
There are more abortions now than when the Court overturned Roe v. Wade. But a ruling on whether to keep abortion pills accessible could change that.
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Host
Abortion pills have been on a bit of a journey in the United States over the past few weeks. The journey begins in Louisiana, where the state sued the Food and Drug Administration to ban access to mifepristone through telehealth pills in the mail. On May 1, a district appeals court temporarily banned access to telehealth, abortion and pills by mail nationwide. So for a few days, a lot of people in the country were like but then the Supreme Court of the United States weighed in.
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Oh yay.
Sponsor Voice 2
Oh yay, oh yay.
Host
The Supreme Court has, at least for now, restored access, but the Supreme Court wasn't finished. They said, we'll have more for you on Monday, yesterday. But then yesterday they said actually Thursday, and we'll see if that happens. The Supreme Court said it would get out of the business of abortion after overturning Roe v. Wade, and they were wrong. So while we wait for them to figure this out again, we're going to talk about what's at stake on Today Explained from Bucks.
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Alice Miranda Olsteen
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Host
Oh yay. Oh yay. Today Explained.
Alice Miranda Olsteen
I am Alice Miranda Olsteen and I am a senior health care reporter for Politico.
Host
By the end of the week, could the nature of access to abortion pills across the country change? Is that what's at stake here?
Alice Miranda Olsteen
Yes, absolutely. So what Louisiana is demanding is that the Supreme Court allow restrictions to go into effect right now, even before the case is finally resolved. Louisiana says every day that patients in our state can get abortion pills online and get them shipped in in violation of our state's ban is a day we are being injured as a state. They're claiming sovereign injury that they say the ability of patients around the country to access these pill by telehealth, to have them prescribed by a doctor online and sent by mail, is helping people in their state circumvent the law. And that's why they want the Supreme Court to step in and cut that off for everyone nationwide because it's a federal policy while the case is still in the works and the drug makers are the ones fighting back against that. The two companies that make this abortion pill and they say there's no sovereign injury to. You can't just get rid of a policy for everyone because you don't like how people are using it.
Legal Expert/Analyst
Louisiana thus suffers no sovereign injury because nothing undermines Louisiana's ability to legislate and enforce abortion restrictions as it sees fit.
Alice Miranda Olsteen
And they say that, you know, this policy has been in effect for several years already. There's no sudden emergency where you need it suddenly banned just now. And thus the Supreme Court should keep everything the way it currently is while the case works its way through.
Host
Do we have any idea where the Supreme Court stands on abortion pills at this point?
Alice Miranda Olsteen
So the reading of the tea leaves is always a tricky venture with the Supreme Court. People try to guess based on the questions that were asked at oral arguments. We haven't even gotten there yet in this case. But it's just very hard to know. It's very hard to know.
Host
Politico hasn't gotten like a leak this time about.
Alice Miranda Olsteen
Not on this one, not on this one. It's very possible that, you know, once again, they sort of duck the heart of the issue on abortion on federal power versus state power. And they just say you don't have standing. You, you can't prove that you, the state are being injured by this policy.
Host
It seems a little contradictory, right? I mean, the Supreme Court said let the states decide. Years later we have Louisiana saying, hey, ban abortion pills for the entire country. That's not letting the states decide at all. Right. Just on its face.
Alice Miranda Olsteen
So what's interesting here is you really have both sides making a states rights argument and saying, my rights as a state are being infringed upon. So you have Louisiana saying, why should other blue States, liberal abortion policies where anybody can get pills. Why should that be allowed to invade our state when we're over here trying to ban abortion?
Legal Expert/Analyst
New York and other states have also passed aggressive shield laws that among other things, permit doctors and clinics to omit identifying information from pill bottles so that a 12 pill bottle with mifepristone can arrive in Louisiana without indicating who sent it.
Alice Miranda Olsteen
And so they're basically saying that allowing this anywhere, you know, infringes on their right as a state to prohibit it. Now of course, as you just articulated, you also have people saying wait a minute. So that means it gets to be restricted for everybody. Even people who, you know, have laws on the books in their states supporting access to abortion.
