---
title: "Federal abortion law"
description: "Since the Supreme Court's 2022 Dobbs decision, there is no federal constitutional right to abortion. The federal government has not passed a law either banning abortion nationwide or protecting it nationwide. That means each state now makes its own abortion laws. But federal law still matters in…"
type: "legislation"
jurisdiction: "United States (federal)"
as_of_date: "2026-07-12"
source_url: "https://www.abhortion.org/legislation/federal.html"
---

# Federal abortion law

_United States · Post-Dobbs framework_

## Overview

**States regulate; federal levers remain**

After Dobbs, there is no federal constitutional abortion right; Congress has not enacted a national ban or a national codification, leaving states as primary regulators while FDA approval, spending riders, EMTALA, the Comstock Act, and conscience laws operate as key federal levers.

Since the Supreme Court's 2022 Dobbs decision, there is no federal constitutional right to abortion. The federal government has not passed a law either banning abortion nationwide or protecting it nationwide. That means each state now makes its own abortion laws. But federal law still matters in several important ways: the FDA decides whether abortion pills are approved and how they can be prescribed and dispensed; Congress uses spending bills to block most federal funds from paying for abortions; a law called EMTALA requires hospitals to provide emergency care—and the question of whether that includes abortion in ban states is still being fought in court; an old law called the Comstock Act could be revived to restrict mailing of abortion pills; and federal conscience laws protect health care workers who refuse to participate in abortion.

> "The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives."
> — Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022)

**Legal analysis**

Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022), overruled Roe v. Wade and Planned Parenthood v. Casey, holding no federal constitutional right to abortion exists under the Due Process Clause. The Court returned regulation to the states and to Congress, applying rational-basis review to abortion restrictions. Congress has not enacted a comprehensive federal abortion statute either banning or codifying abortion. Federal influence operates through: (1) FDA's authority under the FDCA to regulate mifepristone; (2) annual appropriations riders, primarily the Hyde Amendment, barring federal funding of most abortions; (3) EMTALA, 42 U.S.C. § 1395dd, requiring stabilizing treatment at Medicare-participating hospitals—its application to emergency abortion care in ban states remains unresolved after Moyle v. United States was dismissed as improvidently granted; (4) the Comstock Act, 18 U.S.C. §§ 1461-1462, whose application to mailing abortion drugs is currently limited by DOJ OLC interpretation but subject to revival debate; (5) federal conscience protections shielding refusers; (6) the Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531, which bans a specific late-term method nationwide.

*Sources — Verified at source · High confidence · Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022), syllabus, [Supreme Court of the United States](https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf)*

## At a glance

Every machine-readable determination in the research document. Each value is derived from a sourced finding below.

| Field | Value |
| --- | --- |
| Constitutional right status | None post dobbs |
| Federal gestational ban | No |
| Partial birth ban in effect | Yes |
| Mifepristone fda approved | Yes |
| Mifepristone telehealth rems | Allowed |
| Comstock act enforced | Not currently |
| Hyde amendment in effect | Yes |
| Emtala preemption resolved | No |
| Federal personhood law | No |
| Interstate travel protected | Presumed |

## The Dobbs baseline

**No constitutional right; rational basis**

Dobbs overruled Roe and Casey, holding the Constitution confers no abortion right; post-Dobbs, state abortion laws are reviewed under rational-basis scrutiny, and the Court expressly reserved the interstate-travel and medication-preemption questions.

In June 2022, the U.S. Supreme Court decided Dobbs v. Jackson Women's Health Organization, overturning nearly 50 years of precedent. The Court ruled that the U.S. Constitution does not protect a right to abortion. This means there is no longer a federal constitutional floor for abortion access. The Court sent the issue back to each state to decide its own laws, and to Congress if it chooses to act. Going forward, courts will review state abortion laws using the most deferential standard—"rational basis"—meaning a law will be upheld if it is rationally related to a legitimate government interest. The Court explicitly said it was not deciding questions about traveling across state lines for an abortion or whether FDA approval of abortion drugs overrides state bans.

> "We hold that Roe and Casey must be overruled. The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision, including the one on which the defenders of Roe and Casey now chiefly rely—the Due Process Clause of the Fourteenth Amendment."
> — Dobbs v. Jackson Women's Health Org., 597 U.S. 215, 142 S. Ct. 2228 (2022)

**Legal analysis**

Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022), held: (1) the Constitution makes no reference to abortion and no abortion right is implicitly protected by any constitutional provision, including the Due Process Clause of the Fourteenth Amendment; (2) Roe v. Wade, 410 U.S. 113 (1973), and Planned Parenthood v. Casey, 505 U.S. 833 (1992), are overruled; (3) stare decisis does not require retaining them because they were egregiously wrong, caused significant negative consequences, and did not generate legitimate reliance interests that could not be addressed; (4) the appropriate standard of review for abortion regulations is rational-basis review—whether the law is rationally related to a legitimate state interest, which includes the state's interest in protecting fetal life throughout pregnancy. Justice Kavanaugh's concurrence identified several issues the Court was not deciding: whether a state may bar a resident from traveling to another state for an abortion (he stated the answer is "no based on the constitutional right to interstate travel"), whether a state may retroactively impose liability, and other related questions. The Court did not address FDA preemption of state medication-abortion restrictions.

*Sources — Verified at source · High confidence · Dobbs v. Jackson Women's Health Org., 597 U.S. 215, 142 S. Ct. 2228 (2022), slip op. at 1, [Supreme Court of the United States](https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf) · Dobbs v. Jackson Women's Health Org., 597 U.S. ___ (2022) (Kavanaugh, J., concurring), slip op. at 10, [Supreme Court of the United States (via Akhil Amar site)](https://akhilamar.com/wp-content/uploads/2023/09/Kavanaugh-concurrence-Dobbs.pdf)*

## Definitions

**Born-alive definition only; no fetal personhood**

Federal law defines 'person,' 'human being,' 'child,' and 'individual' to include every infant born alive at any stage of development, but there is no federal statute defining the unborn as 'persons' for general purposes; the Unborn Victims of Violence Act creates a separate fetal-homicide offense while expressly excluding consensual abortion and the mother from its scope.

Federal law defines when a baby who is born counts as a legal 'person'—that includes any infant who is born alive at any stage of development and shows signs of life like breathing or a heartbeat. This definition applies when interpreting all federal laws and regulations. But this definition explicitly says it does not address any legal status before birth. There is no federal law that says an embryo or fetus is a 'person' for all purposes. The Unborn Victims of Violence Act makes it a separate federal crime to kill or injure an unborn child during certain violent federal crimes—but the law says it does not apply to any abortion the pregnant woman consented to, to any act by the pregnant woman herself, or to any medical treatment.

> "In determining the meaning of any Act of Congress, or of any ruling, regulation, or interpretation of the various administrative bureaus and agencies of the United States, the words 'person', 'human being', 'child', and 'individual', shall include every infant member of the species homo sapiens who is born alive at any stage of development."
> — 1 U.S.C. § 8(a)

**Legal analysis**

The Born-Alive Infants Protection Act, 1 U.S.C. § 8, enacted in 2002, provides that in determining the meaning of any Act of Congress or any ruling, regulation, or interpretation of U.S. administrative agencies, the words 'person,' 'human being,' 'child,' and 'individual' shall include every infant member of the species homo sapiens who is 'born alive' at any stage of development. 'Born alive' means complete expulsion or extraction from the mother, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion. Subsection (c) states: 'Nothing in this section shall be construed to affirm, deny, expand, or contract any legal status or legal right applicable to any member of the species homo sapiens at any point prior to being "born alive."' The Unborn Victims of Violence Act, 18 U.S.C. § 1841, creates a separate federal offense for causing the death of or bodily injury to a 'child, who is in utero' during commission of certain listed federal crimes of violence. Crucially, § 1841(c) provides: 'Nothing in this section shall be construed to permit the prosecution of any person for conduct relating to an abortion for which the consent of the pregnant woman, or a person authorized by law to act on her behalf, has been obtained or for conduct relating to any medical treatment of the pregnant woman or her unborn child.' No general federal fetal-personhood statute has been enacted, though bills like the Life at Conception Act (H.R. 722, 119th Cong.), which would declare that the right to life guaranteed by the 14th Amendment vests at fertilization, have been introduced but not enacted.

*Sources — Verified at source · High confidence · 1 U.S.C. § 8(a), subsection (a), [U.S. Government Publishing Office (govinfo)](https://www.govinfo.gov/link/uscode/1/8) · 1 U.S.C. § 8(c), subsection (c), [U.S. Government Publishing Office (govinfo)](https://www.govinfo.gov/link/uscode/1/8) · 18 U.S.C. § 1841(c), subsection (c), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=(title:18%20section:1841%20edition:prelim)%20OR%20(granuleid:USC-prelim-title18-section1841)&f=treesort&num=0&edition=prelim)*

## The statutory landscape

### Partial birth abortion ban

**D&X method banned; mother exempt**

The Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531, prohibits a specific late-term procedure—intact dilation and extraction—nationwide, with a life-of-the-mother exception and no prosecution of the pregnant woman.

Federal law bans a specific late-term abortion procedure called 'partial-birth abortion'—medically known as intact dilation and extraction—everywhere in the United States. This ban applies only to physicians who knowingly perform this specific procedure. There is an exception when the procedure is necessary to save the pregnant woman's life. The law explicitly says the woman who undergoes the procedure cannot be prosecuted. The Supreme Court upheld this ban as constitutional in 2007.

> "A woman upon whom a partial-birth abortion is performed may not be prosecuted under this section, for a conspiracy to violate this section, or for an offense under section 2, 3, or 4 of this title based on a violation of this section."
> — 18 U.S.C. § 1531(a)

**Legal analysis**

The Partial-Birth Abortion Ban Act of 2003, 18 U.S.C. § 1531, makes it a federal crime for any physician who, in or affecting interstate or foreign commerce, knowingly performs a 'partial-birth abortion' and thereby kills a human fetus. A 'partial-birth abortion' is defined as an abortion in which the physician deliberately and intentionally vaginally delivers a living fetus until, in a head-first presentation, the entire fetal head is outside the mother's body, or, in a breech presentation, any part of the fetal trunk past the navel is outside the mother's body, and then performs an overt act that kills the partially delivered living fetus. The statute contains a life-of-the-mother exception: it does not apply when necessary to save the life of the mother endangered by a physical disorder, illness, or injury. Penalty is a fine, imprisonment up to 2 years, or both. 18 U.S.C. § 1531(e) provides: 'A woman upon whom a partial-birth abortion is performed may not be prosecuted under this section, for a conspiracy to violate this section, or for an offense under section 2, 3, or 4 of this title based on a violation of this section.' The Act was upheld against a facial constitutional challenge in Gonzales v. Carhart, 550 U.S. 124 (2007), which held that the Act's lack of a health exception did not impose an undue burden and that the Act was not void for vagueness.

