ACLU Lawsuit Keeps Last Abortion Clinic in Kentucky Open

MONTGOMERY, Ala. — Today, an Alabama appeals court ruled that the state can require freestanding birth centers to be licensed and regulated as hospitals, potentially subjecting them to overly restrictive licensing rules that would make it effectively impossible for them to provide midwifery care in the state. The court’s ruling overturns a May 2025 trial court decision in favor of the birth centers, but it will not take effect while the birth centers seek further court review. In the meantime, birth centers in the state will be able to continue providing care. Freestanding birth centers are independent facilities that provide safe, evidence-backed midwifery care to low-risk patients in a homelike setting. Since an Alabama state trial court blocked the Alabama Department of Public Health’s attempt to restrict access to birth center-provided care in September 2023, birth centers like Oasis Family Birthing Center in Birmingham and Alabama Birth Center in Huntsville have been safely operating and providing essential care for pregnant Alabamians. As today’s court decision recognized, birth centers play an important role in expanding access to pregnancy-related care, “particularly [for] low-income and marginalized populations who, historically, have suffered inequitable disparities” in accessing care. Amid the state’s maternal and infant health crisis, which disproportionately impacts Black women and families, Alabamians with low incomes, and rural communities, it is more important than ever to preserve access to these options for birth center care, which evidence shows is safe and improves patient outcomes, including by reducing preterm births and unnecessary cesarean sections. “We are disappointed in the Court of Civil Appeals’ decision, but this isn’t the end,” said Whitney White, staff attorney with the ACLU Reproductive Freedom Project. “We will continue to fight for pregnant Alabamians to be able to access high-quality midwifery care in birth centers without burdensome and unnecessary interference from the state. The essential care birth centers provide to Alabama families has never been more necessary than it is right now, with Alabama facing a serious maternal and infant health crisis that is disproportionately affecting Black Alabamians, those with low incomes, and rural communities. The care birth centers like Oasis Family Birth Center and Alabama Birth Center provide is a critical part of addressing this crisis and ensuring that all pregnant folks have access to high-quality, patient-centered health care.” “The opinion from the Court of Civil Appeals is disappointing, but we remain committed to ensuring that birth centers can continue providing essential healthcare in Alabama,” said JaTaune Bosby-Gilchrist, the ACLU of Alabama’s executive director. “Birth centers are needed here. Midwives and doulas are needed here. And we are committed to continuing this fight on behalf of our clients and all Alabamians.” The lawsuit, Oasis Family Birthing Center et. al. v. Alabama Department of Public Health, was originally filed in the Fifteenth Judicial Circuit Court in Montgomery in August 2023. The plaintiffs – Oasis Family Birthing Center in Birmingham, Heather Skanes, M.D., Alabama Birth Center in Huntsville, Yashica Robinson, M.D., the Alabama affiliate of the American College of Nurse-Midwives, Jo Crawford, CPM, and Tracie Stone, CPM – are represented by the American Civil Liberties Union, the ACLU of Alabama, Covington & Burling LLP, and Bobby Segall of Copeland Franco.