Legal Expert/Analyst
States have no sovereign interest in having other sovereigns policies match theirs. And a divergence in abortion policy at the state level is a natural result of returning abortion policy to the states.
Alice Miranda Olsteen
And so yeah, you really have all sides of this reaching for the states rights banner. It's one of those sort of compromises that pleases nobody because the anti abortion folks, they are not ever gonna be satisfied. They say, why should a fetus's rights end at a state border? And of course on the other side you have folks saying why should a pregnant woman's rights end at a state border? And so this is always gonna be a federal fight.
Host
How big a deal have abortion pills become since the Supreme Court overturned Roe
Alice Miranda Olsteen
v. Wade, since Dobbs, even before that, they were becoming more and more popular as a method of abortion. And especially since the COVID pandemic, they have become the predominant method that people are choosing in order to terminate their pregnancies.
Host
Most abortions today are obtained through medication, often accessed by mail and an in person visit to a doctor, something opponents have tried to stop.
Sponsor Voice 2
Medication is now used to bring about
Alice Miranda Olsteen
2/3 of all abortions and more than a quarter get them by telehealth. So you know, even if the pills aren't banned entirely, but just telehealth is restricted, that's gonna be a big blow. And it's not just a big blow to people living in states like Louisiana, where there's a ban locally and they can't go to a doctor's office and get them even if they want to. But it'll impact people in states like California, where there are these huge swaths of the state where it's very difficult to get to a clinic. You know, we have medical deserts all around the country. We have shortages of providers and telehealth has really broadened access, including in states where it was already legal and technically accessible on paper, but not in practice.
Host
Okay, so give us an idea. Let's say by the end of this week, the Supreme Court weighs in Thursday afternoon, Thursday morning, who knows if they say no more abortion pills via telehealth, what does this look like in the United States?
Alice Miranda Olsteen
Yeah, so we actually got a sneak preview of what it would look like a couple weeks ago. We had a few days between when the 5th Circuit ruled for Louisiana and said, okay, we're gonna restrict these pills, access to these pills nationwide. And it took the Supreme Court a few days after that to step in and say, whoa, whoa, whoa, let's hit pause. Let's go back to the way things were. Let's restore telehealth while we figure this out. So in those few days, you saw these providers who prescribe and ship the pills to people living in states with bans make sort of a variety of decisions. Some of these groups immediately just paused and stopped. Other groups, including, you know, some doctors I talked to in Massachusetts, they have been preparing for this for years. And so they had a plan already in place to pivot to, to only providing the second pill of the two pill abortion regimen. So to have an abortion, you can't just take mifepristone alone. You have to take it in combination with another pill, misoprostol. Now you can take misoprostol alone. And that's actually pretty common in other countries. So these groups, including the ones I talked to, immediately pivoted to only sending misoprostol to patients who were ordering the pills.
Host
Okay, so there's a lot at stake here for abortion access in the United States. This week at the Supreme Court. I'm curious how the President of the United States feels about this. Not that he has a say per se, but has he weighed in?
Alice Miranda Olsteen
He has not and neither has his Justice Department. So what was really striking is, you know, the Supreme Court was like, okay, we're gonna, we're gonna, you know, step in here and at least decide this case on a temporary basis. And, you know, they heard from Louisiana.
Legal Expert/Analyst
Out of state prescribers freed from the in person dispensing requirement are causing approximately 1,000 illegal abortions in Louisiana each month.
Alice Miranda Olsteen
They heard from the drug makers. Louisiana's complaint should have been dismissed outright. They heard from all of these other people.
Philip Wegman
Members of Congress briefed for 259 members of Congress as amici curators, Governors brief
Host
for states of New York, Arizona, California,
Philip Wegman
Colorado, Connecticut, Delaware, Hawaii, medical groups leaving
Legal Expert/Analyst
all medically sound options on the table, including dispensing mifepristone via mail or at local pharmacies, is critical.
Alice Miranda Olsteen
Activist groups on all sides.