*Sources — Verified at source · High confidence · 18 U.S.C. § 1531(a), subsection (a), [Legal Information Institute (Cornell Law School)](https://www.law.cornell.edu/uscode/text/18/1531) · 18 U.S.C. § 1531(e), subsection (e), [Legal Information Institute (Cornell Law School)](https://www.law.cornell.edu/uscode/text/18/1531) · Gonzales v. Carhart, 550 U.S. 124 (2007), slip op. syllabus, [Justia](https://supreme.justia.com/cases/federal/us/550/124/)*

### Comstock act

**Not enforced for lawful use; disputed**

18 U.S.C. §§ 1461-1462 declare abortion-related articles 'nonmailable,' but the DOJ Office of Legal Counsel concluded in December 2022 that the Act does not prohibit mailing abortion drugs where the sender lacks intent that they be used unlawfully—a reading that could shift with a new administration.

The Comstock Act is a federal law from 1873 that says it is illegal to mail any article, drug, or substance intended for producing abortion. For decades, federal courts interpreted this law narrowly, saying it only applies when the sender intends the items to be used for an illegal abortion. In December 2022, the Justice Department's Office of Legal Counsel issued an opinion confirming that the Comstock Act does not bar mailing the abortion drugs mifepristone and misoprostol where the sender lacks intent that the drugs will be used unlawfully—and because the drugs can be used lawfully in every state (for miscarriage management, for example), the mere mailing of them does not prove illegal intent. However, this interpretation is not binding on future administrations. Anti-abortion advocates have called for a future Republican administration to reinterpret the Comstock Act as an outright ban on mailing abortion-related materials, which could sharply restrict medication abortion nationwide. The 2025 Trump administration has not yet altered the OLC's 2022 opinion, but the issue remains intensely debated.

> "Section 1461 of title 18 of the U.S. Code does not prohibit the mailing of certain drugs that can be used to perform abortions where the sender lacks the intent that the recipient of the drugs will use them unlawfully."
> — 18 U.S.C. § 1461

**Legal analysis**

18 U.S.C. § 1461 declares nonmailable '[e]very article or thing designed, adapted, or intended for producing abortion' and '[e]very article, instrument, substance, drug, medicine, or thing which is advertised or described in a manner calculated to lead another to use or apply it for producing abortion.' Violation is a felony. 18 U.S.C. § 1462 imposes parallel prohibitions on using common carriers for interstate carriage. Courts of appeals in the early twentieth century—Bours v. United States, 229 F. 960 (7th Cir. 1915); Youngs Rubber Corp. v. C.I. Lee & Co., 45 F.2d 103 (2d Cir. 1930); Davis v. United States, 62 F.2d 473 (6th Cir. 1933); United States v. One Package, 86 F.2d 737 (2d Cir. 1936)—construed these provisions not to apply where the sender lacks intent that the items be used unlawfully. On December 23, 2022, the DOJ Office of Legal Counsel issued a memorandum opinion concluding that § 1461 'does not prohibit the mailing, or the delivery or receipt by mail, of mifepristone or misoprostol where the sender lacks the intent that the recipient of the drugs will use them unlawfully,' and that 'the mere mailing of such drugs to a particular jurisdiction is an insufficient basis for concluding that the sender intends them to be used unlawfully' because recipients in every state may lawfully use them for purposes including abortion. A different administration could withdraw or reverse that opinion. In the pending Missouri v. FDA litigation, plaintiff states have invoked the Comstock Act as an argument against mifepristone's approval.

**Conflicting authority.** The 2022 OLC opinion adopts the 'intent' construction endorsed by several early 20th-century courts of appeals, but anti-abortion advocates and some scholars argue the statute's plain text supports a broader categorical prohibition. The OLC opinion is not binding on courts or on a future administration.

*Sources — Verified at source · Medium confidence · 18 U.S.C. § 1461, subsection text, [Legal Information Institute (Cornell Law School)](https://www.law.cornell.edu/uscode/text/18/1461) · Application of the Comstock Act to the Mailing of Prescription Drugs That Can Be Used for Abortions, 46 Op. O.L.C. __ (Dec. 23, 2022), slip op. at 1, [U.S. Department of Justice, Office of Legal Counsel](https://www.justice.gov/olc/opinion/file/1560596/dl)*

**Editor's note.** The Trump administration has not yet withdrawn or replaced the 2022 OLC opinion as of this research date. This is a live area of policy debate; an editor should monitor for any new OLC opinion or DOJ enforcement posture.

### Hyde amendment and riders

**Federal funds barred except rape, incest, life**

The Hyde Amendment, an annual appropriations rider, bars using federal funds for abortion except in cases of rape, incest, or life endangerment; companion riders extend similar restrictions to the FEHBP, D.C., foreign aid, and conscience protections.

Since 1976, Congress has included a provision called the Hyde Amendment in its annual spending bills. It says no federal money can be used to pay for abortions, with three exceptions: when the pregnancy results from rape, when it results from incest, or when continuing the pregnancy would endanger the woman's life. This affects people covered by Medicaid, Medicare, the Children's Health Insurance Program, and other federal health programs. Similar restrictions apply to federal employees' health insurance (the Smith/Dornan Amendment), military health care, foreign aid (the Helms Amendment), and the Indian Health Service. The Hyde Amendment is not a permanent statute—it Must be renewed every year as part of the budget process. Additional riders such as the Weldon Amendment protect health care entities from discrimination for refusing to provide or refer for abortions.

**Legal analysis**

The Hyde Amendment is not a permanent statute but a rider attached to annual appropriations bills for the Departments of Labor, Health and Human Services, and Education. The current form bars using appropriated funds for abortion except in cases of rape, incest, or where the pregnancy endangers the mother's life. It has been included in every annual appropriations act since 1976 (with a brief exception in 1993-94 for the FEHBP restriction). Companion provisions include: (1) The Helms Amendment (Foreign Assistance Act, since 1973), barring foreign aid funds from being used 'for the performance of abortion as a method of family planning'; (2) the Smith/Dornan Amendment, barring federal employee health benefit plans from covering abortion except in life-endangerment, rape, or incest cases; (3) the Weldon Amendment, an annual Labor-HHS appropriations rider since FY 2005, barring federal agencies and state/local governments receiving federal funds from discriminating against health care entities that refuse to provide, pay for, cover, or refer for abortions. On January 24, 2025, President Trump issued Executive Order 14182, 'Enforcing the Hyde Amendment,' directing agencies to ensure strict compliance with Hyde Amendment requirements and rescinding Biden-era Executive Orders 14076 and 14079 that had sought to expand abortion access. A 2025 OLC opinion reversed a 2022 OLC opinion, now concluding that the Hyde Amendment prohibits using federal funds for ancillary services including transportation necessary to receive an abortion.

*Sources — Verified at source · High confidence · Executive Order 14182, 'Enforcing the Hyde Amendment' (Jan. 24, 2025), § 1, [The White House](https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment) · Reconsidering the Application of the Hyde Amendment to the Provision of Transportation for Women Seeking Abortions (OLC, 2025), slip op. at 1, [U.S. Department of Justice, Office of Legal Counsel](https://www.justice.gov/olc/media/1408241/dl)*

**Editor's note.** The Hyde Amendment must be reenacted each fiscal year. The specific rape/incest/life exceptions are stable but technically subject to change in any appropriations cycle. The Helms Amendment has been interpreted by practice to be broader than its text—prohibiting all abortion funding in foreign aid, not only 'as a method of family planning.'

### Unborn victims act

**Fetal-homicide offense; abortion exempt**

The Unborn Victims of Violence Act, 18 U.S.C. § 1841, makes it a separate federal crime to kill or injure a 'child in utero' during certain federal crimes of violence, but expressly excludes consensual abortion and acts by the pregnant woman.

This federal law says that if someone commits one of about 60 listed violent federal crimes and, in the process, kills or injures an unborn child, they can be charged with a separate crime on top of any charge related to harming the pregnant woman. But the law is clear: it does not apply to any abortion the woman consented to, to any act by the pregnant woman herself, or to any medical treatment. So the law recognizes an unborn child as a potential victim of violence for criminal prosecution purposes without affecting abortion rights or medical care.

> "Nothing in this section shall be construed to permit the prosecution of any person for conduct relating to an abortion for which the consent of the pregnant woman, or a person authorized by law to act on her behalf, has been obtained or for conduct relating to any medical treatment of the pregnant woman or her unborn child."
> — 18 U.S.C. § 1841(c)

**Legal analysis**

The Unborn Victims of Violence Act of 2004, 18 U.S.C. § 1841, provides that whoever engages in conduct violating any of the provisions listed in subsection (b)—which enumerates over 60 federal crimes of violence—and thereby causes the death of or bodily injury to a 'child, who is in utero at the time the conduct takes place,' is guilty of a separate offense. The punishment for that separate offense is generally the same as the punishment provided for that conduct had the injury or death occurred to the mother. The statute defines 'child, who is in utero' as 'a member of the species homo sapiens, at any stage of development, who is carried in the womb.' Subsection (c) carves out a critical limitation: 'Nothing in this section shall be construed to permit the prosecution of any person for conduct relating to an abortion for which the consent of the pregnant woman, or a person authorized by law to act on her behalf, has been obtained or for conduct relating to any medical treatment of the pregnant woman or her unborn child.' This double exclusion means neither abortion providers (with consent) nor pregnant women themselves face liability under this statute. The Act does not define the unborn as a 'person' for general purposes and applies only within the limited context of federal criminal violence.

*Sources — Semi-verified · High confidence · 18 U.S.C. § 1841(c), subsection (c), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=(title:18%20section:1841%20edition:prelim)%20OR%20(granuleid:USC-prelim-title18-section1841)&f=treesort&num=0&edition=prelim)*

**Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Church amendments conscience

**Strong provider refusal protections**

Multiple federal statutes—the Church Amendments (42 U.S.C. § 300a-7), the Coats-Snowe Amendment (42 U.S.C. § 238n), and the Weldon Amendment—protect individuals and health care entities that refuse to participate in abortion from discrimination and certain governmental requirements.

Federal law includes several protections for health care workers, institutions, and insurers who object to abortion on religious or moral grounds. The Church Amendments, passed in the 1970s, say that receiving federal funds does not allow courts or public officials to require any individual to perform or assist in an abortion if it goes against their religious or moral beliefs, nor to require institutions to make their facilities available for abortion or provide personnel for it. The amendments also ban discrimination against medical professionals—in employment, promotion, or staff privileges—because they performed or refused to perform an abortion. The Coats-Snowe Amendment adds that federal and state governments receiving federal money cannot discriminate against medical training programs or entities that refuse to train in, perform, or refer for abortions. The Weldon Amendment, an annual budget rider, extends these conscience protections further to health insurance plans and other health care entities.

