Abortion Pill Case To Be Heard By The U.S. Supreme Court

Developments in a legal battle over medication abortion in West Virginia could change access in the state.

GenBioPro v. Raynes

In November 2023, GenBioPro filed an appeal to a judge’s August ruling in its case against West Virginia’s near-total abortion ban.

In his ruling, U.S. District Court Judge Robert Chambers dismissed some claims filed by pharmaceutical group GenBioPro in a lawsuit against the state’s attorney general Patrick Morrisey.

GenBioPro v. Raynes claimed that Morrisey violated federal law, more specifically the commerce clause of the U.S. Constitution, by prohibiting the sale of the drug in West Virginia.

“Mifepristone is a medication that is subject to a very specific set of regulations that Congress itself considered,” said Skye Perryman, president and CEO of Democracy Forward, GenBioPro’s legal counsel. “The state of West Virginia cannot and should not, under our constitution, be able to maintain a law that conflicts with that.”

The clause gives Congress broad power to regulate and restrict states from impairing interstate commerce. 

“The theory is based on the Supremacy Clause of the Constitution, which unequivocally says that when federal law and state law conflict, it is the federal law, that must take precedence,” Perryman said.

However, Chambers, who presides over the southern district of West Virginia, said states have the right to regulate public health and morality by curtailing the sale of goods.

The court earlier ruled that GenBioPro had legal standing to bring a suit against the attorney general’s office on the basis of economic damages incurred by the company.

On Feb. 7, GenBioPro filed an appellate brief at the U.S. Court of Appeals for the Fourth Circuit, arguing that West Virginia’s post-Dobbs abortion ban is in direct conflict with federal law.

The brief urges the Court to reverse the District Court’s August ruling in GenBioPro v. Raynes, which dismissed GenBioPro’s challenge to West Virginia’s near-total abortion ban.

According to Morrisey’s office, in August 2023, the district court dismissed the preemption claim against the state’s Unborn Child Protection Act and the constitutional challenges entirely, but it allowed the preemption challenge to the telehealth provisions to proceed.

Morrisey said GenBioPro removed the telehealth challenge in order to proceed with an appeal.

“GenBioPro won its challenge to the telehealth ban, which it is not pursuing now at this time, but the district court ruled for the state with respect to GenBioPro’s challenge to the abortion ban,” Perryman said.

Perryman said GenBioPro believes that West Virginia’s restrictions are unconstitutional and said that is why she is taking the case on appeal to the U.S. Court of Appeals for the Fourth Circuit.

National Litigation

In the first case of its kind since the overturn of Roe v. Wade, oral arguments for and against access to the abortion pill will be heard at the U.S. Supreme Court on March 26.

The outcome of the case will determine how and when patients can access mifepristone, a pharmaceutical approved by the U.S. Food and Drug Administration in 2000.

GenBioPro manufactures a generic version of Mifepristone. The medication is used in conjunction with Misoprostol for medical abortions and can be taken at home to terminate a pregnancy.

Mifepristone is currently approved for use up to 10 weeks gestation and is often used to treat miscarriages and accounts for more than half of abortions in the U.S.

Mifepristone was first approved by the FDA in 2000 and the agency required the drug to be prescribed in person, over three visits to a doctor. Since 2016, the FDA eased restrictions, allowing patients to obtain prescriptions through telemedicine appointments, and to get the drug by mail.

The original lawsuit was brought by the anti-abortion legal organization Alliance Defending Freedom.

On April 7, 2023, U.S. District Judge Matthew Kacsmaryk imposed a nationwide ban on mifepristone, declaring that the FDA had improperly approved the drug.

At practically the same moment, U.S. District Judge Thomas O. Rice in Washington state issued a contrary ruling, in a case brought by 17 states and the District of Columbia seeking to expand the use of mifepristone. Rice declared that the current FDA rules must remain in place.

While the case was argued in lower courts, the Supreme Court put the lower court decisions on hold, allowing the abortion pill to continue on the market as it had been. That stay will remain while the court considers the case.

The Alliance for Hippocratic Medicine argues they have the authority to bring the case because the “FDA overlooked important safety risks in approving mifepristone and amending its restrictions.”

They argue the FDA depends on emergency room doctors to be a crucial component of the mifepristone regimen, as the treating physician in the event of complications.

