Acting Attorney General Todd Blanche committed to ending abortion pills by mail during a Senate confirmation hearing, putting him on a direct collision course with a drug that has been legally prescribed and dispensed in the United States for over two decades. The hearing turned into a multi-hour pressure campaign by Republican senators who want the federal government to do what states alone cannot.
Republicans spent the four years following the Supreme Court’s 2022 overturning of Roe v. Wade insisting that abortion was now a state issue. Trump said after the 2024 election that he wouldn’t revoke access to mifepristone. The July 15, 2026 Senate Judiciary Committee hearing made clear how thoroughly that position has been abandoned.
What Blanche Actually Said
Blanche pledged on Wednesday to take action to stop abortion medication from being available through the mail. He committed to Republican senators that he would prioritize taking action on mifepristone if confirmed, but declined to go into specifics. He said the Trump administration opposes the Biden-era policy that allowed the abortion pill mifepristone to be sent through the mail, and suggested the Department of Justice could review it.
Sen. Katie Britt of Alabama criticized the Biden administration for making it easier to obtain the abortion pill mifepristone by mail, claiming that mailing abortion pills has been dangerous for women. She asked, “Can you commit to me today that this administration and DOJ will prioritize taking meaningful and thoughtful action to address the dangers that occurred in the current status quo to women all over this country?” Blanche replied, “Absolutely, Senator.”
Blanche told lawmakers he would commit resources to end illegal abortion pills flooding across state borders, look into cases of coercion regarding the abortion pill, and review a previously rendered opinion regarding the federal Comstock Act. The Comstock Act, a federal law passed in 1873, makes it a crime to use the mail to ship anything intended for producing an abortion. Anti-abortion advocates have been trying to activate this legal provision for years. The acting attorney general appeared before the committee and made clear he plans to enforce the Comstock Act and end access to telehealth abortion.
Blanche said he did not view it appropriate to discuss legal strategies regarding the abortion pill with lawmakers. After questioning by three senators, he acknowledged that the Trump DOJ opposes Biden-era changes to the abortion pill safeguards, known as REMS, despite having worked to halt several state lawsuits over the matter. REMS, or Risk Evaluation and Mitigation Strategies, is the FDA’s safety framework that governs how mifepristone is prescribed and dispensed.
The Tension Within the Republican Party
Sen. Josh Hawley questioned Blanche over why the Justice Department is in court opposite states challenging the Biden abortion pill policy. Louisiana led a lawsuit last year challenging a Biden administration rule allowing abortion drugs to be sent to women by mail without seeing a doctor in person. The Trump Justice Department asked a federal court to pause the case against the FDA while the FDA conducts a safety review of mifepristone.
Blanche stressed that the Justice Department’s actions in court do not constitute a defense of the Biden-era policy. The distinction he was drawing didn’t fully satisfy Hawley. Hawley proposed that the attorney general reinstate the mifepristone regulations from Trump’s first term while the FDA continues its work, something that in the Missouri senator’s view is not being done with sufficient diligence, in light of the increase in the number of abortions in recent years.
Blanche told the committee, “Remember, we have to have studies that we can defend in court. Because we have to be able to say to a judge that our change was not arbitrary and capricious.” He is asking for time to build paperwork that can survive a legal challenge.
Blanche’s confirmation isn’t assured, as he faces an even narrower Senate margin. Sen. Lindsey Graham’s death left the Judiciary Committee Republicans with just one vote to lose.
The FDA Safety Review and What It’s Based On
Blanche said the FDA is, “for the first time in a decade, actually doing real studies about the safety and the appropriateness of these drugs.” That framing conflicts sharply with what researchers at Johns Hopkins Bloomberg School of Public Health found when they examined more than 5,000 pages of internal FDA documents from 2011 to 2023 and published their findings in a January 2026 JAMA study. They found that agency decisions were consistently driven by scientific evidence, not politics. Agency leaders almost always followed the recommendations of career scientists, repeatedly reviewed safety data, and reaffirmed that mifepristone is safe while making cautious changes to access.