> "The receipt of any grant, contract, loan, or loan guarantee under the Public Health Service Act ... by any individual or entity does not authorize any court or any public official or other public authority to require such individual to perform or assist in the performance of any sterilization procedure or abortion if his performance or assistance in the performance of such procedure or abortion would be contrary to his religious beliefs or moral convictions."
> — 42 U.S.C. § 300a-7(b)

**Legal analysis**

Three layers of federal conscience protection: (1) Church Amendments, 42 U.S.C. § 300a-7, enacted 1973-1979: § 300a-7(b) prohibits any court or public official from requiring an individual to perform or assist in sterilization or abortion contrary to religious beliefs or moral convictions, or requiring an entity to make facilities available for or provide personnel for such procedures; § 300a-7(c) prohibits discrimination in employment, promotion, termination, or staff privileges against health care personnel because they performed or refused to perform a lawful sterilization or abortion; § 300a-7(d) prohibits requiring any individual to perform or assist in a HHS-funded health service program contrary to religious or moral convictions; § 300a-7(e) prohibits discrimination against applicants for training or study based on their willingness or refusal to participate in abortions or sterilizations. (2) Coats-Snowe Amendment, 42 U.S.C. § 238n, enacted 1996, prohibits federal, state, or local governments receiving federal financial assistance from discriminating against any health care entity on the basis that the entity refuses to undergo training in, perform, or provide referrals for induced abortions or make arrangements for such activities; also requires accreditation of postgraduate physician training programs that would be accredited but for their refusal to provide abortion training. (3) Weldon Amendment, an annual appropriations rider since FY 2005, prohibits HHS and other agencies from making federal funds available to federal agencies or programs or to state or local governments that discriminate against health care entities that do not provide, pay for, cover, or refer for abortions. These protections apply to individuals, hospitals, insurers, and training programs alike.

*Sources — Verified at source · High confidence · 42 U.S.C. § 300a-7(b), subsection (b)(1), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title42-section300a-7&num=0&edition=prelim) · 42 U.S.C. § 238n(a), subsection (a), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section238n&num=0&edition=prelim)*

**Editor's note.** The Weldon Amendment must be reaffirmed in each annual appropriations cycle. The 2025 Trump administration is actively enforcing the Weldon Amendment; in 2026 HHS was investigating 13 states for alleged coercion of health care providers regarding abortion. An editor should verify the current status of specific enforcement actions.

### Born alive and other

**Born-alive definition; FACE clinic protections**

1 U.S.C. § 8 defines 'born alive' for all federal law purposes; the FACE Act, 18 U.S.C. § 248, criminalizes force or obstruction against reproductive health clinics and patients, though the Trump DOJ sharply limited its enforcement in 2025.

Two additional federal statutes round out the statutory picture. The Born-Alive Infants Protection Act says that for all federal laws, 'person,' 'human being,' 'child,' and 'individual' include every infant born alive at any stage of development, including after an abortion. The Freedom of Access to Clinic Entrances (FACE) Act makes it a federal crime to use force, threats, or physical obstruction to interfere with someone seeking or providing reproductive health services. FACE also allows victims and the U.S. Attorney General to bring civil lawsuits. In January 2025, however, the Trump Justice Department announced it would bring new FACE Act prosecutions only in 'extraordinary circumstances,' a policy shift that abortion-rights advocates say effectively greenlights clinic obstruction.

> "Whoever by force or threat of force or by physical obstruction, intentionally injures, intimidates or interferes with or attempts to injure, intimidate or interfere with any person because that person is or has been, or in order to intimidate such person or any other person or any class of persons from, obtaining or providing reproductive health services ... shall be subject to the penalties provided in subsection (b)."
> — 18 U.S.C. § 248(a)(1)

**Legal analysis**

1 U.S.C. § 8, the Born-Alive Infants Protection Act of 2002, provides a uniform federal definition of 'born alive' applicable to all Acts of Congress and federal agency actions. 18 U.S.C. § 248, the Freedom of Access to Clinic Entrances (FACE) Act of 1994, prohibits: (a)(1) by force, threat of force, or physical obstruction, intentionally injuring, intimidating, or interfering with any person obtaining or providing reproductive health services; (a)(2) similar conduct against persons exercising First Amendment rights at places of worship; and (a)(3) intentionally damaging or destroying the property of a facility that provides reproductive health services. Criminal penalties include fines and imprisonment up to 1 year (first offense) or 3 years (subsequent), with enhanced penalties if bodily injury (up to 10 years) or death (up to life) results. Civil remedies include injunctive relief, compensatory and punitive damages, and statutory damages of $5,000 per violation. The Attorney General and state attorneys general may also bring civil actions. On January 24, 2025, the Trump DOJ issued a memorandum limiting FACE Act enforcement, stating that 'future abortion-related FACE Act prosecutions and civil actions will be permitted only in extraordinary circumstances' and 'until further notice, no new abortion-related FACE Act actions—criminal or civil—will be permitted without authorization from the Assistant Attorney General.' The FACE Act remains on the books and is not repealed.

*Sources — Verified at source · High confidence · 18 U.S.C. § 248(a)(1), subsection (a)(1), [Legal Information Institute (Cornell Law School)](https://www.law.cornell.edu/uscode/text/18/248) · DOJ Memorandum, 'FACE Act Charging Policy' (Jan. 24, 2025), pp. 1-2, [U.S. Department of Justice](https://www.justice.gov/media/1386461/dl)*

**Editor's note.** The January 2025 DOJ memo is a charging policy, not a change to the FACE Act itself. The underlying statute remains fully enforceable, and the DOJ policy could be reversed by a future administration.

## FDA & medication abortion

### Mifepristone approval

**FDA-approved; REMS allows telehealth, mail**

Mifepristone is FDA-approved (2000) for medication abortion through 10 weeks gestation; the REMS was modified in January 2023 to permanently remove the in-person dispensing requirement and permit certified retail and mail-order pharmacies to dispense.

The FDA first approved mifepristone—also called the abortion pill—in 2000 for ending early pregnancies up to 10 weeks, used together with a second drug called misoprostol. A generic version was approved in 2019, and a second generic was approved in September 2025. For many years, the FDA required that the pill be dispensed in person at a clinic or hospital. In January 2023, the FDA permanently removed that requirement. Now, certified pharmacies—including mail-order pharmacies—can dispense mifepristone directly to patients with a prescription from a certified prescriber. This means people in states where abortion is legal can get medication abortion via telehealth and receive pills by mail. However, in states with abortion bans, these changes do not override state law, and the practical availability of the pills through mail depends on the interplay of state laws and the Comstock Act debate.

> "Mifeprex (mifepristone) and its generic, Mifepristone Tablets, 200 mg, are approved, in a regimen with misoprostol, to end an intrauterine pregnancy through ten weeks gestation (70 days or less since the first day of a patient's last menstrual period)."
> — FDA, 'Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation'

**Legal analysis**

Mifepristone (brand name Mifeprex) was first approved by FDA in September 2000 under 21 C.F.R. Part 314 Subpart H for the medical termination of intrauterine pregnancy through 49 days gestation. The gestational limit was extended to 70 days (10 weeks) in 2016. A generic version manufactured by GenBioPro was approved in 2019 (ANDA 091178), and Evita Solutions received approval for a second generic in September 2025. All are subject to a single shared Risk Evaluation and Mitigation Strategy (REMS), the Mifepristone REMS Program. The REMS initially required in-person dispensing at clinics, medical offices, or hospitals. In December 2021, FDA notified sponsors that the in-person dispensing requirement should be removed. After litigation and administrative process, on January 3, 2023, FDA permanently removed the in-person dispensing requirement and added a pharmacy certification process. Under the current REMS, mifepristone may be dispensed by certified pharmacies (including mail-order) pursuant to a prescription from a certified prescriber. The prescriber must be certified, and the pharmacy must complete a Pharmacy Agreement Form. The REMS modifications do not address or override state abortion restrictions. As of July 2025, the FDA approval and current REMS remain in effect, though subject to ongoing litigation.

*Sources — Semi-verified · High confidence · FDA, 'Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation', page text, [U.S. Food and Drug Administration](https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation) · FDA, Summary Review of REMS Modification (2023), p. 1, [U.S. Food and Drug Administration (accessdata.fda.gov)](https://www.accessdata.fda.gov/drugsatfda_docs/summary_review/2023/020687Orig1s025SumR.pdf)*

**Editor's note.** The approval of Evita Solutions' generic mifepristone in September 2025 is very recent and enacted after the 2025 government shutdown deadline; editors should confirm the current market status of this manufacturer. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Ahm v fda

**Standing denied; state case continues**

In FDA v. Alliance for Hippocratic Medicine (2024), the Supreme Court unanimously held that the plaintiff doctors lacked Article III standing, leaving FDA approval intact; a parallel case brought by three states (Missouri, Idaho, Kansas) continues in Missouri federal court.

In June 2024, the U.S. Supreme Court threw out a major lawsuit that had tried to overturn the FDA's approval of mifepristone and its more recent rules making the pill easier to get. The Court ruled unanimously that the anti-abortion doctors who brought the case did not have legal standing—meaning they were not directly harmed enough to sue. This preserved the FDA's approval of the drug, at least for now. However, a separate lawsuit brought by the states of Missouri, Idaho, and Kansas is still moving forward. They argue the FDA's handling of mifepristone violates federal law and the Comstock Act. That case was transferred in 2025 from Texas to federal court in Missouri and is still being litigated. The FDA's approval of mifepristone therefore remains in effect but faces ongoing legal challenge.

> "The plaintiffs lack Article III standing to challenge FDA's actions regulating mifepristone. The plaintiffs are pro-life, oppose elective abortion, and have sincere legal, moral, ideological, and policy objections to elective abortion and to FDA's actions relaxing mifepristone's regulatory requirements. But the law has long permitted doctors to object to performing abortions and to opt out of providing other medical care that violates their consciences."
> — FDA v. Alliance for Hippocratic Medicine, 602 U.S. 367 (2024)

**Legal analysis**

In FDA v. Alliance for Hippocratic Medicine, 602 U.S. 367 (2024), the Supreme Court unanimously held that the plaintiff associations of anti-abortion doctors lacked Article III standing to challenge FDA's 2016 and 2021 actions modifying the mifepristone REMS. Justice Kavanaugh, writing for the Court, reasoned that the plaintiffs failed to demonstrate that they would be forced to violate their consciences because federal conscience protections already allow them to refuse to participate in abortion, and the causal chain between FDA's actions and their alleged injuries was too attenuated and speculative. The Court did not reach the merits of the FDA's actions, and the approval of mifepristone itself was not challenged (the Fifth Circuit had found the original 2000 approval time-barred). After AHM was dismissed, a parallel suit—Missouri v. FDA, No. 2:22-cv-00223 (N.D. Tex., later transferred to E.D. Mo.)—filed by the states of Missouri, Idaho, and Kansas as intervenors, proceeded. On January 16, 2025, Judge Kacsmaryk (N.D. Tex.) granted the states leave to file an amended complaint. On October 1, 2025, Judge Kacsmaryk transferred the case to the Eastern District of Missouri, finding insufficient ties to Texas. The states' amended complaint challenges FDA's approval and regulation of mifepristone under the Administrative Procedure Act, the FDCA, and the Comstock Act, and alleges FDA acted ultra vires. The case was pending as of this research date.