Host
Intimate partner violence often leads to coerced abortions of wanted children.
Sponsor Voice 1
Many religious traditions view abortion as morally acceptable.
Philip Wegman
Former FDA officials FDA was extremely cautious in approving mifepristone.
Alice Miranda Olsteen
Everybody was sending briefs up to the Supreme Court. But you know who didn't? The Trump administration. The Trump administration, the guy who talks
Host
about everything, didn't say anything, weigh in,
Alice Miranda Olsteen
did not either ask the Supreme Court to maintain the status quo or side with Louisiana. They were silent. The FDA has said it, you know, is reviewing the safety of the pills and will make its own decision. So the Trump administration had told lower courts, hey, back off, you know, let the FDA do its thing. But now that the case is before the Supreme Court, nothing to say. Silent. Now the anti abortion folks took that as a sign that the Trump administration is cool with the Supreme Court imposing restrictions. They said, oh, even they won't defend the FDA's horrible telehealth policy. Blah blah blah blah blah blah. Now we don't know that that's the message that this lack of, that this silence is sending, but it's definitely making people offer their interpretations.
Host
Why the silence when Today Explained returns. Support for the show today comes from Vanta. If you're a business owner, you may have noticed a shift recently. Risk and regulation are increasing, but before they sign anything, customers now expect clear proof of security. Building that trust is essential to closing deals. And that's what we're all about, closing deals. But it's also complex, expensive and time consuming. Vanta says they can automate that process to bring compliance, risk and customer Trust together on one AI powered platform. So whether you're prepping for a SoC2 and who isn't, or running an enterprise GRC program, I know a lot of you are. Vanta keeps you secure and keeps your deals moving. This helps companies get compliant fast and remain compliant in the future, opening doors to huge growth opportunities and freeing up your valuable time. You can get started@vanta.com explained. That is V A N T A dot com explained. Vanta.com explained.
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Philip Wegman
Mr. President, do you have any reaction
Host
to Today Explain being named the best news show?
Interviewee
Wow, I didn't know that. I just. You're telling me now for the first time,
Host
Philip Wegman reports on the White House for the Wall Street Journal and he recently helped write one called the Anti Abortion Movement is Turning on Trump. We asked him to come talk to
Philip Wegman
us about it right now. If you talk to folks in the anti abortion movement, they're pretty disappointed because they thought that they would be doing much better. Right now they have Republican allies in Congress.
Interviewee
Senator Lindsey Graham is promising to hold
Host
a vote on a national abortion ban that would say after 15 weeks, no abortion on demand except in cases of
Philip Wegman
rape Incest The Supreme Court, of course, turned over Roe v. Wade several Years ago, since 1913, 92 versus Jackson Women's Health Organization. And the man that they helped return to the White House, Donald Trump, who brags about being the most pro life president ever.
Interviewee
Well, I'm pro life. I am pro life.
Philip Wegman
He's back in power. And yet last month you had the president of Susan B. Anthony, Pro Life America, a woman named Marjorie Dannenfelser, come out and say that the stakes were existential for their movement.
Marjorie Dannenfelser
If the Republican Party fully follows this administration's states only strategy and abandons its commitments to pro life action at the national level, then the movement as we know it is finished.
Philip Wegman
Basically what you know, it all boils down to in their mind is that there have been more abortions post Roe year after year.
Marjorie Dannenfelser
There are more abortions in the United States now than there were on the day that Roe v. Wade was overturned.
Philip Wegman
And currently the Trump administration has embraced a sort of states rights patchwork framework for regulation.
Interviewee
My view is now that we have abortion where everybody wanted it from a legal standpoint, the states will determine by vote or legislation or perhaps both, and whatever they decide must be the law of the land, in this case the law of the state.
Philip Wegman
And so they were triumphant just a few years ago, but now they're very much on the back foot.
Host
It sounds like you're saying that these lobbying groups thought that the decision from the Supreme Court overturning Roe v. Wade, the Dobbs decision, would mean fewer abortions in the United States. Was that kind of their bad for thinking that?