“According to the doctors, when they treat women who are experiencing complications after taking mifepristone, they are required to perform or complete an abortion, or otherwise required to participate in a process that facilitates abortion,” the filing states. “They maintain that personally conducting those procedures violates their sincerely held moral beliefs.”

The Biden Administration responded that the Alliance for Hippocratic Medicine failed to show “any evidence of injury from the availability” of the medication.

“This Administration will continue to stand by FDA’s independent approval and regulation of mifepristone as safe and effective,” White House spokeswoman Karine Jean-Pierre said in a statement.

Dozens of groups have filed briefs with the supreme court, from both sides of the argument.

On Jan. 30, GenBioPro filed an amicus brief to SCOTUS in Alliance for Hippocratic Medicine v. Federal Drug Administration.

In the brief, GenBioPro claims: “The court never examined the clinical studies underlying and amply supporting FDA’s 2016 changes, which reported that thousands of patients had successfully and safely used mifepristone under the modified conditions.”

Perryman released the following statement:

“The Fifth Circuit’s ruling in this case undermines decades of science and access to evidence-based medication, as well as the FDA’s regulatory authority,” Perryman said. “The ruling was not based on science or facts, but rather furthered another effort waged by extremists in their attacks on women’s rights and ability to access necessary medication.”

The U.S. Supreme Court will hear oral arguments in Alliance for Hippocratic Medicine v. Federal Drug Administration on March 26, 2024.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.

Senate Passes Two Reproductive Rights Bills

Abortion is banned in the state of West Virginia unless medically necessary, or if the pregnancy is no longer viable. There are also exceptions in the abortion ban in the case of rape.

Sen. Patricia Rucker, R-Jefferson, sponsored two notable bills related to pregnant persons in the state.

The Senate is building momentum now that it is well into the second half of the legislative session. Ten bills were passed and sent to the House of Delegates; two bills were sent to the governor’s desk. 

Senate Bill 352

Abortion is banned in the state of West Virginia unless medically necessary, or if the pregnancy is no longer viable. There are also exceptions in the abortion ban in the case of rape.

Sen. Patricia Rucker, R-Jefferson, sponsored two notable bills related to pregnant persons in the state.  

Senate Bill 352 requires informed consent prior to a medically necessary abortion being performed. Informed consent means that the patients that are seeking an abortion must be informed of things like associated medical risks, the probable gestational age, and that perinatal hospital services are available before they decide to go through with the abortion. Some of the information doctors are required to present is on the Department of Health’s website. 

Those opposed to the bill say that the bill requires doctors to present patients with scientifically inaccurate propaganda. 

Rucker said this bill ensures that the patient has all the information that they need to make the decision to have a abortion. 

“This is a decision. We’re affecting life and death,” Rucker said. “It is a decision that will impact a woman’s life after the decision is made- whatever decision is made. So I think it is only the right thing to do that she has all the information available.”

Sen. Mike Caputo, D-Marion, voted against the bill and read a letter on the Senate floor Wednesday from a physician who urged him to do so. 

“I am horrified to learn that the Senate is attacking reproductive health care yet again by advancing Senate Bill 352,” Caputo read. “Banning abortion was not enough. Now lawmakers want to go after the very narrow exceptions afforded in the ban by further demeaning and degrading providers and patients who are deserving of respect and compassion. Enough is enough.”

The physician asked Caputo to try and stop the bill.

“It is dangerous, and far outside the mainstream of medicine,” Caputo read. “Organizations representing 1000s of clinic clinicians, including the American College of Obstetricians and Gynecologists and the American College of Nurse Midwives and the Society for Maternal Fetal Medicine have strongly opposed bills that place lawmakers in the position of interfering with how health care is provided to push a political agenda. ”

Senate Bill 620

Last year the legislature passed a bill that funded the mothers and babies pregnancy support program.

The grants under this program are for anti-abortion pregnancy centers, maternity homes, adoption agencies and “life-affirming social service organizations.”

Rucker’s other bill, Senate Bill 620, adds flexibility to the ways in which that funding can be used. 

Lawmakers Discuss Informed Consent Abortion

A bill moved through the Senate Health and Human Resources Committee on Thursday that would require medical professionals to educate someone granted an abortion in West Virginia about possible risks.

A bill moved through the Senate Health and Human Resources Committee on Thursday that would require medical professionals to educate someone granted an abortion in West Virginia about possible risks.