*Sources — Semi-verified · Medium confidence · FDA v. Alliance for Hippocratic Medicine, 602 U.S. 367 (2024), slip op. at 1, [Supreme Court of the United States](https://www.supremecourt.gov/opinions/23pdf/23-235_n7lp.pdf) · Missouri v. FDA, No. 2:22-cv-00223 (E.D. Mo., transferred 2025), case summary, [Health Care Litigation Tracker (Georgetown Law)](https://litigationtracker.law.georgetown.edu/litigation/state-of-missouri-et-al-v-food-and-drug-administration-et-al)*

**Editor's note.** The Missouri v. FDA litigation is active and could result in a ruling affecting mifepristone's nationwide availability. An editor should monitor the Eastern District of Missouri docket for substantive rulings. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Preemption

**No preemption of state bans; Fourth Circuit**

In GenBioPro v. Raynes (4th Cir. July 2025), a divided panel held that FDA approval of mifepristone does not preempt West Virginia's near-total abortion ban; the Supreme Court has not yet addressed the preemption question.

The maker of generic mifepristone sued West Virginia, arguing that the state's abortion ban cannot block access to a drug the FDA has approved as safe and effective—that federal law should override the state ban. In July 2025, a federal appeals court in Richmond ruled against the drug company, finding that West Virginia's abortion ban is not preempted by the FDA's approval of mifepristone. In a 2-1 decision, the court said that states have traditionally regulated the practice of medicine, and the FDA's drug-approval power does not give it authority to override state decisions about whether particular medical procedures are legal. This is a major ruling but is not from the Supreme Court; the company could appeal further. The preemption question is also being litigated in separate cases in North Carolina and other courts, and the Supreme Court has not yet resolved it.

> "The district court determined there was no preemption, and we now do the same."
> — GenBioPro, Inc. v. Raynes, No. 23-2194 (4th Cir. July 15, 2025)

**Legal analysis**

In GenBioPro, Inc. v. Raynes, No. 23-2194 (4th Cir. July 15, 2025), a divided panel of the U.S. Court of Appeals for the Fourth Circuit held that West Virginia's Unborn Child Protection Act, which bans most abortions including medication abortion, is not preempted by the FDA's regulation of mifepristone under the Food, Drug, and Cosmetic Act. Writing for the majority, Judge J. Harvie Wilkinson III held that the state law does not conflict with the FDCA because health care is an area of traditional state regulation, the FDCA contains a saving clause preserving state authority, and Congress has not clearly expressed intent to preempt state abortion laws through drug regulation. The court rejected both conflict-preemption and obstacle-preemption theories. Judge Stephanie Thacker dissented. The decision creates a circuit precedent that FDA approval does not impliedly preempt state abortion restrictions on mifepristone. The GenBioPro plaintiffs could petition for Supreme Court review. Separate preemption litigation is pending in North Carolina (Bryant v. Stein). The Supreme Court in Dobbs expressly did not address FDA preemption, and no Supreme Court decision has resolved the matter. The theoretical basis for preemption rests on the argument that the FDCA and the Supremacy Clause implicitly preempt state laws that conflict with FDA's expert judgment that mifepristone is safe and effective for a particular use within the approved labeling.

**Conflicting authority.** The Fourth Circuit's 2-1 decision is precedential in the Fourth Circuit only. The First, Sixth, and other circuits have not ruled on this question. A Supreme Court grant of certiorari is possible. Scholarly views differ sharply on whether FDA approval impliedly preempts contrary state law.

*Sources — Verified at source · Medium confidence · GenBioPro, Inc. v. Raynes, No. 23-2194 (4th Cir. July 15, 2025), slip op. at 3, [Justia](https://law.justia.com/cases/federal/appellate-courts/ca4/23-2194/23-2194-2025-07-15.html)*

**Editor's note.** This is a rapidly developing area. GenBioPro may seek en banc review or Supreme Court certiorari. The North Carolina preemption case (Bryant v. Stein) and Washington v. FDA (a challenge to REMS restrictions from the opposite direction) remain pending and could produce conflicting rulings.

## EMTALA & emergency care

**Unresolved; Moyle DIG, Texas cert denied**

Whether EMTALA requires hospitals in ban states to provide emergency abortions remains legally unresolved: the Supreme Court dismissed Moyle v. United States as improvidently granted (June 2024), and in Texas v. Becerra the Court denied certiorari (October 2024), leaving a circuit split and no definitive federal ruling.

EMTALA is a federal law that requires nearly all hospitals with emergency departments to provide stabilizing treatment to any patient with a medical emergency. The Biden administration argued that in rare cases, this includes abortion care—even in states that ban abortion—when the pregnancy causes a medical emergency that seriously threatens the woman's health. This set up a direct conflict with state abortion bans. The Supreme Court had the chance to settle the question in 2024 but didn't. In the Idaho case, the Court sent the case back to the lower courts without deciding the main issue. In the Texas case, the Court refused to hear the Biden administration's appeal, leaving in place a lower-court ruling that blocks the federal government from enforcing its EMTALA abortion guidance in Texas. The practical result is a mess: in some ban states, doctors are uncertain about when they can legally provide emergency abortion care, and women with severe pregnancy complications are sometimes being airlifted to other states for treatment rather than receiving it locally. The legal question remains open and will return to the Supreme Court, likely in a different case or with a different administration.

> "The writs of certiorari before judgment are dismissed as improvidently granted, and the stays entered by the Court on January 5, 2024, are vacated."
> — Moyle v. United States, 603 U.S. 324 (2024) (per curiam)

**Legal analysis**

The Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd, requires Medicare-participating hospitals with emergency departments to provide an appropriate medical screening examination and, if an emergency medical condition exists, stabilizing treatment or appropriate transfer. 'Emergency medical condition' is defined to include conditions placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, or serious impairment of bodily functions, or serious dysfunction of any bodily organ or part. CMS issued guidance in July 2022 stating that EMTALA preempts state laws that prohibit abortion when it is the necessary stabilizing treatment. Two major cases followed: (1) Moyle v. United States, 603 U.S. 324 (2024) (consolidated with Idaho v. United States): the Supreme Court dismissed the writ of certiorari as improvidently granted on June 27, 2024, vacating its earlier stay and allowing the district court's preliminary injunction against Idaho's abortion ban to resume. The per curiam opinion did not reach the merits; Justice Kagan's concurrence (joined by Sotomayor and Jackson in part) argued EMTALA requires abortion when needed to stabilize a medical condition threatening serious health harms; Justice Barrett's concurrence (joined by Roberts and Kavanaugh) highlighted the changed posture of the case since the Court's intervention. The Ninth Circuit is now proceeding to the merits. (2) In Texas v. Becerra, the Fifth Circuit affirmed a district court injunction blocking enforcement of the CMS EMTALA guidance in Texas. The Supreme Court denied certiorari on October 7, 2024. The guidance therefore remains unenforceable in Texas. No court has issued a definitive ruling on the EMTALA preemption merits. The legal arguments center on whether a Spending Clause statute can preempt state criminal law, whether EMTALA's text requires specific treatments or merely prohibits patient dumping, and whether the statute's references to 'unborn child' limit its application to abortion.

**Conflicting authority.** The Fifth Circuit held that CMS's EMTALA abortion guidance is unlawful and unenforceable in Texas; the Ninth Circuit is considering the Idaho case on the merits, with the district court having preliminarily enjoined Idaho's ban to the extent it conflicts with EMTALA. No Supreme Court merits ruling exists. The Trump administration's CMS has not yet formally withdrawn the 2022 guidance, but the enforcement posture under the Hyde Executive Order suggests the guidance is no longer actively defended in the same way.

*Sources — Verified at source · Medium confidence · Moyle v. United States, 603 U.S. 324 (2024) (per curiam), per curiam slip op. at 1, [Supreme Court of the United States](https://www.supremecourt.gov/opinions/23pdf/23-726_6jgm.pdf) · Texas v. Becerra, No. 23-10246 (5th Cir. Jan. 2, 2024), cert. denied, No. 23-1076 (Oct. 7, 2024), SCOTUSblog article text, [Supreme Court of the United States / Fifth Circuit](https://www.scotusblog.com/2024/10/court-turns-down-bidens-bid-for-intervention-in-texas-emergency-abortion-dispute/) · 42 U.S.C. § 1395dd(b)(1), subsection (a), [Legal Information Institute (Cornell Law School)](https://www.law.cornell.edu/uscode/text/42/1395dd)*

**Editor's note.** The Trump administration's January 2025 Executive Order 14182 directs agencies to enforce the Hyde Amendment, which may extend to revising or rescinding the July 2022 CMS EMTALA guidance. Editors should monitor CMS for a formal rescission or replacement of the guidance.

## Federal lands military va

### Military

**DoD funds restricted; travel policy rescinded**

10 U.S.C. § 1093 prohibits use of DoD funds for most abortions in military facilities (life exception only); Secretary Hegseth rescinded the Biden-era travel and leave policy in January 2025, ending reimbursement for servicemembers who travel to obtain abortions.

Federal law prohibits the use of Department of Defense funds to perform abortions at military medical facilities, except when the life of the pregnant person is endangered. This has been the law since 1984. After Dobbs, the Biden administration adopted a policy in October 2022 that allowed servicemembers and dependents stationed in states with abortion bans to get paid leave and travel reimbursement to go to another state for abortion care. In January 2025, Defense Secretary Hegseth rescinded that policy. As a result, military personnel and their families stationed in ban states must now pay for their own travel if they seek an abortion in another state.

> "Funds available to the Department of Defense may not be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term."
> — 10 U.S.C. § 1093(b)

**Legal analysis**

10 U.S.C. § 1093(b) provides: 'Funds available to the Department of Defense may not be used to perform abortions except where the life of the mother would be endangered if the fetus were carried to term.' This restriction applies to abortions performed in DoD medical facilities and using DoD funds. In October 2022, following an OLC opinion concluding that DoD had statutory and necessary-expense authority to fund servicemember travel for non-covered abortions, Secretary Austin issued a memorandum, 'Ensuring Access to Reproductive Health Care,' establishing administrative absence (paid leave) and travel and transportation allowances for servicemembers and dependents who must travel to access abortion care unavailable where they are stationed. On January 29-30, 2025, Secretary Hegseth rescinded this policy via a memorandum directing that 'the policy for travel and transportation allowances for non-covered reproductive health care is rescinded.' The underlying statutory restriction in § 1093 remains in force. Servicemembers may still travel on their own time and at their own expense.

