What The Abortion Pill Case Could Mean For The Workforce And Healthcare

Access to reproductive healthcare has been in the spotlight.

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Access to reproductive healthcare has been in the spotlight. Before Roe v. Wade was overturned in 2022, I unpacked the ways in which reproductive healthcare access is not only a social issue, but also an economic issue. Shortly after, I covered how concern about other legal precedents that the majority of Americans support also being at risk of reversal—such as same-sex marriage and the right to contraception—had prompted the House to try to push forward legislation in an effort to protect those rights. (The Right to Contraception Act has not yet passed, the Respect For Marriage Act passed in late 2022).

Two years later in 2024, I reported on another reproductive healthcare case brought by a group of anti-abortion doctors, Alliance for Hippocratic Medicine v. FDA, that challenged access to the abortion pill known as mifepristone, which had been deemed safe by the FDA since 2000 and was later approved for use from seven to up to 10 weeks of pregnancy without requiring an in-office visit.

After the fall of Roe v. Wade and at a time when telehealth was becoming increasingly popular, telehealth options removed barriers for those who were unable to see an in-person medical provider, as it allowed people to access abortion pills through telemedicine and in the mail. At that time, the Supreme Court ruled unanimously that the plaintiffs lacked sufficient proof to challenge the FDA’s approval for dispensing mifepristone through telemedicine and in the mail.

The issue is coming to a head again in 2026: Louisiana sued the FDA to restrict access to mifepristone, arguing that the availability of the drug by mail allows abortions in states where they are banned. This resulted in a federal appeals court ruling that providers could no longer mail the abortion medication to their patients, anywhere in the country—including in states that do not have abortion restrictions.

The 5th Circuit Court of Appeals order states that mail order access to the drug “injures Louisiana by undermining its laws protecting unborn human life and also by causing it to spend Medicaid funds on emergency care for women harmed by mifepristone.” While the Supreme Court temporarily restored access for mailing mifepristone, that decision expires on May 14, 2026, when the Court is expected to make a more permanent ruling.

Medication abortions now account for the majority of abortions in the U.S., according to the Guttmacher Institute. “Seven and a half million women in the United States have used medication abortion to date,” says Sophia Yen, MD, MPH, co-founder and CEO of Pandia Health. “This drug is safer than Viagra, safer than Tylenol, safer than penicillin. There is no medical or safety reason to require in-person dispensing. If you’re going to require it for mifepristone, then do it with all those other drugs. And if you don’t do it with all the other drugs, then the motive is purely sexist or political.”

Impact Of Abortion Pill Restrictions On The Healthcare System

An estimated one in four people access abortion care via mail-order mifepristone. “Medication abortion decreases the time to getting care. The longer you wait to get care, the more dangerous it is to your health,” says Dr. Yen. “If about 25% of medication abortion is done by telemedicine, we would expect a 25% greater in-person demand, which doctors’ offices may not be able to handle.”

Dr. Yen points out mifepristone is also being mailed to patients for other research studies as a treatment for fibroids, endometriosis, breast cancer, and brain cancer. “Restricting mail-order mifepristone would impact patients participating in medical trials as well, because such a ruling would require this drug to be dispensed in person,” says Dr. Yen. “We never require a prescriber to dispense in person. The only exception is with tuberculosis and that is only if we don’t trust the patient to take it or the tuberculosis is drug resistant.”

Allowing individual states to sidestep the FDA’s regulations without any concrete proof that a medication is unsafe “could significantly disrupt the biopharmaceutical industry, harm patients, and stifle innovation in drug development,” says an amicus brief filed in response to Louisiana v. FDA by The Pharmaceutical Research and Manufacturers of America (PhRMA), which focuses on impacts to drug development and our healthcare systems.

Dr. Yen says it takes two different abortion pills to administer the optimum standard of care, mifepristone and misoprostol, and that misoprostol could be used alone to have an abortion, but it’s subpar.

“We cannot have politicians dictating health,” says Dr. Yen. “We need to do what’s safe and what’s in the patient’s best interest. It is not medically safer to dispense mifepristone in person. This is just creating a barrier for care.”

In a volatile climate for reproductive healthcare access, Dr. Yen encourages women to continue to seek out safe and trusted alternatives, and says there is the option to order pills in advance in case future access is restricted. “Plan C has information on getting medication abortion pills by mail for all 50 states, as well as a free medical and legal advice hotline,” says Dr. Yen. “There is also the international organization Women on Waves.”

