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Abortion rights advocates reacted to a new ruling severely curtailing access to medication abortion with anger and disappointment — but also a resolve to make it a “defining issue” in 2024.

Anti-abortion advocates won a major victory with Friday’s decision from Texas federal Judge Matthew J. Kacsmaryk. His ruling stays the initial approval of mifepristone, a common abortion drug used in a two-step regimen to terminate pregnancies and manage miscarriages, that the Food and Drug Administration (FDA)  issued in 2000. 

Medication abortions will remain accessible at least in the short term. Kacsmaryk’s ruling intentionally gave the federal government seven days to appeal to a higher court. Also on Friday, a federal judge in Washington state issued a contradicting opinion in a separate case ordering the FDA not to reverse its approval of mifepristone, creating a legal conflict that experts say is likely to escalate up to the U.S. Supreme Court.    

Cecile Richards, co-chair of Democratic super PAC American Bridge 21st Century and the former CEO of Planned Parenthood, said in a Friday statement that Kascmaryk’s decision showed that conservatives are “trying to strip Americans of our basic rights to control our bodies and our futures.” 

“The Republican party,” she said, “is playing with fire.”

“This is a moment not only for the abortion rights movement to be tough and tougher, but frankly for everyday Americans who are concerned about their futures and the futures of their families and their communities to stand up,” Richards said in an interview in March, before Kacsmaryk’s ruling. 

“I appreciate what the abortion rights movement is doing to fight back, but this is something where it’s going to take a lot more than that,” she added. “It’s going to take all of us.”

Many Republicans cast the overturn of Roe vs. Wade in June as simply returning the question of abortion to the states. But the ruling from Kacsmaryk, a conservative Christian jurist appointed by former President Donald Trump and confirmed along party lines in 2019, could have sweeping implications for abortion providers and patients across the country, in red and blue states. Of the 38 Republican senators still in office who voted to confirm Kacsmaryk in 2019, only Sen. Cindy Hyde-Smith of Mississippi, had posted a public statement celebrating the decision on Twitter or their website as of 8 a.m. ET on Monday morning.

“​​It is going to lay bare what the Republican Party agenda is, and that is not to make this a state’s issue, as they tried to say, but to take away the right of every single person in this country to make their own decisions about pregnancy,” Richards said of the decision. 

In a January 2022 op-ed published in The New York Times, Richards wrote that her “one regret” from her time leading Planned Parenthood from 2006 to 2018 was that she “underestimated the callousness” of the Republican Party in pushing for abortion bans aimed at overturning Roe. She wrote that abortion rights advocates couldn’t have worked harder, “but maybe we could have been tougher.” 

Now in her role as co-chair of American Bridge, Richards is taking anti-abortion groups like the Alliance Defending Freedom, which argued the Texas mifepristone case on behalf of a consortium of doctors, at their word that they want nothing less than a national ban — and wants to hammer GOP candidates on it going into 2024.

“Every single Republican in office is going to have to take a position on what just happened. There’s nowhere to hide,” Richards said. “Republican leadership is going to be absolutely on the defense now for the next 18 months.”

GOP Rep. Nancy Mace of South Carolina, who has pushed her party to moderate on the issue of abortion, told CNN on Monday that she thought Kacsmaryk’s ruling should be “thrown out” and the Biden administration should ignore it.

“This is an FDA-approved drug. I support the usage of FDA-approved drugs, even if we might disagree,” she said. “This is not up to us to decide legislators, or even as a court system, whether this is the right drug to use or not. I agree with ignoring it at this point.”

Kascmaryk’s decision marks the first time a federal court has ordered the FDA to overturn the approval of a medication against the wishes of the agency and the drug’s manufacturer, also a party in the case. The legal battles over medication abortion have already resulted in uneven access to the drugs for some and will continue to fuel existing confusion and uncertainty around the drugs. And a high-profile fight over unpopular restrictions on abortion pills in the high courts will continue to keep the issue in the spotlight in the 2024 election cycle.

“This decision is wildly opposed to begin with,” said Celinda Lake, a leading Democratic pollster and president of Lake Research Partners. “And then when you spell out the repercussions, you really have a fight on your hands — people are very upset.” 

Lake Research surveys conducted in September 2022 and January 2023 found that 62 percent of likely voters, including 64 percent of independents and nearly half of Republicans, opposed blocking access to medication abortion. Over 60 percent of voters also opposed restricting telemedicine abortion care, an increasingly popular way of accessing medication abortion, and 68 percent said they would support a federal law guaranteeing access to abortion pills.  

“Taking away people’s rights is not a theoretical issue,” Richards said. “The harm and injury and fear that is facing women, families, parents and potential grandparents is so widespread now, that it isn’t just isolated to one group of people.” 

Richards also wants to inform and mobilize women voters, particularly less politically engaged women, starting now. “We are not going to wait until 2024 to educate them about what the stakes are in the election,” Richards said.

“A lot of the issues we’re discussing, they don’t think of as political,” Richards added. “And they can’t figure out why in the world the Republican Party has taken aim at them.”

Democrats and abortion rights advocates won another major electoral victory in Wisconsin on Tuesday. Judge Janet Protasiewicz, who explicitly ran on her personal support for abortion rights, defeated her conservative opponent to give liberals a majority on the state Supreme Court, which is likely to hear a case challenging the state’s 1849 abortion ban. 

Kacsmaryk’s ruling also comes as Republican lawmakers in Florida are preparing to pass a six-week abortion ban, which would severely curtail abortion access throughout the entire South. Lake said that both the ongoing rollbacks of abortion rights in Republican-controlled states and the mifepristone ruling will “keep the abortion issue front and center” for voters. 

“I think it’ll make a big difference in a lot of races in 2024,” she said.