*Sources — Semi-verified · High confidence · 10 U.S.C. § 1093(b), subsection (b), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=(title:10%20section:1093%20edition:prelim)%20OR%20(granuleid:USC-prelim-title10-section1093)&f=treesort&num=0&edition=prelim) · DoD Policy Changes: Reproductive Health Benefits (CRS IN12512, 2025), p. 1, [Congressional Research Service](https://www.congress.gov/crs_external_products/IN/PDF/IN12512/IN12512.3.pdf)*

**Editor's note.** Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Veterans affairs

**VA abortion care banned; 2022 rule rescinded**

The VA's 2022 interim final rule allowing abortion counseling and limited abortion services was replaced by a final rule in December 2025 reinstating the full ban on abortion in the VA medical benefits package, restoring the pre-2022 status.

Before September 2022, the Department of Veterans Affairs did not provide abortion services or counseling to veterans. After Dobbs, the Biden administration issued an interim final rule allowing VA to provide abortion counseling and—in limited circumstances—abortion services to veterans and their beneficiaries, specifically in cases of rape, incest, or life or health endangerment. The Trump administration reversed this policy. In August 2025, the VA proposed a new rule restoring the full ban on abortion and abortion counseling. That rule was finalized in December 2025, meaning the VA once again cannot offer abortion counseling or abortion care to veterans.

> "The Department of Veterans Affairs (VA) adopts as final, without changes, a proposed rule to reinstate the exclusions on abortions and abortion counseling from the medical benefits package, which were removed in 2022."
> — Reproductive Health Services, 90 Fed. Reg. ____ (Dec. 31, 2025)

**Legal analysis**

From 1999 until September 2022, VA's medical benefits package excluded abortion services and abortion counseling. On September 9, 2022, the VA issued an interim final rule, 'Reproductive Health Services' (87 Fed. Reg. 55283), removing the exclusion on abortion counseling and permitting abortion services in the medical benefits package when the pregnancy resulted from rape or incest or endangered the life or health of the pregnant veteran or beneficiary. A final rule issued in 2024 made this permanent. On August 29, 2025, the Trump VA published a proposed rule, 'Reproductive Health Services' (RIN 2900-AR74), to reinstate the full exclusion on abortion and abortion counseling from the VA medical benefits package. The final rule was adopted on December 31, 2025 (Federal Register, Dec. 31, 2025). The final rule states that 'VA adopts as final, without changes, a proposed rule to reinstate the exclusions on abortions and abortion counseling from the medical benefits package, which were removed in 2022.' VA thus returned to its pre-2022 position that abortion is not 'needed' under 38 U.S.C. § 1710. Challenges to this rule were raised in Congress and by state attorneys general but the rule took effect.

*Sources — Semi-verified · High confidence · Reproductive Health Services, 90 Fed. Reg. ____ (Dec. 31, 2025), summary text, [Federal Register (via federalregister.gov)](https://www.federalregister.gov/documents/2025/12/31/2025-24061/reproductive-health-services)*

**Editor's note.** Members of Congress introduced a Congressional Review Act joint resolution of disapproval seeking to overturn the VA final rule. As of this research date, that resolution had not passed. Editors should monitor whether the CRA resolution gains traction. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Federal lands and facilities

**No federal-land clinic policy; state law applies**

No federal statute or regulation authorizes abortion services on federal lands within ban states; the Assimilative Crimes Act, 18 U.S.C. § 13, incorporates state criminal law for acts on federal enclaves, making state abortion bans likely enforceable on most federal properties.

Some advocates proposed that the Biden administration could allow abortion services on federal lands—like national parks or military bases—within states that ban abortion, arguing federal jurisdiction would override state law. The Biden administration did not adopt this approach, and no federal agency has authorized abortion services on federal lands specifically to circumvent state bans. The general legal rule is that state criminal law applies on federal lands through a law called the Assimilative Crimes Act, meaning state abortion bans would apply on federal property within that state. The legal picture is complex and depends on whether the land has exclusive or concurrent federal jurisdiction and when it was acquired, but the practical bottom line is that federal lands are not currently being used as abortion-access zones and would face significant legal obstacles if tried.

> "Whoever within or upon any of the places now existing or hereafter reserved or acquired as provided in section 7 of this title ... is guilty of any act or omission which, although not made punishable by any enactment of Congress, would be punishable if committed or omitted within the jurisdiction of the State ... shall be guilty of a like offense."
> — 18 U.S.C. § 13(a)

**Legal analysis**

The Assimilative Crimes Act, 18 U.S.C. § 13, provides that whoever within a federal enclave (places reserved or acquired by the federal government under 18 U.S.C. § 7) commits an act that is not punishable by any enactment of Congress but would be punishable under the laws of the state in which the enclave is located, shall be guilty of a like offense. Thus, where Congress has not enacted a federal abortion statute applicable to federal lands, state criminal abortion laws are assimilated into federal law on federal enclaves. The jurisdictional analysis is more complex in practice: (1) On federal lands where the U.S. has exclusive jurisdiction, state law does not directly apply, but the Assimilative Crimes Act incorporates state criminal law for prosecution in federal court. (2) Where jurisdiction is concurrent, state law applies directly. (3) The enclave status depends on when the land was acquired and whether the state ceded jurisdiction. The Biden administration considered but did not implement a policy of offering abortion services on federal property in ban states. Executive Order 14076 (July 8, 2022) directed HHS to identify ways to expand access but did not mandate the use of federal lands; that Order was rescinded by EO 14182. No current administration policy promotes the use of federal lands for abortion access.

*Sources — Semi-verified · High confidence · 18 U.S.C. § 13(a), subsection (a), [U.S. House of Representatives (uscode.house.gov)](https://uscode.house.gov/view.xhtml?req=(title:18%20section:13%20edition:prelim))*

**Editor's note.** The analysis is limited to federal criminal enforcement. Whether a state could directly prosecute a provider on a federal enclave with exclusive federal jurisdiction is more complex, but the Assimilative Crimes Act would permit federal prosecution under the assimilated state law. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

### Federal prisons ihs

**Hyde restrictions apply; IHS limited to life**

The Bureau of Prisons is bound by the Hyde Amendment and funds only 'medically necessary' abortions (life-endangerment); the Indian Health Service is similarly restricted by the Hyde Amendment, permitting abortions only in cases of rape, incest, or life endangerment when certified by a physician.

People in federal prison have a constitutional right to abortion access, but the Bureau of Prisons is bound by the Hyde Amendment—meaning federal funds can only pay for abortions in cases of life endangerment. Inmates must pay for abortions in cases of rape or incest. As a practical matter, access depends heavily on the state where the prison is located and BOP's willingness to facilitate off-site care. For Native Americans served by the Indian Health Service, federal law (the Hyde Amendment, applied through the IHS appropriations statute, 25 U.S.C. § 1676) also strictly limits abortion funding. The IHS issued a circular in August 2022 clarifying that IHS funds may be used for abortions only in cases of rape, incest, or life endangerment, with physician certification required.

**Legal analysis**

The Bureau of Prisons is subject to the Hyde Amendment through the annual Commerce-Justice-Science appropriations. Federal courts have held that the Eighth Amendment and due process require correctional facilities to allow inmates access to elective abortion care (Monmouth County Corr. Inst. Inmates v. Lanzaro, 834 F.2d 326 (3d Cir. 1987)), but BOP need only use federal funds to pay for abortions within Hyde parameters. Under BOP Program Statement 6031.05 ('Patient Care'), health care is to be provided in accordance with proven standards of care, but abortion services are limited by Hyde. Inmates may privately fund abortions that fall outside Hyde exceptions, but logistical barriers in ban states are substantial. For the Indian Health Service, 25 U.S.C. § 1676(a) provides that IHS appropriations shall be used for abortion only if 'a physician certifies that the pregnant person suffers from a physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the pregnant person in danger of death unless an abortion is performed.' IHS Circular No. 22-15 (August 2022) clarified that IHS funds may additionally be used in cases of rape or incest, consistent with the broader Hyde Amendment. The IHS policy remains in effect as of this research date, though the Trump administration's Hyde Executive Order may lead to further tightening.

*Sources — Verified at source · Medium confidence · Indian Health Service Circular No. 22-15, 'Use of Indian Health Service Funds for Abortions' (Aug. 2022), circular text, [Indian Health Service](https://www.ihs.gov/ihm/circulars/2022/use-of-indian-health-service-funds-for-abortions) · Reproductive Health Rights in BOP, Kansas Federal Defender (Aug. 2024), page text, [Kansas Federal Public Defender](https://ks.fd.org/blog/2024/08/8713-reproductive-health-rights-bop-what-rights-can-clients-invoke-referencing-bops)*

**Editor's note.** BOP reproductive health policies have been under review. The 2025 leadership change at BOP could affect access. An editor should monitor whether BOP issues new formal guidance on abortion services for inmates.

## Interstate questions

### Right to travel

**Presumed protected; Kavanaugh concurrence**

Justice Kavanaugh's Dobbs concurrence states that a state may not bar a resident from traveling to another state for an abortion under the constitutional right to interstate travel; no Supreme Court majority has held this, but it represents the Court's currently expressed understanding.

Justice Brett Kavanaugh wrote in his separate opinion in the Dobbs case that, in his view, a state cannot stop its residents from traveling to another state to get an abortion—he said the constitutional right to interstate travel protects that freedom. This was not the official holding of the Court, but it is the most direct statement any Justice has written on the question. No law currently in effect has tried to ban interstate travel for abortion, and no court has had to rule on it yet. But various people and groups have proposed laws that would penalize crossing state lines for abortion—for example, by allowing lawsuits against people who help someone travel. Such laws would face significant constitutional challenges under the right to travel, the Due Process Clause, and the Dormant Commerce Clause. For now, traveling for an abortion remains legally protected in practice, but the question has not been tested in court.

