New York City Leads Coalition of Cities and Counties From Across Nation to Fight for Continued Access to Medication Abortion Drug

April 12, 2023

Filing of Amicus Brief Comes After Texas District Court Ruling That Would Ban Long-Accepted Medication Abortion Regimen Nationwide

Brief Supporting Federal Government for Emergency Stay Argues That Ruling Undermines Public Health and Rests on Baseless Claims

New York – New York City Mayor Eric Adams and New York City Corporation Counsel Sylvia O. Hinds-Radix today announced that the City of New York has co-led a coalition of cities and counties from around the nation that operate public health-care systems in a legal filing to protect safe access to medication abortions nationwide. In an amicus brief filed in Alliance of Hippocratic Medicine v. U.S. Food and Drug Administration (FDA) in the U.S. Court of Appeals for the Fifth Circuit, New York City and the coalition of local governments signal their strong support for the federal government's application for an emergency stay of a federal district court's ruling that – starting this Friday – would put a hold on the FDA's 2000 approval of the medication abortion drug mifepristone. In their brief, the coalition argues that the district court's order undermines public health because it will harm already overburdened public hospitals without realizing the detrimental impact it would have on health care for residents of each locality, as well as makes baseless claims that medication abortion is unsafe.

"The decision last week was nothing more than an assault on women's rights by a Trump-appointed judge in Texas simply set on trampling the law instead of upholding it," said Mayor Adams. "New York City is proud to lead this coalition in filing an amicus brief in full support of the federal government's effort to reverse this harmful decision and restore the authority that the FDA has under the law. If the safe and effective two-drug regimen is suddenly removed, our public health care system will have to divert resources to provide alternate options and procedures, which will undoubtedly affect our public hospitals' ability to provide care to patients seeking abortions and could impact their ability to provide care across the board. This decision was nothing more than an effort to control women's bodies, their choices, and their freedoms, and we will do everything in our power legally, personally, and politically to fight this ruling and defend the rights of all women."

"As detailed in our amicus brief, this misguided ruling by the Texas court would undermine public health across the nation," said Corporation Counsel Hinds-Radix. "If the court suspends the FDA's approval of mifepristone, it will immediately harm pregnant women who will be forced to seek more invasive or less effective care. That burden would be disproportionately borne by the most vulnerable individuals in our communities and further stress overburdened public health-care systems across the country."

"New York City has been and will remain a hub for access to reproductive health care. These services are generations long freedoms that we will fight to restore and maintain," said Deputy Mayor for Health and Human Services Anne Williams-Isom. "Our amicus brief, alongside our counterparts in California, Illinois, and Washington states, show the strength of our coalition to push back against the recent ruling in Texas. Both our Health Department and our public hospital system will remain strong resources for every person seeking guidance and support in their reproductive health care."

"The Texas court ruling goes against an overwhelming body of scientific evidence that says mifepristone is safe, and it could complicate the delivery of abortion services to those who need it most," said Mitchell Katz, MD, president and CEO, NYC Health + Hospitals. "Depriving our providers of the ability to prescribe mifepristone not only impacts their ability to provide abortion care, but also impacts their ability to treat persons who are suffering the tragedy of a miscarriage. This decision will not deter NYC Health + Hospitals from its commitment to make abortion services available to anyone. We will continue providing this essential service to our patients, and, if needed, we will adapt our protocol to comply with the law in the future."

"We know that reproductive health is an integral part of public health, and that limiting access to proven care options hurt those who need it most," said New York City Department of Health and Mental Hygiene Commissioner Dr. Ashwin Vasan. "Our agency, in partnership with trusted providers, is committed to supporting access to safe, culturally competent services for anyone in need both at our sexual health clinics and through the Abortion Access Hub. Medication abortions will remain available in New York City."

For more than 20 years, mifepristone, used in combination with the drug misoprostol, has been a safe option for those managing an abortion or miscarriage in the United States, and has now become the most common method to terminate a pregnancy in the country. But, last Friday, Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas – a Donald Trump appointee – issued a ruling effectively making the prescription of mifepristone illegal nationwide, including here in New York City, starting this Friday, barring emergency relief being ordered by the U.S. Court of Appeals for the Fifth Circuit.

In their brief, New York City and the coalition warn that withdrawing federal approval of mifepristone would gravely harm public health care systems across the country that are still struggling with severe funding and staffing challenges following the COVID-19 pandemic. The amicus highlights how the district court's decision will aggravate those challenges, making it harder for residents, including the most vulnerable, to access care of all kinds, and ultimately undermine the very community health that local governments are charged with protecting.

As argued in the brief, if medication abortion is suddenly removed as an option for health-care providers and their patients, demands placed on public hospitals will increase. Public hospitals, in turn, would then have to divert resources to meet the increased demand for emergency care and for procedural abortions from their existing patients and from new patients who otherwise would have sought care from providers who cannot pivot to providing procedural abortions.

Because public hospitals operate with limited resources, the impact of the district court's decision will not be confined to only patients seeking abortions, or even just those seeking reproductive health care. Thousands of patients in need of all kinds of non-emergency surgical care will find themselves facing significant delays in obtaining procedures, and some may forgo care altogether. Reducing the ability of public hospitals to provide resource-effective, high-quality care will erode patients' confidence in care and make the provision of health care to already-vulnerable patients even more difficult. If left in place, the district court's decision could undermine public health services across the board.

Joining the City of New York and NYC Health + Hospitals in co-leading this amicus brief is Santa Clara County, California. They are joined by Los Angeles and San Francisco counties, California; the city of San Francisco, California; Cook County, Illinois; and King County, Washington.