Abortion pill rulings bring the issue back to the forefront in a midterm election year

Boxes of the drug mifepristone sit on a shelf at the West Alabama Women's Center in Tuscaloosa, Ala., March 16, 2022. (AP Photo/Allen G. Breed, File)

2026-05-05T04:03:00Z

NEW YORK (AP) — Back-to-back court rulings on abortion pill access are thrusting a contentious political issue back into the spotlight ahead of this year’s midterm elections that will determine control of Congress for the second half of President Donald Trump’s term.

Friday’s ruling from a federal appeals court restricted mail access to mifepristone prescriptions, one of the most common abortion methods around the country, in the biggest shift to federal abortion policy since the Supreme Court’s 2022 decision allowing states to enforce abortion bans.

The Supreme Court then temporarily restored broad access to the drug on Monday while it further considers the case, setting the stage for a potential decision that could have wide-ranging consequences for patients and providers.

It’s too early to say whether the latest rulings will affect the outcome of races this year, when issues around affordability are expected to take top billing for voters. But advocates on both sides of the issue are hoping it will sway voters their way.

Some abortion rights groups already are strategizing ways to reach voters they think may be more motivated to turn out for Democrats because of the possibility of further restrictions. Meanwhile, abortion opponents who say the GOP-led federal government hasn’t done enough to ban the pills are warning their typically loyal Republican voters could sit out future elections, with a leading anti-abortion advocate calling it “a five-alarm crisis” for the GOP.

Democrats say the abortion issue presents an opportunity

After the overturning of Roe v. Wade in 2022, several states voted to enshrine abortion rights into their own constitutions, driving historic turnout that sometimes contributed to Democratic wins elsewhere on the ballot.

But Democratic pollster Celinda Lake believes the issue had lost some of its potency among voters, not because Democrats don’t care, but because they have a sense that the “damage has been done.”

Though Friday’s ruling has been temporarily halted, it reminded voters that their access to abortion medication through telehealth isn’t guaranteed, even in states where abortion rights are, Lake said. That created a tremendous but “horrific” opportunity to tell voters what could be at stake in this year’s midterms, she said.

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Mini Timmaraju, president and CEO of the abortion rights group Reproductive Freedom for All, said outreach to voters about the volatility of abortion access will be part of her group’s strategy in the midterms. That includes contacting voters who supported Trump but also abortion rights in their state elections in 2024.

“The only way for us to really stop this back and forth is to have abortion access be legal in all 50 states,” she said. “The only way we do that is through federal legislation, which makes the midterm elections even more urgent.”

Republicans face fracturing over abortion politics

The Republican coalition, meanwhile, is contending with an increasingly agitated right flank of abortion opponents who expected Trump to fulfill his promise to be the “most pro-life president in history” but say they haven’t seen it yet.

Most urgently at issue is a Food and Drug Administration safety review of mifepristone that anti-abortion groups hope will result in further restrictions, including blocking its prescribing via telehealth platforms. Anti-abortion groups have urged FDA commissioner Dr. Marty Makary to complete the review sooner, while the administration says it “is taking care to do this study properly and in the right way.”

On Monday, the anti-abortion group SBA Pro-Life America further ratcheted up its messaging, calling for Makary’s firing over the issue.

“This is a five-alarm crisis for the pro-life movement and for the GOP,” the group’s president Marjorie Dannenfelser said in a statement. “The GOP cannot win without its base and simply will not get the enthusiasm that drives turnout without leadership from the top.”

Trump, whose first-term nominations set the stage for the Supreme Court that voted to overturn Roe, has taken some steps that abortion opponents have cheered, including an effort to withhold funds from Planned Parenthood and launching investigations into states that require state-regulated health insurance plans to cover abortion.

But he has also often sought to steer clear of the abortion issue, saying he thinks it should be left to the states. The president publicly supported abortion rights until he entered politics in 2015, and his wife, Melania Trump, announced her broad support for abortion rights in 2024.

Abortion opponents say they have no plans to let Trump avoid the issue for the remainder of his term. Marc Wheat, general counsel at former Vice President Mike Pence’s political advocacy group Advancing American Freedom, said his group will increase pressure on the administration. That will include urging the FDA to speedily release documents about mifepristone that it owes the group through a lawsuit.

“President Trump thinks that pro-life is a loser,” Wheat said. “He might see that the pro-lifers may not turn out in the numbers that he needs.”

Americans largely oppose a nationwide ban on mifepristone

Even as Trump and the Republican-led Congress face mounting pressure from the right to restrict access to medication abortion, Republicans around the country are far from united in taking that position.

About two-thirds of Americans opposed nationwide bans on mifepristone, according to a KFF poll conducted late last year. Most Democrats and independents objected to such bans, while Republicans were more split.

Americans’ overall opinions on abortion remain complex, with about two-thirds of U.S. adults saying abortion should be legal in all or most cases, according to AP-NORC polling. Relatively few think abortion should be illegal in all cases.

At least one abortion opponent, Americans United for Life CEO John Mize, said he is focused on incremental victories over the sweeping changes that some of his allies are calling for. While he wishes the FDA would move faster on its safety review, he recognizes that not all Americans are in the same place that he is.

“I think there is advancement being made in a positive direction,” he said. “While it might not meet the pace that many in the pro-life movement want to see, I think it meets the acceptable place of where we’re at culturally.”

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Associated Press writer Linley Sanders in Washington contributed to this report.

ALI SWENSON Swenson covers politics and the information landscape for The Associated Press. She is based in New York. twitter