> "For example, may a State bar a resident of that State from traveling to another State to obtain an abortion? In my view, the answer is no based on the constitutional right to interstate travel."
> — Dobbs v. Jackson Women's Health Org., 597 U.S. ___ (2022) (Kavanaugh, J., concurring)

**Legal analysis**

In his Dobbs concurrence, Justice Kavanaugh wrote: 'For example, may a State bar a resident of that State from traveling to another State to obtain an abortion? In my view, the answer is no based on the constitutional right to interstate travel.' Slip op. at 10. The majority opinion did not address this question. The constitutional right to travel has deep roots in Supreme Court precedent: Saenz v. Roe, 526 U.S. 489 (1999), recognized it as a fundamental right protected by the Privileges or Immunities Clause of the Fourteenth Amendment. Shapiro v. Thompson, 394 U.S. 618 (1969), struck down durational residency requirements that penalized the exercise of the right to travel. Zobel v. Williams, 457 U.S. 55 (1982), reaffirmed the right. No state has yet enacted a law that directly bans interstate travel for abortion, though some have proposed civil liability schemes targeting those who 'aid or abet' out-of-state abortions (e.g., Texas S.B. 8-style civil enforcement). A Texas-style travel-ban proposal would face multiple constitutional hurdles: the right to travel, the Dormant Commerce Clause (which prevents states from regulating commerce occurring wholly outside their borders), the Due Process Clause, and potentially the First Amendment's protections for speech and association related to travel assistance. The DOJ under President Biden stated its commitment to protecting the right to travel for reproductive health services; the Trump DOJ has not taken a formal position. No federal court has ruled on whether a state may restrict interstate travel for abortion.

*Sources — Verified at source · Medium confidence · Dobbs v. Jackson Women's Health Org., 597 U.S. ___ (2022) (Kavanaugh, J., concurring), slip op. at 10, [Supreme Court of the United States (via Akhil Amar site)](https://akhilamar.com/wp-content/uploads/2023/09/Kavanaugh-concurrence-Dobbs.pdf)*

**Editor's note.** Kavanaugh's concurrence is not binding precedent. No Supreme Court majority has held that the right to travel prohibits state regulation of interstate abortion travel. Editors should monitor for any state law attempting to penalize out-of-state abortion travel and any resulting litigation.

### Extraterritorial state laws

**Unresolved; multiple constitutional theories**

No federal court has ruled whether states can extend their abortion laws to conduct in other states; Dormant Commerce Clause, due process, and full faith and credit doctrines would all limit state extraterritorial reach, but the question is unsettled.

After Dobbs, some states and advocates have explored laws that would try to punish out-of-state conduct related to abortion—for example, suing someone who helps a resident travel to another state, or prosecuting a doctor in another state who provides abortion care to a resident. No state has actually enacted a law like this yet, and no federal court has ruled on whether one would be constitutional. But multiple federal constitutional doctrines would likely stand in the way: the Constitution gives Congress, not states, the power to regulate commerce between states (the Dormant Commerce Clause); the Due Process Clause limits a state's ability to regulate conduct outside its borders; and the Full Faith and Credit Clause generally does not require one state to enforce another state's criminal laws. If a state does try to reach across its borders, the legal fight would almost certainly end up in federal court and could take years to resolve.

**Legal analysis**

The extraterritorial application of state abortion restrictions raises several federal constitutional questions. First, the Dormant Commerce Clause, derived from Article I, § 8, cl. 3, prohibits states from discriminating against or unduly burdening interstate commerce. A state law that criminalizes or imposes civil liability on abortions performed in another state on its residents would arguably discriminate against interstate commerce by treating out-of-state services differently or would impose an impermissible extraterritorial regulatory burden, as in Healy v. Beer Institute, 491 U.S. 324 (1989). Second, the Due Process Clause of the Fourteenth Amendment limits a state's legislative jurisdiction; under the 'significant contact' test, a state generally cannot regulate conduct occurring wholly outside its territory that lacks a sufficient nexus to the state. Third, the Full Faith and Credit Clause, Art. IV, § 1, does not require one state to enforce the penal laws or public policies of another state. These doctrines collectively create a strong presumption against the constitutionality of extraterritorial abortion laws. However, no federal court has squarely addressed these questions in the post-Dobbs context, and none of these doctrines have been applied to abortion-specific state laws. The Supreme Court has also indicated openness to reconsidering certain Dormant Commerce Clause doctrine, as in National Pork Producers Council v. Ross, 598 U.S. 356 (2023), where the Court upheld California's Proposition 12 but signaled potential narrowing of extraterritoriality doctrine. The legal landscape remains uncertain pending actual legislation and litigation.

*Sources — Verify before publication · Medium confidence · National Pork Producers Council v. Ross, 598 U.S. 356 (2023), [Justia](https://supreme.justia.com/cases/federal/us/598/356/)*

**Editor's note.** No federal court has ruled on extraterritorial abortion laws because no state has yet enacted one (though some have proposed them). The constitutional analysis is therefore predictive.

### Shield law conflicts

**Interstate clashes brewing; unresolved**

States with abortion 'shield' laws protecting providers from out-of-state subpoenas and extradition are on a collision course with ban states seeking to investigate cross-border abortion care; federal courts have not yet resolved which sovereign prevails.

Some states that protect abortion rights have passed 'shield laws' that say their officials will not cooperate with out-of-state investigations or extradition requests related to abortion care lawfully provided within their borders. States that ban abortion, on the other hand, might try to subpoena records from shield-state clinics or seek to extradite shield-state doctors. This creates a direct interstate conflict. Federal courts have not yet resolved these clashes. The key federal legal questions include: whether the Extradition Clause requires one state to surrender a person charged with a crime in another state; whether the Full Faith and Credit Clause requires recognition of another state's judgments; and whether a doctor in a shield state can challenge a ban-state subpoena in federal court. In early 2025, Texas sought to subpoena a New York doctor who provided abortion pills via telehealth; New York's shield law and governor blocked cooperation. Several cases are expected to bring these questions before federal courts.

**Legal analysis**

States protecting abortion access—including New York, California, Massachusetts, Washington, Illinois, and others—have enacted 'shield laws' that: (1) prohibit state officials from cooperating with out-of-state investigations, subpoenas, or extradition requests related to abortion care lawfully provided within the state, (2) protect providers' professional licenses from discipline based on out-of-state abortion-related actions, and (3) create civil causes of action against those who bring out-of-state abortion lawsuits. Ban states, conversely, have signaled interest in investigating cross-border abortion activity. The federal constitutional analysis involves: (1) The Extradition Clause, Art. IV, § 2, cl. 2, which states that a person charged with a crime who flees to another state 'shall on Demand of the executive Authority of the State from which he fled, be delivered up.' The Supreme Court in Puerto Rico v. Branstad, 483 U.S. 219 (1987), held that the extradition duty is mandatory and enforceable in federal court. However, extradition applies only to fugitives from justice; a shield-state doctor who never entered the demanding state arguably is not a fugitive. (2) The Full Faith and Credit Clause and its implementing statute, 28 U.S.C. § 1738, generally require states to give effect to other states' judgments, but the public-policy exception and the distinction between judgments and penal laws may limit their application. (3) Federal courts may adjudicate these interstate disputes under their diversity jurisdiction or federal-question jurisdiction (where a Supremacy Clause or constitutional issue is presented). No federal appellate court has ruled on a post-Dobbs shield-law conflict. The Texas-New York telehealth subpoena dispute is currently the most prominent example.

*Sources — Verify before publication · Medium confidence · Puerto Rico v. Branstad, 483 U.S. 219 (1987), [Justia](https://supreme.justia.com/cases/federal/us/483/219/)*

**Editor's note.** These conflicts are developing in real time. Specific subpoena demands and extradition requests have been reported in the press but no federal court has yet issued a merits ruling. Editors should monitor for any federal district court or appellate rulings on interstate abortion subpoenas or extradition.

## Congressional activity

**Riders are law; no national ban or codification**

No national abortion ban or codification has been enacted; appropriations riders (Hyde, Weldon, Helms) remain the operative federal legislative tools; bills proposing national 15-week bans, fetal-personhood laws, and the Women's Health Protection Act have been introduced but lack the votes for passage.

Congress has not passed a national law either banning abortion or protecting it. The main tool Congress uses is the appropriations process—the annual spending bills that include restrictions like the Hyde Amendment and the Weldon Amendment. Several bills have been introduced: the Women's Health Protection Act, which would create a federal statutory right to abortion, has been reintroduced in every recent Congress but cannot overcome the Senate filibuster. On the other side, Senator Graham proposed a 15-week national ban in 2022, and the Life at Conception Act (H.R. 722) was introduced in January 2025, declaring that the right to life begins at fertilization. None of these have passed. The Born-Alive Abortion Survivors Protection Act (H.R. 21) passed the House in January 2025 but has not passed the Senate. The realistic picture is that Congress remains gridlocked on abortion legislation; the spending riders are the only federal laws that reliably continue year after year.

**Legal analysis**

Since Dobbs, Congress has not enacted any major abortion legislation changing the federal baseline. The most significant enacted measures remain the annual appropriations riders. Proposed but not enacted: (1) Women's Health Protection Act (WHPA) — most recently introduced as H.R. 12 / S. 25 in the 119th Congress (2025-26); would create a federal statutory right for health care providers to provide abortion services and for patients to receive them, preempting many state restrictions. Referred to committee. (2) Protecting Pain-Capable Unborn Children from Late-Term Abortions Act (Sen. Graham, 2022) — would ban abortion after 15 weeks nationwide with exceptions. Not reintroduced in current Congress as a standalone but subject to ongoing advocacy. (3) Life at Conception Act, H.R. 722 (119th Cong., introduced Jan. 24, 2025) — would declare that the right to life guaranteed by the 14th Amendment vests at the moment of fertilization. Referred to House Judiciary Committee. (4) Born-Alive Abortion Survivors Protection Act, H.R. 21 (119th Cong.) — passed the House on January 23, 2025, by a vote of 217-204; requires health care practitioners to provide the same degree of care to a child born alive after an abortion as to any other child born alive. Pending in the Senate. (5) Conscience Protection Act of 2025, H.R. 3411 — would strengthen federal conscience protections with a private right of action. The Senate filibuster (requiring 60 votes for most legislation) effectively blocks passage of both abortion-rights and abortion-restriction bills under current political alignment. The appropriations process, which requires annual renewal, remains the vehicle through which Congress shapes federal abortion policy.

*Sources — Semi-verified · High confidence · H.R. 12, Women's Health Protection Act of 2025, 119th Cong. (2025), bill title, [Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/12/text) · H.R. 722, Life at Conception Act, 119th Cong. (2025), bill title, [Congress.gov](https://www.congress.gov/bill/119th-congress/house-bill/722) · H.R. 21, Born-Alive Abortion Survivors Protection Act, 119th Cong. (2025), bill summary, [GovTrack.us](https://www.govtrack.us/congress/bills/119/hr21)*

**Editor's note.** The appropriations cycle is annual. Editors should confirm the inclusion of Hyde, Weldon, and Helms riders in the FY 2026 appropriations bills when enacted. Status set by the research runner: the claim matched search-result snippets, but none of the cited pages were opened in full during research. Confirm the quoted text at the cited URL before publication.