Philip Wegman
There certainly was an expectation that once Roe was reversed, there were going to be all sorts of other fights that they were gonna fight this out in all 50 different states. the same time, though, these anti abortion group, they're of the opinion that the Dobbs decision leaves room for federal action. And what they're frustrated by right now is that Trump in their mind has really held them at arm's length. Not only does he not want a federal abortion ban, many states will be different.
Interviewee
Many will have a different number of weeks, or some will have more conservative than others, and that's what they will be.
Philip Wegman
But his administration has moved forward, you know, with the approval of a generic version of mifepristone. They have kept on the books Biden era regulations that allow a woman to order these drugs through a telehealth service and not actually have to go see a doctor in person. They believe that Republicans are standing still at a moment when Democrats and frankly this is backed up by the reporting say that they want to codify Roe. So for these pro lifers, it's existential.
Host
These groups you're talking about. Can we get more specific? Who are we talking about here?
Philip Wegman
So there's a lot of different groups here. You know, when it comes to the pro life lobby, there's Americans United for Life, the March for Life, the Family Research Council. But the most politically connected is the Susan B. Anthony list. If a member of Congress gets a call from the March for Life, they're picking up the phone eager to talk. If they get a call from Susan B. Anthony list, they might be sweating.
Host
No,
Philip Wegman
Marjorie. Dennis Felser, president of SBA Pro Life America, is very much a political operator. The entire group, they are knife fighters through and through. And they really put the Republican Party on notice last month when they announced that they were planning to spend 160 million, not just in the coming midterms, but in the 2028 Republican presidential primary.
Marjorie Dannenfelser
Time is short, but our tasks can be accomplished. And over these next two cycles, we plan to spend $160 million to try to accomplish this great task.
Philip Wegman
The pro lifers at sba, they have not hid their frustration. They were angry at FDA administrator Marty Makary because he approved a generic approving
Alice Miranda Olsteen
a new generic version of the drug myth of Pristone. These are medications used in about two thirds of all abortions nationwide.
Philip Wegman
With FDA approval, activists say it will be easier to get abortion pills through the mail, despite laws in some states that aim to make that illegal.
Alice Miranda Olsteen
The Susan B. Anthony group saying this reckless decision by the FDA is unconscionable.
Philip Wegman
So last December, they called for McCary to be fired. You know, SBA, they've been sort of rattling the saber. But in our interview with her, she told the Wall Street Journal, the president is the problem. That's a direct quote. She believes that, you know, Trump, who was as pro life of an advocate as you could have in 2016 and again in 2020, has set aside the issue.
Host
And the president on Friday met with people from the Susan B. Anthony list, including their leader, Marjorie. Do we know how much Marjorie and the President see the midterms in the 2028 elections differently?
Philip Wegman
The pro life lobby thinks that there is a way for Republicans to run on abortion and not run away from it. And so they are gonna spend a lot of money in these coming midterms, but they're also gonna spend a ton of money in the coming presidential primary. And the expectation here is that any candidate that they're gonna Support has to agree to federal action on the abortion issue. Marjorie told the Wall Street Journal in our reporting that the President, who had been staunchly and openly pro Life, remember in 2016, there's that moment on the debate stage where he says that Hillary Clinton is okay with partial birth abortion and describes that in vivid terms based
Interviewee
on where she's going and where she's been. You can take the baby and rip the baby out of the womb in the ninth month on the final day, and that's not acceptable.
Alice Miranda Olsteen
Well, that is not what happened that
Philip Wegman
got all of the social conservatives to stop thinking twice about this billionaire playboy from New York and see him instead as a social conservative champion. Well, in the 2024 election, you know, Trump sort of says, hey, I delivered you three pro life Supreme Court justices. My work here is done. I'm gonna focus on other things. And when Marjorie went and said, hey, we need federal action. I need you to get on board, the answer that she got was no. This issue is killing us.
Sponsor Voice 4
A majority of Americans do, in fact, believe abortion should be legal in most cases. Just about 2/3 of those polled, 66%, believe abortion should be legal in all or most cases.