The FDA approved mifepristone for early pregnancy termination in 2000. Today mifepristone, in combination with another drug, misoprostol, is the most widely used abortion regimen in the U.S. and is also widely used throughout the world.
Medication abortion, a two-drug regimen that includes mifepristone and misoprostol, has been safely used by more than 7.5 million people since its approval and accounts for nearly two-thirds of abortions in the United States. The FDA reviewed over 5,000 pages of internal safety documents on mifepristone spanning more than a decade, and that analysis was then published in one of the world’s leading medical journals. The FDA’s recent announcement that it would review mifepristone’s safety revisits decades of research from the U.S. and globally that overwhelmingly shows the drug is safe and effective. The study cited as prompting the FDA’s review, unlike the rigorous research that led to the FDA’s 2000 approval, was not peer-reviewed.
As of April 2026, the FDA continues to work on the collection of robust and timely data necessary for a well-controlled study with adequate statistical power. The review, which courts and parties expect to conclude by late 2026, is the reason the DOJ asked to pause several state lawsuits.
The Lawsuit Running Through the Courts
The Fifth U.S. Circuit Court of Appeals issued a ruling that was a major victory in the anti-abortion movement’s war against medication abortion, which now accounts for roughly two-thirds of all abortions in the United States. The ruling stemmed from a lawsuit filed by Louisiana last year against the FDA, after the Trump administration refused to act on calls to reinstate the in-person dispensing requirement for abortion pills through the regulatory process.
On May 4, 2026, the U.S. Supreme Court granted an emergency administrative stay to a pair of abortion pill manufacturers. This paused the Fifth Circuit’s ruling that had reinstated a rule requiring any prescription for mifepristone to include an in-person visit with a healthcare provider, rather than being available by mail after a telehealth consultation.
Joining Louisiana as a plaintiff in the lawsuit against the FDA is a woman who alleges that she was coerced into terminating a pregnancy by taking abortion pills that were shipped in from out of state. Sen. Britt brought up a recent story of a woman whose partner gave her the abortion pill without the woman’s consent or knowledge, saying access to abortion pills needed to be curtailed, rather than saying the woman’s partner should be penalized for intimate partner violence. Using documented cases of assault to argue for restricting access rather than prosecuting the assailant drew sharp responses from reproductive rights advocates.
How Telehealth Changed the Numbers
The policy that Blanche committed to reversing was set in motion during the COVID-19 pandemic. The Biden-era FDA in 2021 removed the in-person requirement from abortion pill prescriptions so that healthcare providers could prescribe the abortion pills to patients completely online. The FDA finalized the removal of the in-person requirement in 2023.
Telehealth abortion grew from 5% of all abortions in April 2022 to 29% by December 2025, according to the #WeCount project, a national abortion tracking effort sponsored by the Society of Family Planning. Across 2025, over 300,000 abortions were provided via telehealth. Tens of thousands of people still travel across state lines to receive an abortion in person, but that number is falling as telehealth abortion becomes more common.
Since Dobbs, telehealth abortions have become a particular lifeline for abortion access, especially thanks to shield laws, which permit providers in states without bans to prescribe medication in the 13 states where abortion is totally banned. Currently, 22 states and Washington D.C. have some kind of shield law in place. Reinstating the in-person requirement would not, in itself, automatically reverse this, but it would create a legal basis to go after the providers and the pharmacies participating in this model.
The Comstock Question Nobody Wants to Answer Directly
Blanche’s commitment to review the Biden-era Office of Legal Counsel opinion on the Comstock Act may carry more long-term weight than anything else he said. During the Biden administration, the Office of Legal Counsel issued an opinion concluding that the Comstock Act’s provisions generally do not prohibit mailing abortion drugs unless the sender intends them to be used unlawfully. Sen. Ted Cruz asked Blanche directly whether he would reconsider that opinion. Blanche said yes.
