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The White House is preparing for the end of Roe v. Wade

ADRIAN FLORIDO, HOST:

Any day now, the U.S. Supreme Court is widely expected to overturn Roe v. Wade, ending the constitutional right to an abortion in the U.S. In May, a draft opinion leaked from the court showed that a majority of its justices support the move. If Roe is overturned, many states have laws already in place that would immediately ban abortions. In anticipation of all of this, Democrats have been asking President Biden to sign executive orders that would establish abortion services on federal lands and increase access to abortion pills. And the president has said he is considering action.

To talk more about what's being proposed, I'm joined by NPR national correspondent Sarah McCammon, who covers reproductive rights. Hi, Sarah.

SARAH MCCAMMON, BYLINE: Hey there.

FLORIDO: Sarah, medication abortion, the use of pills for an abortion, is a method that many people already use. How do advocates want the Biden administration to expand access to this option?

MCCAMMON: Medication abortions have emerged as a new front, really, in this fight over abortion rights in recent years. They now account for more than half of abortions, and both sides of this debate have taken notice. One of the drugs that's commonly prescribed for medication abortion, mifepristone, has been heavily regulated since it was approved by the Food and Drug Administration more than 20 years ago.

Until recently, Adrian, patients had to pick up those pills in person at a hospital or a clinic. Now, that rule was suspended during the pandemic, which made it possible for patients to receive the pills by mail after consulting with a provider over telehealth. And then in December, the FDA under President Biden made that change permanent. But the administration left other rules in place, like certification requirements for prescribers and extra forms that patients have to sign. Many abortion rights groups would like the FDA to go further and make the abortion pill as accessible as any other prescription drug. And I should mention that some states are also passing restrictions around these pills that would add other layers of rules.

FLORIDO: So how does that work? You know, who actually regulates these pills?

MCCAMMON: So the FDA regulates the drugs themselves in terms of, you know, approving them for use like it does many other medications. But states can pass their own regulations and requirements. Many, for instance, require providers to be physically present when prescribing medication abortion. Others, like Texas, have tried to ban mailing abortion pills. It's unclear how enforceable that will be. Kentucky lawmakers recently passed their own state-level regulations for abortion pills, which shut down the provision of medication abortion for several days in April before they were temporarily blocked in court. So even if the federal government loosens restrictions further, there is still a lot of room for states to put up their own barriers.

FLORIDO: Well, something else Democrats are asking for is for an executive order that would expand reproductive health care services on federal lands or through other means. What is the idea there?

MCCAMMON: Yeah, that's one of several ideas that abortion rights advocates have suggested. And as our colleague Tamara Keith has reported, they've called on the Biden administration to provide federal funds to help people who want to travel from states with restrictive abortion laws to states with more access, which will become, you know, even more important for people seeking abortion access if Roe is overturned. And also, they've asked the administration to provide funds to providers in those states to help them increase access and expand their capacity.

But a big obstacle to giving federal grants to clinics is the fact that federal funding for abortion is prohibited in most cases under what's known as the Hyde Amendment. That's something Biden has supported doing away with but so far has not succeeded in getting Congress on board.

FLORIDO: Overturning Roe would have sweeping consequences immediately, Sarah. So how much could these workarounds actually blunt the impact of that decision and protect access, especially for people who live in states that plan to restrict or ban abortion?

MCCAMMON: So as we've said, there are real limitations on what can be done at the federal level, although there are some actions that could help, like further easing access to medication abortion. But many people are finding workarounds with or without government help. Some will simply self-induce abortions at home using pills obtained online. That's already happening, and it's easier than ever to do because of the internet. Doctors say it can be done quite safely with the right information and in the right circumstances but that it's safer for patients to have medical support.

And then those who have the means or can get support from organizations like Abortion Funds will travel to get abortions - again, something that's already happening, something which advocates are working hard to make easier and more accessible through fundraising and improving access to information about these options. But bottom line, Adrian, is experts I talked to say that if Roe is overturned, the reality is there will be fewer abortions because some people just will not be able to get them.

FLORIDO: That's NPR's Sarah McCammon. Thanks for joining us.

MCCAMMON: Thank you. Transcript provided by NPR, Copyright NPR.