mifepristone is banned, and more patients may consider surgery to end early-stage pregnancies, Hart Holder said. 

The waiting period while Kacsmaryk considers the case is “very frustrating,” Hart Holder said, but advocates are focused on containing panic, which she says government action like the Healey advisory can help with. “All abortion care is legal in Massachusetts,” she said. “Patients will still be able to access care after the ruling because we will need to see how the FDA reacts.”