Another big shoe has dropped in the struggle of the Biden administration and reproductive-rights advocates against Republican state officials and anti-abortion advocates. In the wake of an administration green light for retail sale of pills used to terminate pregnancies, Walgreens, the second-largest retail pharmacy chain in the country, has bent to pressure from 21 Republican attorneys general (20 signed a joint letter, with Kansas’s notorious Kris Kobach making his own threats separately) announcing it would not sell mifepristone or distribute it by mail in their states. What makes the step notable is that abortion and/or abortion pills are still legal in several of those states, as Politico reports:
The list includes several states where abortion in general, and the medications specifically, remain legal — including Alaska, Iowa, Kansas and Montana. For example, Kansas’ law that patients only obtain the pills directly from a physician is blocked in court.
“There is currently complexity around this issue in Kansas and elsewhere,” said Fraser Engerman, Walgreens’ senior director of external relations.
So Walgreens is basically saying it is not willing to assume any risk of legal peril in order to serve its red-state customers. Indeed, the chain is not yet distributing abortion pills anywhere, but it is going through the process of getting FDA-certified to sell them in places where there isn’t that peril. Meanwhile, the legality of red-state restrictions on distribution of abortion pills by mail could be contested in the courts for some time.
The impact of this decision will fall on women in red-state rural areas (many of them providing no access to clinical abortions), where Walgreens is the principal retail pharmacy outlet. But the bigger question is whether the other big chains (CVS, the largest, along with Albertsons, Rite Aid, Costco, Walmart, and Kroger) will follow suit and submit to legal and political intimidation. If they do, the remaining pharmacies may also be exposed to protests from anti-abortion activists aiming to make shopping there for any purpose a logistical nightmare. Efforts to hassle pharmacies even where abortion is fully legal began last month, as Ms. Magazine reported at the time:
On Feb. 4, anti-abortion groups are organizing a national day of protests targeting pharmacies that have announced plans to offer abortion pills, including Walgreens, CVS and Rite Aid. The protests are organized by the so-called Progressive Anti-Abortion Uprising (PAAU)—a group that claims to be peaceful and progressive, but whose members have repeatedly broken the law to achieve their goal of intimidating, harassing and blocking women from accessing reproductive healthcare. … PAAU is planning protests at pharmacies across the country, including in Boston, New York City, Washington D.C., Chicago, L.A. and San Francisco.
Anti-abortion activists also disrupted a Walgreens shareholders meeting in California.
The stakes in this murky battle on the streets and in the courts are high. As the Guttmacher Institute recently noted, medication abortions have grown steadily more important in an era when access to clinical abortions has declined:
Guttmacher Institute’s periodic census of all known abortion providers show that in 2020, medication abortion accounted for 53% of US abortions. That year is the first time medication abortion crossed the threshold to become the majority of all abortions and it is a significant jump from 39% in 2017, when Guttmacher last reported these data. Preliminary data originally published in February 2022 showed that medication abortion accounted for 54% of all abortions in the US.
If pharmacy chains splinter in their willingness to distribute abortion pills, you could even envision pro-choice customers in blue states taking their business to pharmacies that are less compliant with red-state political pressure. But that scenario remains miles down the road.