How Reproductive Healthcare Restrictions Affect The Workforce And The Marketplace

Restrictions on reproductive healthcare can also harm businesses and the economy, says Jen Stark, director of inclusive business and human rights at BSR, and co-founder of Don’t Ban Equality, a coalition of 1,100+ businesses making the case that abortion access is a workforce and economic issue.

“It’s a slippery slope if one state can decide it doesn’t like a medication—it could be vaccines, a form of family planning, or some other widely-used treatment—and can then try to use the courts to impose national restrictions or barriers beyond what the FDA says is needed or effective,” says Stark. “Over time, this instability could slow innovation in the U.S. marketplace, create more risk, and also create an ongoing chronic patchwork across the states around how care is accessible, requiring employers to try to mitigate some of that harm.”

The mifepristone case could bring the country closer to a nationwide ban on abortion access, and that would impact the workforce and the economy, says Stark. “The data shows that being denied abortion access means women have lower rates of full-time employment, higher poverty risk, and are more likely to need government assistance over years,” says Stark. “Building a family is a beautiful thing, but it requires time, money, economic stability, and other things that come from having a job with benefits. Employers are a major gatekeeper or firewall for reproductive health access and coverage.”

Restrictions on access to abortion pills via telehealth creates unnecessary costs for people seeking reproductive healthcare, such as the cost of having to travel, taking time off work, and paying for childcare for any existing children. “The more reduced access to medical abortion is, the greater the number of people who get affected,” Caitlin Myers, professor of economics at Middlebury College, told me in an interview for a previous Forbes story. “It could create larger financial inequities as we’re likely to see impacts on low-income families in particular. Many of these people seeking abortions already have children, and many of them are already in financially vulnerable, precarious situations. There would be economic impacts.”

Reproductive Healthcare Rulings May Have a Ripple Effect

A majority of Americans think abortion access should be legal in all or most cases, according to the Pew Research Center. Further restricting access to abortion medication may not represent the will of the majority of people.

“Abortion is a popular issue. Most Americans support access to abortion, yet their elected officials are not representing that majority position,” says Ann Warner, executive director for the Collaborative for Gender + Reproductive Equity (CGRE). “Reproductive rights and voting rights are absolutely intertwined, and we saw two monumental court rulings coming out within a span of about 48 hours: one on access to equal representation [in voting maps] and one on access to mifepristone via telehealth. Both of these rulings originated in Louisiana, yet they have massive impacts on the entire country. At the individual level, it’s clear the connections between having control over your body and what happens to it, and having access to the vote and being able to participate in a free and equal democracy.”

In states that have voted for measures that would protect abortion access, some states could try to redraw voting maps in light of the latest SCOTUS ruling that narrowed the scope of Section 2 of the Voting Rights Act of 1965 and then have another vote, says Gretchen Borchelt, vice president for reproductive rights and Health at the National Women’s Law Center. “The rolling back of voting rights and rolling back of people’s personal autonomy and ability to decide for themselves what they want to do with their bodies, such as with abortion access, are connected.”

Warner and Borchelt stress the importance of being in touch with the people who represent you, in both the House and the Senate. This includes when you agree with their decisions so your reps are clear on when they have your support. “If you’re in a state that has a shield law, or that is protecting access to reproductive healthcare, it’s important to reaffirm to your governor or state representative if you are proud they are standing up for access to care,” says Borchelt.

Also, support the organizations that are making investments in local, grassroots, state-based organizations that are there to represent and advocate for their communities. “Those organizations are most in touch with what’s going on and what’s needed most,” says Warner.

Another issue is that when Roe v. Wade was overturned in 2022, SCOTUS was taking decision-making power for abortion out of the hands of the federal government and putting it into the hands of individual states. The pending Louisiana v. FDA is challenging that.

“A critical piece of this puzzle is whether the court is going to allow Louisiana to essentially set the [abortion] policy for the whole country, and take away access for states that want to protect abortion rights,” says Borchelt. “Telehealth helps residents in states that want to protect abortion access to get access to care. This is especially important for rural areas, or for folks who otherwise have barriers to care, such as for survivors of intimate partner violence, because it gives them the ability to access care privately.”