Abortion is banned in West Virginia with exceptions for rape, incest, or to save a pregnant person’s life.

Senate Bill 352 requires physicians to offer those who are granted an abortion in West Virginia an ultrasound and information on the gestational age of the fetus or embryo and possible risks associated with the procedure.

The bill states that consent is only voluntary and informed if the licensed medical professional informs the patient of the medical risks associated with the particular abortion procedure including the possibility of infection, hemorrhage, danger to subsequent pregnancies, infertility and reversal. 

Physicians would also be required to educate patients on options for perinatal hospice services if they carry a non-viable pregnancy to term.

Sen. Patricia Rucker, a R-Jefferson,  said the bill does not further restrict abortion in West Virginia.

“What this does is ensure women have informed decisions, and information to make decisions under the limited circumstances we allow,” Rucker said.

The committee substitute for Senate Bill 352, Modifying the Unborn Child Protection Act, passed the committee and goes to the full Senate floor for consideration.

Appeal Filed In Abortion Pill Court Battle

The lawsuit claimed that Morrisey violated federal law, more specifically the commerce clause of the U.S Constitution, by prohibiting the sale of the drug in West Virginia.

Abortion pill manufacturer GenBioPro has filed an appeal to the judge’s August ruling in its case against West Virginia’s near-total abortion ban. 

In his ruling, U.S. District Court Judge Robert Chambers dismissed some claims filed by pharmaceutical group GenBioPro in a lawsuit against the state’s attorney general, Patrick Morrisey.

GenBioPro manufactures a generic version of Mifepristone, an FDA approved, non-invasive prescription pill. The medication is used in conjunction with Misoprostol for medical abortions and can be taken at home to terminate a pregnancy.

The lawsuit claimed that Morrisey violated federal law, more specifically the commerce clause of the U.S Constitution, by prohibiting the sale of the drug in West Virginia.

The clause gives Congress broad power to regulate and restrict states from impairing interstate commerce. However, Chambers, who presides over the southern district of West Virginia, said states have the right to regulate public health and morality by curtailing the sale of goods.

The court earlier ruled that GenBioPro had legal standing to bring a suit against the attorney general’s office on the basis of economic damages incurred by the company. 

West Virginia Attorney General Patrick Morrisey said his office stands ready to fight an appeal and that the judge’s former ruling made it clear the regulation of abortion falls on the states.

“As we did in federal district court, we stand ready to defend West Virginia law to the fullest,” Morrisey said. “There’s no doubt in my mind the new Unborn Child Protection Act is not preempted by federal law and that all of these statutes are constitutional.”

Skye Perryman, Legal Counsel to GenBioPro and President and CEO of Democracy Forward, said this appeal is a critical next step in her organization’s fight to protect access to medication abortion.

“West Virginia’s decision to step in where Congress has granted FDA the authority to regulate mifepristone is unlawful and could undermine not only access to medication, but the country’s entire drug regulation system,” Perryman said. “What’s more, decades of science support mifepristone’s safety and efficacy and it is unacceptable that people living in West Virginia who need this basic health care are being forced to travel out of state or forgo care altogether. We look forward to continuing to represent GenBioPro in the further stages of this case.”

According to Morrisey’s office, in August, the district court dismissed the preemption claim against the state’s Unborn Child Protection Act and the constitutional challenges entirely, but it allowed the preemption challenge to the telehealth provisions to proceed.

Morrisey said GenBioPro removed the telehealth challenge in order to proceed with an appeal.

Abortion Access Eases With New Clinic In Maryland

The Women’s Health Center of Maryland in Cumberland will see its first patients on Sept. 13.

West Virginia is part of a so-called “abortion desert,” but a clinic with ties to the Mountain State is opening just over the border.

The Women’s Health Center of Maryland in Cumberland will see its first patients on Sept. 13 to provide abortion services to patients across central Appalachia.

Originally, the clinic was set to open this summer, but some contractor timelines set the renovation back.

Katie Quiñonez, executive director of the Charleston-based Women’s Health Center of West Virginia, will serve as executive director of the new Maryland clinic.

“Pretty standard for renovations, they typically always take longer than you expect,” Quiñonez said, referencing the delay in opening. “And as abortion providers, we often do what feels like impossible, so we can become pretty ambitious. And we might have set an early goal.”

By opening in Maryland, the clinic will be able to employ physicians who are licensed in states with less regulation, easing access to abortion services.