Philip Wegman
That is nearly 10 points higher than it was just over a decade ago. And there's a belief inside of the current administration that if they didn't have to deal with abortion, then maybe Republicans will be picking up dozens of additional seats. So the fact that this meeting was put on the schedule is incredibly significant because it shows that the White House knows, look, we have to service this part of our coalition. We have to get on board with them. Maybe it reflects that the administration believed that they let a core constituency outside of the fold.
Host
It seems pretty clear if you look at his decades of history of weighing in on every last issue, that abortion didn't weigh heavily on the President's mind until it became politically expedient to do so. Do you really think if, say, J.D. vance, come 2027 or so, starts advocating for a federal abortion ban, 20 week abortion ban, whatever it might be, that it's gonna upset President Trump, who probably doesn't really have a dog in the fight to begin with.
Philip Wegman
We don't know, how much of a leash does the president actually give J.D. vance to go pursue the nomination? And as he's. Is Donald Trump a stage mom giving helpful advice, or is he one of the judges saying, hey, I thought you were the MAGA heir apparent. But some of these other guys have better stump speeches and they are more deferential towards me, you know, Donald Trump. I think that everything is transactional. And so where you have these pro lifers who are motivated by a single principle and then you have a politician who is motivated just by getting the best deal that he can do, they get it back on the same page. Or is this a break? And look, you know, the anti abortion lobby has been one of the most loyal constituencies for Republicans for decades.
Legal Expert/Analyst
Sean.
Philip Wegman
This is the story of the Trump era. He shows up and he tears the curtain on what Republican orthodoxy is remaking the party in his own image. There are some things he absolutely cares about. Trade, immigration, foreign policy. On all of the other areas though, now there's no gatekeeper to say what is and isn't conservative. And all have sort of freely entered in to have this argument. Some folks like the pro lifers are saying this has been a party platform issue for decades, it cannot change, it shouldn't change. They are looking not just to change the direction of the current administration, they're looking for the future of the party and saying what will Republicans believe in 2028? And their argument is that any definition of conservatism has to include robust limitations on abortion. And previously a lot of Republicans were very successful in saying, hey, you know, we want to overturn Roe v. Wade. And that was sort of the consensus. And so this is going to be a fascinating, fascinating fight that is going to tell us a lot about the identity of the new American right.
Host
Read philip@thejournal WSJ.com read Alice from earlier@politico.com listen to today explained because Peter Balin on Rosen produces, Joey Myers edits, Gabriel Donatoff fact checks David Tadashore and Bridger Dunnigan mix. I'm Sean Ramos for him. Goodbye. Support for the show today comes from Quo. Missed calls and slow follow ups are silent killers. Yikes. That's how businesses leave money on the table without ever realizing. That's why today's episode is brought to you by Quo, spelled Q U O like status. The business communication system built so you never miss a call. Quo isn't just a phone system, it's a smart one. AI hello. Automatically logs calls, generates summaries and flags next steps so nothing falls through the cracks. And it can even qualify leads or respond after hours so your business stays on even when you're off. And Quo says it's easy. Calls, text, voicemails, transcripts and contact details all in one clean view so your team always has the full picture and can show up for every customer conversation, ensuring a seamless and more personalized experience. Money is on the line. You can always say hello. With Quo. You can try Quo for free, plus get 20% off your first six months when you go to quo.com explained. That's quo.com explained.
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Date: May 12, 2026
Hosted by: Sean Rameswaram, Noel King
Main Guest Experts: Alice Miranda Olsteen (Politico Senior Health Care Reporter), Philip Wegman (White House Reporter, Wall Street Journal), Legal Analysts
This episode tackles the urgent national debate over abortion pill access and legal battles culminating at the Supreme Court. Focusing on Louisiana’s challenge to the FDA’s telehealth policy for mifepristone (the most commonly used abortion pill), the hosts speak with legal and political experts to break down what’s at stake, what’s happening at the Supreme Court, and how the political landscape is shifting on abortion rights since Roe v. Wade was overturned.
