AILSA CHANG, HOST:
California Governor Gavin Newsom sent a warning on Twitter to Walgreens yesterday after the pharmacy chain announced that it would only dispense a medication used for abortion in some states where it operates. Newsom tweeted, quote, "California won't be doing business with Walgreens or any company that cowers to the extremists and puts women's lives at risk." NPR's Selena Simmons-Duffin has been looking at what that means for abortion access and what's behind this decision from Walgreens. She's here to fill us in. Hey, Selena.
SELENA SIMMONS-DUFFIN, BYLINE: Hi, Ailsa.
CHANG: OK, so let's back up for a moment. Can you just explain the role that pharmacies currently play in providing access to the medication we're talking about here?
SIMMONS-DUFFIN: Right. So we're talking about mifepristone. It's one of two medications that's used to induce an abortion or to treat a miscarriage. It blocks the hormone called progesterone. And since the drug was approved in 2000, there have been lots of restrictions on who can provide it, who can prescribe it, how patients can get it. They have to, you know, take it in a clinic in front of a clinician. Those rules loosened a bit in the pandemic. And at this point, about half of all abortions in the country are done with medications, so it's a big part of this story. In January, the Food and Drug Administration announced that it would allow retail pharmacies to apply to be certified to dispense this medication for the first time. So that's a big deal for access. And for a lot of OB-GYNs, like Dr. Daniel Grossman at UCSF, it's long overdue.
DANIEL GROSSMAN: We now have a tremendous amount of evidence, including our own research, showing that pharmacists dispensing mifepristone is safe and effective. And so, finally, the policy is starting to catch up to the science.
SIMMONS-DUFFIN: After the FDA said that they could, Walgreens and CVS both announced that they'd be applying to be certified. But they're facing a lot of pressure since making those announcements.
CHANG: Wait. What kind of pressure?
SIMMONS-DUFFIN: Well, Walgreens' board meeting was interrupted by some anti-abortion protesters in late January. Then 20 attorneys general from Republican states sent a letter in February to Walgreens and lots of other pharmacy chains warning them that if they allowed mifepristone to be sent through the mail, they would be violating a 19th-century federal law. Now, the reason that we're talking about Walgreens today is because it actually responded to the letter. Other chains like CVS and Walmart and Kroger, which also got the letter, apparently have not responded at all. Walgreens did. And it said to the AGs, essentially, don't worry. We'll only be dispensing this medication in places where we legally can. So I called up Lindsay Wiley, a health law professor at UCLA.
LINDSAY WILEY: I would imagine that, you know, CVS is feeling pretty good about hanging back and seeing how this plays out right now.
SIMMONS-DUFFIN: To be clear, nothing has changed yet. This is about an announced plan for expanded access to this medication through retail pharmacies. It's a fight about the future. But Wiley says it's an important fight now that states have much more influence over access to reproductive health care.
WILEY: Mifepristone abortion pills have become a political football for state elected officials - governors, attorneys general - to assert the power that they have.
CHANG: OK, well, Selena, politics aside, what does Governor Newsom's announcement mean, practically speaking, this idea that California will not be doing business with Walgreens?
SIMMONS-DUFFIN: Yeah, I put that question to Richard Dang today. He's the president of the California Pharmacists Association, and here's how he responded.
RICHARD DANG: That's a really great question and a question that we're trying to answer ourselves as well.
SIMMONS-DUFFIN: His best guess is that California might try to use its public health insurance plans - like the Obamacare exchange plans, Medicaid, insurance for state employees - to make those plan not contract with Walgreens. That would mean people with those plans wouldn't be able to get any of their medications filled through Walgreens. But Wiley, the law professor, says executing on that would be super-complicated since there are a lot of private insurance contracts involved. It would be super-slow. It's also a guess. As I said, Newsom's office hasn't provided any details to NPR or other outlets about a timeline or specifics. Wiley says, to her, it's less about a policy and more about sending a message, which is what the Republican attorneys general were trying to do too, to use their clout to influence what these pharmacy chains do next when it comes to access to abortion pills.
CHANG: That is NPR's Selena Simmons-Duffin. Thank you, Selena.
SIMMONS-DUFFIN: Thank you. Transcript provided by NPR, Copyright NPR.
