This single Texas judge could outlaw abortion pills for the entire country

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U.S. District Judge Matthew Kacsmaryk is drawing fresh attention and scrutiny as he weighs a ruling that could impose new limits on abortion access for millions of women.

Kacsmaryk, a federal judge for the Amarillo division of the Northern District of Texas, is expected to soon rule on a lawsuit seeking to revoke U.S. government’s approval of mifepristone, a key abortion medication. The ruling could stop legal abortions across in much of the country, even in states where abortion rights are protected.

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It is not clear whether the ruling would be lasting, but it could be the latest victory for abortion opponents and another major blow to an abortion rights movement still reeling from the U.S. Supreme Court last summer overturning Roe v. Wade, a landmark ruling that guaranteed women's right to abortion.

The high stakes on both sides of the abortion fight are drawing new interest in Kacsmaryk’s legal background, political work and speaking engagements across Texas.

Has U.S. District Judge Matthew Kacsmaryk spoken in Houston? 

Yes, to the local Federalist Society chapter as a panelist for a “Supreme Court Term in Review.” The panel was held in July 2017 and noted in Kacsmaryk’s district judge confirmation testimony for the Northern District of Texas. The local Federalist Society chapter didn't immediately respond to questions. According to their website, the society seeks to promote an awareness of conservatives and libertarians principles and further their application. 

Why is Kacsmaryk in the news?

A Texas lawsuit is challenging the nationwide availability of medications used in abortions done at home or with doctor supervision, which makes up most U.S. abortions. Kacsmaryk is ruling on the case.

The case has the potential to end the use mifepristone in abortions in every state. If this happens, the national percentage of reproductive individuals with access to an abortion is expected to drop by 4%, or 2.4 million people, according to research.

In Texas, the use of medication to cause abortions is already banned. 

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The case, Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration, was filed November 2022 and the ruling could come any day.

The Biden administration already said it plans to appeal Kacsmaryk’s decision if he rules ban the medication, the Washington Post reported.

How does medication abortion work? 

The FDA approved mifepristone in combination with another drug, misoprostol, in 2000 as a way to end a pregnancy, according to the FDA. The drug was deemed safe and effective. 

The pills can be taken at home in some states or with in-person physician supervision in others. A prescription is required. 

Mifepristone blocks a hormone called progesterone that is needed to sustain pregnancy, the FDA said. Misoprostol is used to induce labor. Combined, the drugs work together to end a pregnancy.

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The abortion medications are approved up to the 10th week of pregnancy and are more than 95% effective.  

The FDA’s periodic reviews of the drugs have not brought new safety concerns.

What is Kacsmaryk’s background? 

Kacsmaryk has a conservative legal background, rising to the bench from the group First Liberty Institute. President Donald Trump nominated him for U.S. District Judge in 2017. 

After growing up in Fort Worth, Kacsmaryk attended Abilene Christian University where he was leader of their College Republicans student group, according to the Washington Post. He then went to law school at the University of Texas. 

Kacsmaryk has volunteered for Republican campaigns, including Sen. Ted Cruz, Sen. John Cornyn and Texas Gov. Greg Abbott. 

He also served on the board of Christian Homes and Family Services and eventually became a trustee. The organization offered resources to women facing unexpected pregnancies seeking to provide an alternative to abortion. He left the board when he became a judge.

Kacsmaryk has steadfastly said he will be impartial as a judge, particularly when Senate Democrats pressed him on his personal views and political and nonprofit work during his confirmation hearings.