Abortion pill providers targeted by new Texas law refuse ‘anticipatory obedience’

Greg Abbott, the Republican governor of Texas, on Wednesday signed into law a bill that lets people sue anyone suspected of manufacturing, distributing or mailing abortion pills to or from Texas. The first-of-its-kind law is almost certain to dramatically escalate the state-by-state showdown over abortion laws in the post Roe v Wade United States – especially as some out-of-state abortion providers have already vowed that they will continue shipping pills to Texans.

“Our mantra as a practice is: ‘No anticipatory obedience’,” said Dr Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project (Map), a Boston-area based group that uses telemedicine to ship abortion pills to patients across the United States. “We will continue to provide care until we are legally unable to do so in Massachusetts.”

Under the new law, which will take effect 4 December, abortion providers could face penalties of at least $100,000 if they mail pills into the state, which bans virtually all abortions. Pharmaceutical manufacturers who make drugs that Texans use for abortions could also be found liable, but they may be able to defend themselves by proving in court that they adopted and implemented “a policy to not distribute, mail, transport, deliver, provide, or possess abortion-inducing drugs” – though the language of the law is somewhat ambiguous on whether that provision applies to Texas or more broadly. Women who take abortion pills are not eligible to be sued.

“We want to create liability for manufacturers that Aid Access is using,” John Seago, president of Texas Right to Life and a chief backer of the new legislation, said in an interview before the bill’s passage. Aid Access is one of the biggest telemedicine abortion services in the US. It shipped almost 120,000 packs of abortion pills to US residents between 2023 and 2024.

Seago continued: “The best we can do at this point is create a higher liability and start trying to deter some of those individuals.”

The law represents the cutting edge of the anti-abortion movement’s campaign against abortion pills and telehealth, which have become increasingly popular in the years since the US supreme court overturned Roe v Wade in 2022. By the end of 2024, one in four US abortions were being facilitated through telemedicine, according to #WeCount, a research project by the Society of Family Planning. #WeCount found that, in December 2024, nearly 4,000 Texans used telehealth to end their pregnancies.

Providers like the Map mail pills under legal innovations known as “shield laws”, which have been enacted by a handful of blue states and aim to protect abortion providers from out-of-state prosecutions when they send pills into states with bans. However, shield laws have yet to be seriously tested in court.

Rachel Rebouché, professor at the University of Texas, Austin School of Law who studies shield laws, said Texas’s new law is the first legislative challenge to shield laws. But the state has already challenged them in other ways. The Texas attorney general, Republican Ken Paxton, has sent cease-and-desist letters to abortion pill providers and a website that provides information about abortion pills. He has also sued a New York doctor accused of mailing abortion pills to a Texan, as well as a New York court official who said New York’s shield law prevented him from enforcing a Texas fine against the doctor. New York’s attorney general, Letitia James, has declared that she will intervene in that lawsuit.

Many post-Roe abortion pill providers, Rebouché pointed out, have already accepted that their work involves a great deal of risk. “But it might chill, it might hamper or dissuade people who don’t want to be implicated, who don’t want to face the risk of liability.”

Her Safe Harbor, an organization that uses shield laws to mail abortion pills to people and received one of Paxton’s cease-and-desist letters, has no plans to block Texans from its services, said Debra Lynch, a nurse practitioner who works with the group, in an interview before Abbott signed the law. In fact, as the Texas law neared passage in the state legislature, Her Safe Harbor started receiving so many requests for help from patients that it had to double its number of abortion providers, according to Lynch.

“Even if a law was passed that said they would come after us criminally and not civilly – that would not have any impact whatsoever on the services that we provide,” Lynch said. “It’s important that women know that.”