If the Trump DOJ reverses that OLC opinion and declares that mailing mifepristone violates the Comstock Act, the consequences wouldn’t be limited to states with abortion bans. The Comstock Act is a federal law, and it applies everywhere.
“Today Todd Blanche demonstrated that if confirmed as Attorney General, he will be content to go along with anti-abortion extremists’ plan to restrict medication abortion nationwide,” said Deirdre Schifeling, the chief political and advocacy officer at the American Civil Liberties Union. Liz Wagner, senior federal policy counsel at the Center for Reproductive Rights, stated: “Whether in a clinic or via telehealth, medication abortion is popular and the anti-abortion movement can’t stand it. The only takeaway from this hearing is that they’ll stop at nothing to try and ban abortion nationwide.”
The Part That Isn’t a Surprise
None of the positions Blanche staked out at this hearing are entirely new. What’s new is how openly they’re being stated and how little appetite there is, at least among Senate Republicans, for the pre-Dobbs caution around the topic.
The argument being assembled has several moving parts: the FDA is being pushed toward a conclusion on mifepristone that its own scientists have not reached. The Comstock Act is being revived as a potential nationwide instrument. The in-person dispensing requirement is being treated as a safety measure when the available evidence describes it, overwhelmingly, as a burden with no commensurate clinical benefit. Coercion cases, which would ordinarily point toward strengthening domestic violence enforcement, are being used instead to restrict general access.
Despite the detailed analysis documenting the rigor of the FDA’s review process, the Senate’s Health, Education, Labor, and Pensions Committee held a hearing framed as an inquiry into the abortion pill’s safety, with statements describing mifepristone as putting women in “serious danger.” That framing has now migrated from a HELP Committee hearing into a full attorney general confirmation proceeding.
Where This Is Likely Headed
The administration has decided that waiting for the FDA safety review to conclude is its path to action on abortion pills by mail, but it is no longer pretending to be neutral on what that review should find. Blanche said the administration “will not” defend what Biden did. He said the FDA is doing work “so we can continue to protect the lives of unborn children.” He committed to reviewing the OLC opinion on Comstock.
Blanche told the committee, “We will always, and when I say we, I’m not just saying the Department of Justice, I’m saying President Trump’s administration in its entirety, protect the life of the unborn.” He asked anti-abortion advocates for time to comply with bureaucratic deadlines so that the online dispensing of the abortion pill can be repealed through regulations that will stand up in court.
Every serious legal observer watching these proceedings knows that any attempt to reinstate the in-person requirement nationwide, or to invoke Comstock as a basis for banning mail delivery of mifepristone, will be litigated immediately and intensively. The Fifth Circuit’s May 2026 ruling was paused by a Supreme Court emergency stay within days. The legal structure around abortion pill access is not thin. It has been built up through the FDA approval process, through REMS modifications, through telehealth expansion, through 26 years of clinical use.
The Clock Is Running
Commitments made in Senate confirmation hearings have a way of becoming policy. Blanche has no confirmed court win to point to yet, and the FDA review is still ongoing, but the public posture of the man being asked to lead the DOJ shifted unmistakably on July 15, 2026. For millions of people whose access to medication abortion currently depends on a telehealth appointment and a prescription in the mail, that posture is not abstract.
The legal structure being built here, Comstock plus a new FDA safety finding plus a reversed OLC opinion, is designed to work together. None of the three components alone would be enough to end mail-order access nationwide. All three together might be. Anti-abortion legal strategists have been working toward this convergence for years. What changed this week is that the person likely to lead the Department of Justice said, on the record, that he plans to help them get there.
The fight over abortion pills by mail is not primarily a fight about safety. Mifepristone’s safety record, reviewed by the FDA across more than two decades and examined in over 5,000 pages of internal agency documents, is not seriously in dispute among scientists. The fight is about access, about whether a legal, FDA-approved medication can reach people who need it without requiring them to travel, take time off work, or live in a state that hasn’t banned the procedure. Blanche made the administration’s answer to that question explicit. Now the courts will have their say.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.