Texas Extremists Are Trying Everything to Block Abortion Medication 

In likely the most aggressive attempt to stymie the flow of abortion medication by any state thus far, Republican Gov. Greg Abbott on Wednesday signed into law an extreme bill that seeks to stop its residents from receiving abortion pills by mail. House Bill 7^[3] empowers private citizens to sue abortion medication manufacturers, distributors, and anyone else across the United States who mails, prescribes, or provides abortion-inducing pills to the state and reap a minimum of $100,000 in court.

The measure is an iteration of SB 8, the state’s 2021 near-total abortion ban^[4] that similarly deputized its citizens, but offers ten times the cash reward. Reproductive rights advocates say the law, an attempt to spread an extremist agenda beyond state lines, will sow fear in abortion-seekers and supporters and encourage vigilante surveillance among Texans. The law is slated to take effect Dec. 4.

“Once again, Texas Republicans are leading the way in inflicting cruelty and harm on their constituents,” said Mini Timmaraju, president of Reproductive Freedom for All in a statement. “This [law] will set a very dangerous precedent, and Texans aren’t the only ones who will suffer. We need to sound the alarm and fight back against these bans that reward people for turning against their neighbors for financial gain,” said Timmaraju, who grew up in Houston and previously worked as a Texas-based abortion rights advocate.

Texas anti-abortion advocates and Republicans herald the measure as the “nation’s strongest tool”^[5] for closing what they consider a gap in abortion law, and one they hope other GOP-led states adopt as a blueprint to quash access. Despite the sweep of abortion bans following the collapse of Roe v. Wade in 2022, tens of thousands are still able to obtain mifepristone and misoprostol—the two pill regime used to terminate pregnancy—through online pill providers like Aid Access^[6] and by telehealth appointments with individual out-of-state physicians.

Researchers at the University of Texas at Austin^[7] found that 84 percent of Aid Access’s more than 118,000 online prescriptions were sent to patients living in abortion-ban states. In Texas, nearly 3,000 residents per month continue to access abortion through telehealth, according to the Society of Family Planning^[8], and overall, in banned states, more than 99 percent of abortions are provided by this online option.

While the bill does not target abortion patients, it does cast a wide net on who can file suit: HB 7 not only allows those connected to the pregnant person—such as a vengeful boyfriend or family member—to sue for sizable damages, but anyone unrelated to the embryo or fetus can bring suit and be awarded a portion of the payout with the remaining funds going toward a charitable organization. The measure also makes the process more difficult for defendants; for instance, if they prevail in court, they are not allowed to recover legal fees, as often is the case for those who succeed.

“HB 7 invites anyone—including those with no connection at all to an abortion patient—to bring a complaint, which really incentivizes harassing lawsuits from anti-abortion activists,” says Liz Sepper, an expert in reproductive rights and law professor at the University of Texas-Austin. “This could spur an outpouring of fishing expeditions against anyone who is advocating for care in Texas or suspected of sending pills into the state. It’s a pretty preposterous and troubling bill.”

Sepper stresses HB 7 carries risk for nearly anyone assisting abortion patients: For example, if a friend traveled to California and brought back abortion pills to someone in Texas, they could be sued for “transporting” the medication. Moreover, the legislation even chillingly targets those who merely intend to order pills—a provision tantamount to a “thought crime” says Sepper. On the Capitol floor shortly before the bill’s passage, Houston Democrat Carol Alvarado said the “cruelest part” of this bill is that it “punishes intent.”

Ultimately, HB 7’s central goal appears to be instilling fear in out-of-state abortion pill providers to prevent them from helping Texans’ access care—and, ideally for Republicans, to reduce access nationwide with an avalanche of costly lawsuits that could burden doctors, online support groups, and drug manufacturers, by circumventing the power of shield laws^[9]. Such measures are designed to legally protect abortion providers in non-banned states by refusing to cooperate with prosecutions from states like Texas.

Among the 23 states that enacted these laws, eight (New York, California, Colorado, Maine, Massachusetts, Rhode Island, Vermont, and Washington) explicitly protect telehealth providers offering abortion pill care to patients in states with total bans, according to the Guttmacher Institute^[10]. In light of the proliferation of abortion bans, some Democratic-led states have taken steps to strengthen these protections: This month, California lawmakers approved a bill^[11] that allows the name of the patient, prescriber, and pharmacist to be omitted from pill bottles. Every month, more than 12,000 abortions^[12] are provided by those operating in states with shield laws. However, under HB 7, shield laws are not a sufficient defense in challenging potential lawsuits.

The law arrives just as Texas has launched a heated battle against a New York-based physician for allegedly providing one of its residents with abortion pills. In December, Attorney General Ken Paxton—a zealous anti-abortion official currently mired in an alleged infidelity scandal^[13]—sued^[14] Dr. Margaret Carpenter for violating Texas abortion law. When a Texas judge ordered Carpenter to pay more than $100,000 in fines^[15], a county clerk in Ulster County twice refused to enforce the penalty, using the state’s shield law as a defense. Paxton then sued the county clerk and argued the New York protection law is unconstitutional. In early September, New York Attorney General Leticia James^[16] intervened^[17], using her authority to invoke the shield law, which prohibits enforcing out-of-state subpoenas, judgments, arrests, or extraditions for abortion providers.

“I am stepping in to defend the integrity of our laws and our courts against this blatant overreach,” said James in a statement. “Texas has no authority in New York, and no power to impose its cruel abortion ban here.”