“We know that there are a large number of doctors in Maryland and regionally that are interested in providing abortion care in the state of Maryland just because where Women’s Health Center of Maryland is opening is going to be such a key regional access point for abortion care,” Quiñonez said.

Originally, the clinic was set to open this summer, but some contractor timelines set the renovation back.

Courtesy Women’s Health Center of Maryland

Quiñonez said the clinic will be a key regional access point for people seeking an abortion near West Virginia and other states that have passed abortion bans. Even in the state of Maryland, only two abortion providers operate, and they only offer first-trimester abortions and medication abortion.

“So again, that limits access for folks who need procedural abortion and folks who need abortion into the second trimester,” Quiñonez said.

Quiñonez said that while speaking with other clinics in the planning process of the Women’s Health Center of Maryland, she learned clinics in Pittsburgh, another option for West Virginia patients, were scheduling out six weeks ahead of time.

“So it’s really our sincere hope that Women’s Health Center of Maryland will be that regional access point for abortion care and hope to alleviate the intense demands the existing abortion providers that have been able to continue to provide that care in their states,” Quiñonez said.

The clinic will not only offer abortions, but comprehensive reproductive healthcare like contraception, annual exams, breast and cervical cancer screenings, STI testing and treatment, pregnancy and parenting support and gender-affirming hormone therapy.

“The Women’s Health Center of Maryland will be the western most abortion provider and gender-affirming hormone provider in the state of Maryland,” Quiñonez said. “And it will be the only nonprofit reproductive health care center in mountain Maryland.”

A bill passed during the 2023 West Virginia Legislative session outlaws West Virginians under 18 from being prescribed hormone therapy and fully reversible puberty blockers. It also bans minors from receiving gender-affirming surgery, something physicians say doesn’t happen in West Virginia anyway.

Unlike measures passed in other states, however, West Virginia’s law contains a unique exemption: It permits doctors to prescribe medical therapy if a teenager is considered at risk for self-harm or suicide.

Under the law, which will take effect in January 2024, a patient can be prescribed puberty blockers and hormone therapy after receiving parental consent and a diagnosis of severe gender dysphoria from two clinicians, including a mental health provider or an adolescent medicine specialist.

“Even if the only service that Women’s Health Center of West Virginia offered or that Women’s Health Center in Maryland will offer was abortion care, that would still be valid and necessary, because abortion is part of comprehensive reproductive health care that everyone should have access to,” Quiñonez said. “But the reality is that, much like many other independent clinics across the country that are providing abortion care, we are also providing other comprehensive reproductive health care”

The Women’s Health Center of West Virginia continues to provide cancer screenings, contraception and HIV and STI testing among other reproductive health care services.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

ACLU Drops Federal Lawsuit Against W.Va. Abortion Ban

West Virginia abortion providers and advocates dropped a federal lawsuit challenging multiple provisions of the state’s near-total abortion ban.

West Virginia abortion providers and advocates dropped a federal lawsuit challenging multiple provisions of the state’s near-total abortion ban.

The Women’s Health Center of West Virginia said in a court filing Monday that one of the physicians involved in the suit “has now determined that he will not be able to resume providing abortion care in West Virginia at this time.” The other physician involved in the lawsuit is “no longer available for that role.”

“The physicians who previously worked at the clinic are not able to resume providing abortion care in West Virginia at this time, and so the plaintiffs have decided to discontinue the lawsuit, but have reserved the right to refile if and when the circumstances are right,” said Aubrey Sparks, managing attorney of the ACLU of West Virginia. “The ACLU remains committed to using every tool at our disposal to ensure that everyone in West Virginia can get the essential care they need.”

The lawsuit filed on Feb. 1 claimed West Virginia’s Unborn Child Protection Act is unconstitutional, irrational and caused irreparable harm to the clinic and its patients.

West Virginia Attorney General Patrick Morrisey said in a press release that his office will continue to defend the state’s near-total abortion ban.

“As West Virginia’s first pro-life attorney general, I stand firm in the belief that it is our duty to protect innocent life,” Morrisey said. “We need to save as many innocent babies’ lives as legally possible. I am proud to stand for the most vulnerable of our society and the sanctity of life. My office stands ready to defend this clearly constitutional law to the fullest should this lawsuit be refiled, or against any other legal challenge.”

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