Bill Overview
Title: Protecting Life from Chemical Abortions Act
Description: This bill prohibits certain changes made by the Food and Drug Administration (FDA) to dispensing requirements for mifepristone. (Mifepristone is a drug that is approved to end pregnancies through 10 weeks gestation when used in conjunction with the drug misoprostol. The procedure is often referred to as medication abortion or the abortion pill.) The FDA regulates the use of mifepristone through the Mifepristone Risk Evaluation and Mitigation Strategy (REMS) program. The program requires health care providers to comply with certain requirements in order to prescribe or dispense mifepristone to end a pregnancy; the program previously included an in-person dispensing requirement that required mifepristone to be directly dispensed to patients in clinics, medical offices, or hospitals. During the COVID-19 public health emergency, the FDA temporarily stopped enforcing the in-person dispensing requirement, which allowed mail-order pharmacies to fill and dispense mifepristone prescriptions. The bill prohibits the FDA from (1) exercising any enforcement discretion with respect to program requirements, or (2) reducing program protections until every state submits certain data regarding abortions to the Centers for Disease Control and Prevention. The bill also generally prohibits the declaration of a public health emergency with respect to abortions.
Sponsors: Rep. Hern, Kevin [R-OK-1]
Target Audience
Population: Individuals potentially undergoing medical abortions
Estimated Size: 500000
- The bill impacts individuals seeking medical abortions through drugs such as mifepristone and misoprostol, which are used to terminate pregnancies up to 10 weeks gestation.
- The prohibition on mail-order pharmacies affects individuals living in areas lacking nearby clinics or where access to in-person medical services is limited.
- The restriction on the ability to declare a public health emergency with respect to abortions could affect broader public health policy, potentially impacting individuals during future health crises.
- Globally, access to mifepristone for medical abortion is a key reproductive health service used by millions, suggesting the population impacted is large.
Reasoning
- The policy affects women who are considering or need to access medical abortions up to 10 weeks gestation, particularly those in rural areas or places with limited access to clinics.
- Currently, approximately 54% of abortions in the U.S. are medication abortions, indicating the potential scale of impact is significant.
- The population impacted may also include those who favor or oppose abortion rights, affecting their perception of wellbeing irrespective of direct medical implications.
- Individuals in healthcare professions might see changes in demand and in the nature of services they provide, influencing their wellbeing indirectly.
Simulated Interviews
College Student (Rural Alabama)
Age: 24 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- I prefer the privacy and convenience of obtaining mifepristone through mail-order pharmacies.
- Reverting to in-person requirements would make it very difficult for me if I needed the service.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 5 | 6 |
| Year 3 | 6 | 7 |
| Year 5 | 6 | 7 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 8 |
Human Resource Manager (New York City)
Age: 32 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 1.0 years
Commonness: 4/20
Statement of Opinion:
- I have healthcare access, but I'm worried about women in less accessible areas.
- This policy seems regressive and could hurt those with fewer resources.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 7 |
| Year 3 | 6 | 7 |
| Year 5 | 6 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 8 |
General Practitioner (Dallas, Texas)
Age: 40 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 5/20
Statement of Opinion:
- If in-person is required again, we'll likely see more patients coming through our doors.
- This could increase our workload but also potentially improve patient interaction.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Software Developer (San Francisco, California)
Age: 29 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- I think it's backwards to remove the mail-order option. Technology should aid accessibility, not restrict it.
- This seems like a political decision rather than a health decision.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 8 |
| Year 2 | 7 | 9 |
| Year 3 | 8 | 9 |
| Year 5 | 8 | 9 |
| Year 10 | 8 | 9 |
| Year 20 | 8 | 9 |
Retired Nurse (Phoenix, Arizona)
Age: 65 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 1.0 years
Commonness: 18/20
Statement of Opinion:
- Limiting access once again reinforces barriers many fought hard to break.
- While I'm retired, this impacts my sense of justice and fairness.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 7 |
| Year 3 | 6 | 7 |
| Year 5 | 7 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 8 |
High School Student (Charlotte, North Carolina)
Age: 18 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm concerned about what this means for my future and having choices.
- Everyone should have access to the full spectrum of health services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 8 |
| Year 2 | 7 | 8 |
| Year 3 | 7 | 9 |
| Year 5 | 8 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Pharmacist (Chicago, Illinois)
Age: 48 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- We had adapted to mail-order services for many medications. It felt more efficient.
- This rollback might lead to operational bulk at pharmacies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 7 | 8 |
Freelance Graphic Designer (Salt Lake City, Utah)
Age: 27 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I'm an independent contractor and I value the ability to manage my health privately.
- The rollback restricts choice and autonomy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 8 |
| Year 3 | 6 | 8 |
| Year 5 | 7 | 9 |
| Year 10 | 8 | 9 |
| Year 20 | 8 | 9 |
Barista (Portland, Oregon)
Age: 22 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 2.0 years
Commonness: 7/20
Statement of Opinion:
- The option of mail order was a relief to many my age, it felt like freedom.
- I hope this isn't the start of more rollbacks to progressive health solutions.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 9 |
| Year 2 | 8 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Community Health Advocate (Miami, Florida)
Age: 33 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 2/20
Statement of Opinion:
- The policy mainly affects women's access in poorer areas, a primary concern for my work.
- It's restrictive and not in line with public health goals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 7 |
| Year 3 | 6 | 8 |
| Year 5 | 6 | 8 |
| Year 10 | 7 | 8 |
| Year 20 | 8 | 8 |
Cost Estimates
Year 1: $15000000 (Low: $10000000, High: $20000000)
Year 2: $15000000 (Low: $10000000, High: $20000000)
Year 3: $15000000 (Low: $10000000, High: $20000000)
Year 5: $15000000 (Low: $10000000, High: $20000000)
Year 10: $15000000 (Low: $10000000, High: $20000000)
Year 100: $15000000 (Low: $10000000, High: $20000000)
Key Considerations
- Implementation complexities surrounding state-level data submission to CDC could delay the bill's full operational effect.
- Supply chain impacts, particularly for mail-order pharmacies, might lead to broader economic repercussions or challenges in access to medication.
- Monitoring and compliance enforcement of in-person dispensing will require coordination between the FDA and state health departments.