## Penalties

| Actor | Offense | Penalty | Verification |
| --- | --- | --- | --- |
| Physician performing a partial-birth abortion (non-life-saving) | Knowingly performing a partial-birth abortion in violation of 18 U.S.C. § 1531 | Fine under Title 18, imprisonment up to 2 years, or both; civil liability for money damages, including statutory damages of three times the cost of the procedure, to the father or maternal grandparents | Verified at source |
| Pregnant woman upon whom a partial-birth abortion is performed | Expressly exempt from prosecution under 18 U.S.C. § 1531(e) | None — statute explicitly prohibits prosecution of the woman under § 1531, for conspiracy to violate it, or for aiding and abetting | Verified at source |
| Person who mails or ships abortion-related articles with unlawful intent | Mailing nonmailable abortion-related matter under 18 U.S.C. § 1461 or using a common carrier under § 1462 | Fine under Title 18, imprisonment up to 5 years (for first offense), or both (under § 1461); same for § 1462 | Verified at source |
| Person who obstructs, threatens, or uses force against abortion clinic patients or providers | Violating the FACE Act, 18 U.S.C. § 248(a)(1) | First offense: fine or imprisonment up to 1 year, or both; subsequent: up to 3 years; nonviolent physical obstruction: fine up to $10,000 and up to 6 months; if bodily injury results: up to 10 years; if death results: any term of years or life | Verified at source |
| Health care provider or entity receiving federal HHS funds who refuses to perform or assist in abortion | Protected conduct; no offense committed — protected by Church Amendments (42 U.S.C. § 300a-7) and Coats-Snowe (42 U.S.C. § 238n) | None for the refuser; any entity discriminating against a refuser is subject to loss of federal financial assistance | Verified at source |

## Recent changes

- **June 24, 2022** — Supreme Court decides Dobbs v. Jackson Women's Health Organization, overruling Roe v. Wade and Planned Parenthood v. Casey; holds Constitution does not confer a right to abortion; returns regulation to the states.
  *Sources — Dobbs v. Jackson Women's Health Org., 597 U.S. 215 (2022), [Supreme Court of the United States](https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf)*
- **July 8, 2022** — President Biden signs Executive Order 14076, 'Protecting Access to Reproductive Healthcare Services,' directing HHS and other agencies to identify ways to protect and expand abortion access, including through EMTALA enforcement and medication abortion.
  *Sources — Executive Order 14076, 87 Fed. Reg. 42053 (July 8, 2022), [The White House / Federal Register](https://www.presidency.ucsb.edu/documents/executive-order-14076-protecting-access-reproductive-health-care-services)*
- **July 11, 2022** — CMS issues EMTALA guidance stating that EMTALA preempts state abortion bans when abortion is necessary to stabilize a pregnant patient's emergency medical condition.
  *Sources — CMS, 'Reinforcement of EMTALA Obligations Specific to Patients Who Are Pregnant or Are Experiencing Pregnancy Loss' (July 11, 2022, rev. Aug. 25, 2022), [Centers for Medicare & Medicaid Services](https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/reinforcement-emtala-obligations-specific-patients-who-are-pregnant-or-are-experiencing-pregnancy-0)*
- **September 9, 2022** — VA issues interim final rule removing long-standing exclusions on abortion counseling and permitting abortion services in cases of rape, incest, or life/health endangerment for veterans and CHAMPVA beneficiaries.
  *Sources — Reproductive Health Services, 87 Fed. Reg. 55283 (Sept. 9, 2022), [Federal Register](https://www.federalregister.gov/documents/2022/09/09/2022-19673/reproductive-health-services)*
- **October 20, 2022** — Secretary of Defense Austin issues memorandum establishing paid administrative leave and travel allowances for servicemembers and dependents who must travel to access non-covered reproductive health care.
  *Sources — Department of Defense, 'Ensuring Access to Reproductive Health Care' (Oct. 20, 2022), [U.S. Department of Defense](https://www.defense.gov/News/Releases/Release/Article/3194507/)*
- **December 23, 2022** — DOJ Office of Legal Counsel issues opinion concluding that the Comstock Act, 18 U.S.C. § 1461, does not prohibit mailing mifepristone and misoprostol where the sender lacks intent that the drugs be used unlawfully.
  *Sources — Application of the Comstock Act to the Mailing of Prescription Drugs That Can Be Used for Abortions, 46 Op. O.L.C. __ (Dec. 23, 2022), [U.S. Department of Justice, Office of Legal Counsel](https://www.justice.gov/olc/opinion/file/1560596/dl)*
- **January 3, 2023** — FDA permanently removes the in-person dispensing requirement for mifepristone and adds a pharmacy certification process, enabling certified retail and mail-order pharmacies to dispense the drug.
  *Sources — FDA, Summary Review of REMS Modification (2023), [U.S. Food and Drug Administration (accessdata.fda.gov)](https://www.accessdata.fda.gov/drugsatfda_docs/summary_review/2023/020687Orig1s025SumR.pdf)*
- **January 2, 2024** — Fifth Circuit affirms district court injunction blocking enforcement of CMS EMTALA abortion guidance in Texas (Texas v. Becerra).
  *Sources — Texas v. Becerra, No. 23-10246 (5th Cir. Jan. 2, 2024), [U.S. Court of Appeals for the Fifth Circuit](https://www.ca5.uscourts.gov/opinions/pub/23/23-10246-CV0.pdf)*
- **June 13, 2024** — Supreme Court unanimously holds in FDA v. Alliance for Hippocratic Medicine that anti-abortion doctors lack Article III standing to challenge FDA's mifepristone regulation, preserving current access.
  *Sources — FDA v. Alliance for Hippocratic Medicine, 602 U.S. 367 (2024), [Supreme Court of the United States](https://www.supremecourt.gov/opinions/23pdf/23-235_n7lp.pdf)*
- **June 27, 2024** — Supreme Court dismisses Moyle v. United States as improvidently granted, vacating its stay; district court preliminary injunction against Idaho's abortion ban resumes; EMTALA preemption question remains unresolved.
  *Sources — Moyle v. United States, 603 U.S. 324 (2024) (per curiam), [Supreme Court of the United States](https://www.supremecourt.gov/opinions/23pdf/23-726_6jgm.pdf)*
- **October 7, 2024** — Supreme Court denies certiorari in Texas v. Becerra, leaving in place the Fifth Circuit's decision blocking CMS EMTALA guidance enforcement in Texas.
  *Sources — Becerra v. Texas, No. 23-1076, cert. denied (Oct. 7, 2024), [SCOTUSblog](https://www.scotusblog.com/2024/10/court-turns-down-bidens-bid-for-intervention-in-texas-emergency-abortion-dispute/)*
- **January 24, 2025** — President Trump signs Executive Order 14182, 'Enforcing the Hyde Amendment,' rescinding Biden-era EOs 14076 and 14079 and directing agencies to end federal funding or promotion of elective abortion; same day, DOJ issues memorandum sharply limiting FACE Act enforcement.
  *Sources — Executive Order 14182, 'Enforcing the Hyde Amendment' (Jan. 24, 2025), [The White House](https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment) · DOJ Memorandum, 'FACE Act Charging Policy' (Jan. 24, 2025), [U.S. Department of Justice](https://www.justice.gov/media/1386461/dl)*
- **January 30, 2025** — Secretary of Defense Hegseth rescinds Biden-era policy providing travel allowances and paid leave for servicemembers traveling for non-covered reproductive health care.
  *Sources — CRS Insight IN12512, 'DOD Policy Changes: Reproductive Health Benefits' (Feb. 2025), [Congressional Research Service](https://www.congress.gov/crs_external_products/IN/PDF/IN12512/IN12512.3.pdf)*
- **July 15, 2025** — Fourth Circuit holds in GenBioPro v. Raynes that FDA regulation of mifepristone does not preempt West Virginia's near-total abortion ban, rejecting conflict-preemption and obstacle-preemption theories.
  *Sources — GenBioPro, Inc. v. Raynes, No. 23-2194 (4th Cir. July 15, 2025), [Justia](https://law.justia.com/cases/federal/appellate-courts/ca4/23-2194/23-2194-2025-07-15.html)*
- **December 31, 2025** — VA finalizes rule reinstating the full exclusion on abortion and abortion counseling from the VA medical benefits package and CHAMPVA, reversing the 2022 interim final rule.
  *Sources — Reproductive Health Services, 90 Fed. Reg. ____ (Dec. 31, 2025), [Federal Register](https://www.federalregister.gov/documents/2025/12/31/2025-24061/reproductive-health-services)*

## Pending changes

### Missouri v. FDA (E.D. Mo.) (Litigation)

**Status.** States of Missouri, Idaho, and Kansas challenge FDA's approval and regulation of mifepristone under the APA, FDCA, and Comstock Act; case transferred from N.D. Tex. to E.D. Mo. in October 2025; amended complaint filed; pending motion practice.

If successful, could result in nationwide restrictions on mifepristone, including reinstatement of pre-2016 REMS conditions, limitations on telehealth prescribing, or a finding that FDA violated the Comstock Act.

*Sources — Missouri v. FDA, No. 2:22-cv-00223 (E.D. Mo.), [Health Care Litigation Tracker (Georgetown Law)](https://litigationtracker.law.georgetown.edu/litigation/state-of-missouri-et-al-v-food-and-drug-administration-et-al)*

### United States v. Idaho / Moyle v. United States (9th Cir.) (Litigation)

**Status.** On remand following Supreme Court's DIG; district court preliminary injunction against Idaho's abortion ban remains in effect; Ninth Circuit to decide merits of EMTALA preemption.

A Ninth Circuit ruling on EMTALA preemption could either strengthen or weaken the federal government's ability to require emergency abortion care in ban states; a circuit split with the Fifth Circuit could prompt Supreme Court review.

*Sources — United States v. Idaho, No. 1:22-cv-00329 (D. Idaho); appeal pending, No. 23-35440 (9th Cir.), [SCOTUSblog](https://www.scotusblog.com/cases/moyle-v-united-states-2)*

### GenBioPro v. Raynes — potential Supreme Court petition (Litigation)

**Status.** Fourth Circuit issued 2-1 decision July 2025 rejecting preemption; GenBioPro may seek en banc review or file a certiorari petition at the Supreme Court.

Supreme Court review could definitively resolve whether FDA approval of mifepristone preempts state abortion bans, a question with nationwide implications for medication abortion access.

*Sources — GenBioPro, Inc. v. Raynes, No. 23-2194 (4th Cir. July 15, 2025), [Justia](https://law.justia.com/cases/federal/appellate-courts/ca4/23-2194/23-2194-2025-07-15.html)*

### Bryant v. Stein — North Carolina mifepristone preemption (Litigation)

**Status.** Pending in the Fourth Circuit; involves a challenge by a physician to North Carolina's medication abortion restrictions on preemption grounds. Briefing underway; held pending GenBioPro resolution.

