As federal attacks on abortion pills escalate, Illinois charts a new course by turning to international standards.
While antiabortion extremists work to eliminate mifepristone from the shelves—and the FDA faces mounting antiabortion political pressure to revoke its approval—Illinois lawmakers are fighting back with a legal firewall: a first-of-its-kind bill to keep abortion pills on the market, even if the Trump administration bans them.
The Illinois General Assembly has passed HB 3637, legislation allowing clinicians to prescribe drugs removed from the FDA’s approved list—as long as the World Health Organization still recommends them. Under the bill, Illinois clinicians could continue prescribing and dispensing the abortion medication mifepristone, even if the Trump administration rolls back the FDA’s longstanding approval of the medication. The legislation now awaits the signature of Illinois Gov. JB Pritzker.
“The current federal administration presents a national threat to reproductive healthcare access,” said state Sen. Karina Villa, a Democrat who represents West Chicago. “As we continue to see other states attempting to restrict care and impose their laws on people in Illinois, it is instrumental that we push back and fortify our laws to keep individuals and providers safe.”
As abortion opponents escalate their attack on mifepristone, Illinois isn’t waiting to see what happens. The bill fires back at mounting federal attempts to ban mifepristone and roll back abortion access nationwide.
On May 14, Secretary of Health and Human Services Robert F. Kennedy, Jr announced that the FDA would consider reviewing the safety of mifepristone if new data emerged and supported it. Shortly after, an antiabortion group released a flawed report falsely claiming mifepristone is not safe. In response to demands in a letter from Sen. Josh Hawley (R-Mo.), FDA commissioner Marty Makary announced on June 3 that the agency would “review” its regulation of mifepristone.
But the science hasn’t changed. Approved by the FDA in 2000, mifepristone in combination with a second medication—misoprostol—has been safely and effectively used to end early pregnancies for decades. Since then, the medication has been used safely by 7.5 million women. Over 100 peer-reviewed studies confirm that mifepristone is safe—in fact, it’s safer than many medications with far fewer restrictions, such as penicillin, Viagra and Tylenol. Today, mifepristone is used in over 60 percent of all abortions nationwide.
The attempt to remove mifepristone from the market is no fringe idea—it’s embedded in the Heritage Foundation’s Project 2025 agenda goals, aimed at gutting abortion rights through federal power.
The Illinois House passed HB 3637, the Protecting Access Act, on April 7 by a margin of 67-39. The Illinois Senate followed on May 30, approving the bill by the margin of 38-19. In addition to preserving Illinois clinicians’ ability to prescribe and dispense mifepristone if federal approval is withdrawn, HB 3637 also expands legal protections for Illinois healthcare providers caring for patients traveling from outside of Illinois.
The bill states:
“If a drug had been approved by the U.S. Food and Drug Administration before January 1, 2025, the revocation of approval of the drug by the U.S. Food and Drug Administration after that date shall not cause it to be deemed an adulterated drug in violation of this Act if the drug is recommended for use by the World Health Organization, even if the drug’s labeling reflects prior approval that is no longer in effect, so long as the drug’s labeling was true and accurate at the time of its manufacture.”
“We want to make sure … if the FDA were to take this medication out of its FDA approval, that it would not still ban or limit access to medication abortion in Illinois,” said Rep. Dagmara Avelar (D) after the legislation’s approval in April.
Federal law normally preempts state laws, but that hasn’t stopped antiabortion states from banning FDA-approved abortion pills. Legal challenges to these bans have had mixed results. Now, Illinois is flipping the script—with the same strategy used in antiabortion states by allowing mifepristone to stay on the market, even if the FDA revokes its approval.
“This law demonstrates how state governments can play an important role protecting licensed practitioners who are offering proven-safe care,” said Julie F. Kay, co-founder and executive director of Abortion Coalition for Telemedicine. “This kind of proactive thinking will help ensure that women’s health is not treated with disregard or contempt by abortion opponents.”
Abortion pill access has expanded significantly in recent years, especially after the FDA lifted its in-person dispensing requirement for mifepristone in 2021. Telehealth abortion—where clinicians consult with patients online and mail abortion pills directly to them—is now used in 20 percent of all U.S. abortions.
In May, after Secretary Kennedy indicated the FDA would review mifepristone safety, Pritzker didn’t hold back, “How many times must it be said? Mifepristone has proven to be affordable and safe for those seeking reproductive health care. We’ve enshrined the right to choose in Illinois, and we’ll fight like hell to keep that right.”
Now, with HB 3637 on his desk, Pritzker has the chance to turn that promise into law and send a clear message: Illinois won’t back down.