The episode also explores the tensions within the anti-abortion movement, especially as former President Trump’s approach diverges from that of key advocacy groups.
Louisiana’s Lawsuit: Louisiana sued the FDA to halt abortion pill access by telehealth and mail, claiming it enables abortions that circumvent state bans.
Nationwide Implications: The 5th Circuit temporarily banned access to mifepristone via telehealth and mail nationwide, affecting all states. Supreme Court quickly paused the lower court's ruling, but another decision is expected soon.
States’ Rights Paradox: Both sides use “states’ rights” arguments. Louisiana claims federal policy undermines its state bans, while others argue imposing restrictions nationwide actually negates states’ autonomy to allow access.
Standing Dispute: Louisiana argues the state is “injured” by federal policy, while drugmakers and blue states contest that claim, arguing no “sovereign injury” exists.
Possible Supreme Court Response: The Court could rule on technical grounds, sidestepping the core issue by saying Louisiana lacks standing, or could allow the lower-court restrictions to take effect before a final ruling.
Pill Use Rising: Two-thirds of abortions are now medication-based, and over a quarter happen via telehealth.
Impact Beyond Red States: Even in states where abortion is legal, telehealth and mail-order pills are crucial for rural residents or those in “medical deserts.”
Adaptation Strategies: Some providers shifted to only prescribing misoprostol (the second pill in a two-drug regimen) when legal uncertainty interrupted access to mifepristone.
White House Stance: Neither the President nor the Justice Department has responded publicly to the Supreme Court case.
Interpretations: Silence interpreted by anti-abortion advocates as tacit acceptance of restrictions; uncertainty abounds over true intent.
Disappointment Post-Roe: Influential anti-abortion groups expected Roe’s reversal to lead to a sharp reduction in abortions, but the rise of medication abortion and varied state laws have thwarted that expectation.
Trump’s States' Rights Approach: Trump has embraced a “let the states decide” patchwork, frustrating national organizations seeking a federal ban.
Susan B. Anthony Pro-Life America (SBA): Largest political force in the anti-abortion lobby, openly critical of Trump and ready to spend $160 million to influence upcoming elections and push for federal action.
FDA as a Target: SBA and allies outraged by continued FDA approval and relaxed regulations for mifepristone.
Activist Frustration: Some demand Trump fire FDA officials and enact national restrictions.
Abortion and Elections: Pro-life leaders feel the GOP can't succeed long-term without taking a harder line. Trump, in contrast, wants to move beyond the abortion debate, citing electoral risks.
Public Opinion: Majority of Americans support legal abortion access; GOP strategists recognize legal and political pitfalls.
2028 and Beyond: SBA’s Marjorie Dannenfelser says any candidate they’ll support must promise federal anti-abortion action, setting the stage for a GOP identity fight.
On States’ Rights Double Bind:
“This is always gonna be a federal fight.”
— Alice Miranda Olsteen ([06:35])
On Adaptation to Legal Uncertainty:
“Some doctors … had a plan already in place to pivot to only providing the second pill of the two-pill abortion regimen.”
— Alice Miranda Olsteen ([09:23])
On Legal Strategy and Judicial Guesswork:
“The reading of the tea leaves is always a tricky venture with the Supreme Court … it’s very hard to know.”
— Alice Miranda Olsteen ([04:31])
On Trump’s Transactional Politics:
“Everything is transactional. … Where you have these pro-lifers motivated by a single principle and then a politician motivated just by getting the best deal he can do, [can] they get back on the same page?”
— Philip Wegman ([25:21])
This episode delivers a comprehensive, real-time analysis of the high-stakes legal fight over abortion-pill access now before the Supreme Court. It weaves in how anti-abortion politics—and the Republican Party—are fracturing over this issue post-Roe, how the debate is already affecting patient care, and why both sides see an existential battle over abortion that extends well beyond individual state borders. Experts and reporters clarify what the legal arguments are, what ordinary Americans could experience if access is restricted, and how upcoming elections could hinge on where the GOP—and its likely standard bearers—land on this pivotal question.