Legal experts anticipate the interstate constitutional showdown will land before the US Supreme Court. The court would have to address whether the Full Faith and Credit Clause of the Constitution—which requires states to respect judgments and laws from other states—means that red states can enforce criminal and civil penalties against defendants in shield states, or whether shield laws will hold up under constitutional challenge. Mary Ziegler^[19], abortion law historian and professor at the University of California-Davis School of Law, says HB 7 is a way for Texas officials to set themselves up as “favorably as possible” for the looming battle.

“I think Texas Republicans understood that we’re headed to federal court, that we know that there is this war brewing between the states over abortion shield laws so they asked ‘what can we do to position ourselves to win?’ They’re hoping that HB7 puts the thumb on the scale as much as possible for them,” said Ziegler.

If these efforts to target pill providers weren’t enough, Texas anti-abortion officials have unloaded a barrage of additional attacks: In August, Paxton sent cease-and-desist letters^[20] to two abortion pill providers as well as Plan C, a website that offers information about how to obtain them. He’s also requested that Texas help lead a federal lawsuit^[21] against the Food and Drug Administration that seeks to revoke approval of mifepristone, including allowing it to be sent by mail. The request is in the hands of Texas-based Judge Matthew Kacsmaryk, a Trump appointee who sought to roll back^[22] federal approval of the drug in 2023. And, along with 14 other states, Paxton has directly asked Congress^[23] to ban abortion shield laws.

In addition, the ever litigious Jonathan F. Mitchell^[24], who crafted the state abortion law’s private enforcement scheme, has teed up two separate lawsuits to combat the flow of abortion pills. Mitchell is representing a Texan man who argues^[25] California doctor Remy Coeytaux (also a recipient of a Paxton cease-and-desist letter) is liable for wrongful death for sending abortion pills to his girlfriend. In another lawsuit, a woman has sued Aid Access claiming her boyfriend covertly slipped abortion pills into her hot chocolate—that case has taken a bizarre twist^[26] and backfired, with a $100 million countersuit alleging the woman fabricated the entire story as part of a pattern of threatening behavior. (Ziegler points out^[27] these two cases are fraught with problems that hardly make them models for the anti-abortion camp.)

In their legal filings, both Paxton and Mitchell continually cite the Comstock Act^[28], a dormant 19th-century federal obscenity law that anti-abortion advocates hope the Trump administration revives as a vehicle to bar the mailing of all abortion-related drugs nationwide. Frustrating abortion opponents, President Donald Trump has not indicated^[29] that he is open to enforcing the 150-year-old law, so far.

“All these efforts to ban medication abortion signal that the federal government is not being aggressive enough or moving quickly enough for the extremists in Texas, and that’s why they’re kind of throwing everything at the wall right now,” says Ziegler. “They’re clearly impatient with the Trump administration.”

As the various legal battles play out, many are left wondering how out-of-state providers will respond to HB 7. While the threat of litigation from SB 8 immediately halted^[30] nearly all abortion providers—fearful of financially ruinous lawsuits—from offering care in the state of Texas in 2021, the new vigilante-style bill may not have the same dramatic impact as out-of-state providers are insulated by the power of shield laws.

“Texas Republicans succeeded in their gambit with SB 8. But now we are talking about preventing medical professionals not located in Texas from providing care that is entirely legal in their state,” says Molly Duane, senior attorney with the Center for Reproductive Rights. “Texas extremists are mad they can’t control what is happening outside their borders so they’re trying to extend their extraterritorial tentacles into other states—even though that’s antithetical to our system of federalism.”

“It’s unclear how these providers are going to act, but it sure seems like those folks are brave and dedicated to protecting Texans,” says Duane.

Indeed, at least two out-of-state providers I spoke with plan to continue providing care to Texans despite the risk of HB 7. Dr. Angel Foster, who leads the Massachusetts Medication Abortion Access Project^[31] confirmed to me earlier this month that her organization will not be “deterred” in its mission^[32]; the group serves roughly 800 Texans each month. Her Safe Harbor—a Delaware-based abortion telehealth provider—is similarly resolute. The organization says the demand from Texas^[33] is not only significant, but rising—especially in response to the new legal threats. After Paxton’s cease-and-desist letter, the group received more than 150 requests from Texas in a single day and have doubled their capacity to keep up with demand.

“We will not halt shipments to Texas. We refuse to comply with cruelty disguised as law,” Debra Lynch, nurse practitioner and founder of Her Safe Harbor, tells me. “HB 7 is an intimidation tactic, not a reflection of the reality of people’s needs. Laws like this are written to scare women, to trap them in unwanted pregnancies, and to strip them of control over their own futures. Our mission is to ensure that Texans who seek abortion medication have safe, reliable access—no matter how many fines or lawsuits the state tries to weaponize against us.”

Meanwhile, those helping abortion patients within Texas borders—unprotected by shield law—are feeling the more immediate threat of HB 7. The leaders of six Texas abortion funds say the measure is designed to “scare, punish, and isolate people who are pregnant and those who support them,” including their staff and volunteers. Texans, especially those in rural areas, depend on each other for assistance. The bill would make those connections and that type of support “problematic” and “create a chilling effect on help,” Anna Rupani, executive director of Fund Texas Choice, tells me.

Facing perennial state-led^[34] challenges to their existence, Texas abortion funds say they nevertheless “refuse to cave” to the “harmful and unconstitutional” legislation. Rupani says the groups are “working closely” with attorneys to continue to offer support.

“We are not going anywhere. Abortion funds are no stranger to attacks on our work, and we have been resilient and will continue fighting,” says Rupani. “We know that taking away abortion access in any form doesn’t stop abortions—as we have seen even with SB 8 or the fall of Roe. Texans deserve care, free from governmental interference, in their own zip codes, and in the places they feel the most safe.”

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