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In filing, big cities urge Supreme Court to preserve abortion pill access

Six large blue-state municipalities filed a friend-of-the-court brief with the U.S. Supreme Court on Tuesday urging the court not to limit Americans’ access to a widely used abortion pill.

The brief said a Supreme Court ruling reducing access to the pill would put added pressure on strained municipal hospital systems by forcing them to carry out more abortions at the expense of other care.

New York City; San Francisco; Los Angeles County; Cook County in Illinois, which includes Chicago; King County in Washington, which includes Seattle; and Santa Clara County in California signed onto the filing, formally referred to as an amicus brief.

The city’s 33-page brief comes in a closely watched case over the fate of mifepristone, one drug in the two-part sequence typically used in pill-induced abortions. The conservative-leaning Supreme Court is considering vacating or limiting the drug’s quarter-century-old Food and Drug Administration approval.

Last summer, a U.S. Court of Appeals panel in New Orleans ruled in favor of limiting access to the pill, a ruling that partially reversed a Texas federal judge’s order aimed at quashing the drug’s federal approval altogether. The appeals court’s ruling, if adopted by the Supreme Court, would return the pill to a regulatory framework that existed until 2016.

The case is the Supreme Court’s most significant involving abortion rights since it overturned Roe v. Wade in 2022, erasing the federal right to abortion.

A decision in the pill case — Food and Drug Administration v. Alliance for Hippocratic Medicine — is expected by the late spring or early summer, and could have far-reaching health care and political implications, coming months ahead of the November elections. Oral arguments are scheduled for March 26.

About one in two abortions in the U.S. are carried out with medication.

The Supreme Court, which was remade by former President Donald Trump and now has a 6-to-3 conservative supermajority, is not seen as likely to fully vacate the pill’s Food and Drug Administration authorization.

But a ruling in line with the Louisiana appeals court’s decision would prevent patients from accessing the pill by mail or without repeated consultations with doctors. New York, led by Mayor Adams, and other municipalities with Democratic leadership said such a shift would be painful for public hospitals.

“Winding back the FDA’s actions to before 2016 would significantly increase costs on already overburdened public hospitals and health-care systems,” said the brief. “Thousands of patients in need of all kinds of nonemergency surgical care could find themselves facing significant delays in obtaining procedures.”

Separately, New York Gov. Hochul joined a coalition of governors in filing another amicus brief that made a similar argument emphasizing health care services, according to her office.

In a statement, Hochul said she joined other governors in “demanding an end to the harmful politicizing of reproductive healthcare” and urging the Supreme Court to “recognize the longstanding, independent scientific authority of the FDA.”