A ruling that North Carolina's restrictions are preempted could create a circuit split with the GenBioPro panel, increasing the likelihood of Supreme Court review on the preemption question.

*Sources — Bryant v. Stein, appeal pending (4th Cir.), [UCLA Law Mifepristone Litigation Tracker](https://law.ucla.edu/sites/default/files/images/CRHLP%20Mifepristone%20Litigation%20and%20Federal%20Action%20Tracker%20Sept%202025%20update.pdf)*

### Born-Alive Abortion Survivors Protection Act (H.R. 21) (Legislation)

**Status.** Passed the House on January 23, 2025 (217-204); pending in the Senate. Requires health care practitioners to provide the same degree of professional skill and care to a child born alive after an abortion as would be provided to any other child born alive at the same gestational age.

Would impose federal criminal penalties on practitioners who fail to provide care to infants born alive after abortion; opponents argue existing federal born-alive protections already exist under 1 U.S.C. § 8 and that the bill is redundant and could intimidate providers.

*Sources — H.R. 21, 119th Cong. (2025), [GovTrack.us](https://www.govtrack.us/congress/bills/119/hr21)*

### Potential rescission or revision of CMS EMTALA abortion guidance (Rule making)

**Status.** The July 2022 CMS EMTALA guidance remains on the books but the Trump administration has not actively defended it in litigation; the Hyde Amendment Executive Order (EO 14182) directs agencies to end federal funding or promotion of elective abortion.

Formal rescission of the guidance would eliminate the federal government's position that EMTALA requires emergency abortion care in ban states, though the underlying statutory question would remain for courts to decide.

*Sources — Executive Order 14182, 'Enforcing the Hyde Amendment' (Jan. 24, 2025), [The White House](https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment)*

## Key authorities

- **Dobbs v. Jackson Women's Health Organization** — 597 U.S. 215 (2022) _(Case)_ · [supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf](https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf)
  Overruled Roe and Casey, eliminating the federal constitutional right to abortion and returning abortion regulation to states and Congress under rational-basis review.
- **Dobbs v. Jackson Women's Health Org. (Kavanaugh, J., concurring)** — 597 U.S. ___ (2022) _(Case)_ · [akhilamar.com/wp-content/uploads/…](https://akhilamar.com/wp-content/uploads/2023/09/Kavanaugh-concurrence-Dobbs.pdf)
  The closest authority on whether states may bar interstate travel for abortion; Kavanaugh stated the answer is 'no' based on the constitutional right to interstate travel.
- **Partial-Birth Abortion Ban Act of 2003** — 18 U.S.C. § 1531 _(Statute)_ · [law.cornell.edu/uscode/text/18/1531](https://www.law.cornell.edu/uscode/text/18/1531)
  The only federal statute criminalizing a specific abortion procedure nationwide; bans intact D&X with a life exception and exempts the pregnant woman.
- **Gonzales v. Carhart** — 550 U.S. 124 (2007) _(Case)_ · [supreme.justia.com/cases/federal/us/550/124](https://supreme.justia.com/cases/federal/us/550/124/)
  Upheld the Partial-Birth Abortion Ban Act against a facial constitutional challenge, marking the first time the Supreme Court upheld a federal abortion restriction lacking a health exception.
- **Comstock Act (mailing prohibition)** — 18 U.S.C. §§ 1461-1462 _(Statute)_ · [law.cornell.edu/uscode/text/18/1461](https://www.law.cornell.edu/uscode/text/18/1461)
  Foundational prohibition on mailing abortion-related articles; its application to medication abortion remains subject to interpretive debate and potential revival.
- **DOJ OLC Opinion on Comstock Act (Dec. 23, 2022)** — 46 Op. O.L.C. __ (Dec. 23, 2022) _(Agency action)_ · [justice.gov/olc/opinion/file/1560596/dl](https://www.justice.gov/olc/opinion/file/1560596/dl)
  Current executive-branch interpretation that the Comstock Act does not prohibit mailing abortion drugs absent unlawful intent; subject to change by a future administration.
- **FDA v. Alliance for Hippocratic Medicine** — 602 U.S. 367 (2024) _(Case)_ · [supremecourt.gov/opinions/23pdf/23-235_n7lp.pdf](https://www.supremecourt.gov/opinions/23pdf/23-235_n7lp.pdf)
  Unanimous Supreme Court standing ruling that preserved current mifepristone access without reaching the merits of FDA's regulatory decisions.
- **GenBioPro, Inc. v. Raynes** — No. 23-2194 (4th Cir. July 15, 2025) _(Case)_ · [law.justia.com/cases/federal/appel…](https://law.justia.com/cases/federal/appellate-courts/ca4/23-2194/23-2194-2025-07-15.html)
  First federal appellate ruling that FDA regulation of mifepristone does not preempt state abortion bans; may be appealed to the Supreme Court.
- **Moyle v. United States** — 603 U.S. 324 (2024) (per curiam) _(Case)_ · [supremecourt.gov/opinions/23pdf/23-726_6jgm.pdf](https://www.supremecourt.gov/opinions/23pdf/23-726_6jgm.pdf)
  Supreme Court dismissed the EMTALA preemption case as improvidently granted, leaving the core preemption question unresolved and the district court injunction in place.
- **EMTALA** — 42 U.S.C. § 1395dd _(Statute)_ · [law.cornell.edu/uscode/text/42/1395dd](https://www.law.cornell.edu/uscode/text/42/1395dd)
  Federal statute requiring stabilizing treatment in hospital emergency departments; its application to emergency abortion care in ban states is the central unresolved post-Dobbs federal question.
- **Hyde Amendment (annual appropriations rider)** — See, e.g., Consolidated Appropriations Act, 2024, Pub. L. No. 118-42, Div. D, §§ 506-507 _(Statute)_ · [congress.gov/crs-product/IF12167](https://www.congress.gov/crs-product/IF12167)
  The operative federal funding restriction barring most federal abortion expenditures with rape, incest, and life exceptions; must be reenacted annually.
- **Church Amendments** — 42 U.S.C. § 300a-7 _(Statute)_ · [uscode.house.gov/view.xhtml](https://uscode.house.gov/view.xhtml?req=granuleid%3AUSC-prelim-title42-section300a-7&num=0&edition=prelim)
  Foundational federal conscience protection shielding individuals and entities from being required to participate in abortion contrary to religious or moral convictions.
- **Coats-Snowe Amendment** — 42 U.S.C. § 238n _(Statute)_ · [uscode.house.gov/view.xhtml](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section238n&num=0&edition=prelim)
  Prohibits government discrimination against health care entities and training programs that refuse to perform, train in, or refer for abortions.
- **Born-Alive Infants Protection Act** — 1 U.S.C. § 8 _(Statute)_ · [govinfo.gov/link/uscode/1/8](https://www.govinfo.gov/link/uscode/1/8)
  Defines 'born alive' for all federal law purposes, explicitly reserving the question of legal status before birth.
- **Unborn Victims of Violence Act** — 18 U.S.C. § 1841 _(Statute)_ · [uscode.house.gov/view.xhtml](https://uscode.house.gov/view.xhtml?req=(title:18%20section:1841%20edition:prelim)%20OR%20(granuleid:USC-prelim-title18-section1841)&f=treesort&num=0&edition=prelim)
  Creates federal fetal-homicide liability for certain crimes while expressly excluding consensual abortion and the pregnant woman from liability.
- **FACE Act** — 18 U.S.C. § 248 _(Statute)_ · [law.cornell.edu/uscode/text/18/248](https://www.law.cornell.edu/uscode/text/18/248)
  Federal criminal prohibition on force, threats, or obstruction against reproductive health clinics, providers, and patients; enforcement significantly curtailed under current DOJ policy.
- **DoD Abortion Funding Restriction** — 10 U.S.C. § 1093 _(Statute)_ · [uscode.house.gov/view.xhtml](https://uscode.house.gov/view.xhtml?req=(title:10%20section:1093%20edition:prelim)%20OR%20(granuleid:USC-prelim-title10-section1093)&f=treesort&num=0&edition=prelim)
  Restricts use of DoD funds for abortion to life-endangerment cases only; travel reimbursement policy rescinded in 2025.
- **Executive Order 14182 (Enforcing the Hyde Amendment)** — Exec. Order No. 14182, 90 Fed. Reg. ___ (Jan. 24, 2025) _(Executive action)_ · [whitehouse.gov/presidential-action…](https://www.whitehouse.gov/presidential-actions/2025/01/enforcing-the-hyde-amendment)
  Rescinded Biden-era reproductive health EOs and directed all agencies to enforce Hyde restrictions strictly, signaling a broad shift in federal enforcement posture.

## Research notes

> Overall confidence: High. Analysis current as of July 12, 2026; research completed July 12, 2026. This analysis is current through July 16, 2025. Key items requiring re-verification before publication: (1) Whether the FY 2026 appropriations acts include Hyde, Weldon, and other riders in their traditional form; (2) whether CMS has formally rescinded or revised the July 2022 EMTALA abortion guidance; (3) the status of any certiorari petition in GenBioPro v. Raynes; (4) any substantive rulings in the Missouri v. FDA litigation in the Eastern District of Missouri; (5) whether the VA final rule (Dec. 31, 2025) was challenged under the Congressional Review Act and the outcome; (6) the status of the Born-Alive Abortion Survivors Protection Act in the Senate; (7) whether any new OLC opinion has been issued modifying or withdrawing the December 2022 Comstock Act opinion. The Helms Amendment's interpretation in practice goes beyond its text (barring 'abortion as a method of family planning' but in practice barring all abortion funding in foreign aid); this discrepancy should be noted to readers. Unresolved points: The Bureau of Prisons' current formal program statement on abortion services was not located in full text; BOP policy documents were under revision as of early 2025 and the precise current status of inmate abortion access policies should be verified with the latest BOP Program Statement on Patient Care. — The CMS EMTALA abortion guidance from July 2022 has not been formally rescinded as of this research date, but the Trump administration's enforcement posture is unclear; an editor should verify whether a formal rescission has occurred since this research was completed. — Whether GenBioPro will petition for Supreme Court review of the Fourth Circuit's July 2025 decision is not yet known; editors should monitor the docket for a certiorari petition deadline (typically 90 days from judgment). — Several shield-law interstate conflict scenarios are developing in real time (e.g., Texas subpoenas to New York telehealth providers) with no federal court rulings yet; these should be tracked as they develop. — The IHS Circular No. 22-15 (August 2022) remains in effect but may be revised or rescinded under the Trump administration's Hyde Executive Order; editors should monitor IHS circulars for any update..