NEW ORLEANS — Today, the State of Louisiana asked a federal judge to impose sweeping nationwide restrictions on mifepristone, a safe and effective medication used in two-thirds of U.S. abortions and as part of a gold-standard regimen for miscarriage care. If the court grants Louisiana’s motion, patients will no longer be able to fill their mifepristone prescription by mail or from a pharmacy. Instead, patients all across the country—including in states where abortion care is legally protected—will be required to pick up the pill in person at a hospital, clinic, or medical office, even when they have already received care through telemedicine and there is no medical reason for the travel. Mifepristone’s excellent safety record has been confirmed by more than a hundred peer-reviewed studies and leading medical authorities like the American Medical Association and the American College of Obstetricians and Gynecologists. Recent data show that, by June 2025, more than 1 in 4 U.S. abortions were provided via telemedicine using mifepristone—including more than 25% of abortions in Colorado, Delaware, Hawaii, Maine, Michigan, Minnesota, Montana, Nevada, New Hampshire, Ohio, Rhode Island, and Virginia. “This attack is about one thing only: making it as hard as possible for people everywhere in the country to get an abortion,” said Julia Kaye, senior staff attorney with the ACLU’s Reproductive Freedom Project. “Forcing patients to travel hundreds of miles to a health center just to be handed a pill obviously has no safety benefit, which is why every leading medical group opposes this change.” Accessing abortion via telemedicine is especially important for people who live on low incomes; who struggle to secure transportation, childcare, or time off work; who live in rural areas; and who are experiencing domestic violence. Louisiana v. FDA is one of three pending federal lawsuits brought by anti-abortion state politicians trying to end the use of telemedicine for mifepristone. The other two suits—Missouri v. FDA and Florida v. FDA—seek to impose other nationwide restrictions on mifepristone as well, and Florida seeks to ban the medication altogether by undoing FDA’s original approval from 25 years ago. Louisiana’s new filing comes as the Trump administration appears to be following a separate track to make it even harder for people to access the medication nationwide. Earlier this year, the Trump administration announced that the FDA is conducting a new review of its mifepristone regulations, prompted by a self-published report from a Project 2025 sponsor that purposefully distorts the safety record of medication abortion and has been denounced by more than 260 expert researchers. Polling consistently shows that American voters support access to abortion, including medication abortion via mail and telemedicine. At the same time, voters worry that access to abortion remains under threat: a June 2025 poll by Navigator Research showed that nearly seven in ten voters believe abortion will be harder to access in the next five years.

WASHINGTON — Today, instead of addressing the massive premium increases about to hit families nationwide due to expiring Affordable Care Act (ACA) subsidies, the Senate majority is pushing for new federal restrictions on abortion coverage in private insurance plans, to decimate access to gender affirming care, and to erect additional hurdles to health care for immigrants. The bill has been offered as an alternative to renewing tax credits to make health insurance affordable for more than 22 million people. In addition to not adequately addressing the looming health care affordability crisis, it would prohibit millions of people who get health insurance through the ACA from paying for private plans that include abortion coverage, which will dissuade private insurance coverage of abortion and push abortion care out of reach for people across the country, including in states where it is legal. The bill would also prohibit people on exchange plans, Medicaid, and CHIP from accessing gender-affirming medical care and add complicated hurdles for immigrants to access Medicaid coverage, including penalizing states that use their own money to cover health care costs for those who are excluded from Medicaid. Under these provisions, millions of eligible people could have essential care denied or delayed, including those who are part of mixed status families or citizens who simply fear being exposed to overzealous immigration enforcement. In response to the Senate’s upcoming vote on S.3386, American Civil Liberties Union National Director of Policy & Government Affairs Mike Zamore released the following statement: “Today, instead of acting to prevent massive health premiums hikes in three weeks, the Senate majority is working to make the health crisis even worse for families across the country by stripping the coverage of life-saving care in order to pursue their ideological agenda. Instead of lowering costs, the bill would prevent people from accessing abortion through ACA health care coverage, block access to medically necessary gender affirming care, and punish states for trying to extend coverage to their uninsured residents. “A serious solution is still needed to address expiring ACA tax credits without sacrificing people’s access to essential health care services. The Trump administration and the congressional majority must stop playing political games with the health care of the American people before millions see their premiums skyrocket and their quality of care drastically decline.”

WASHINGTON — Today, the states of Florida and Texas filed a new lawsuit in federal court in Texas seeking to end all nationwide access to mifepristone, a safe and effective medication used in two-thirds of U.S. abortions and as part of a gold-standard regimen for miscarriage care. The new lawsuit, Florida v. FDA, seeks to undo every FDA policy decision on mifepristone going back to the medication’s original approval 25 years ago. Florida v. FDA is one of three pending federal lawsuits attacking mifepristone. The other two, Missouri v. FDA and Louisiana v. FDA, seek to severely restrict medication abortion access nationwide by, among other things, banning the use of telemedicine and pharmacies for mifepristone — forcing every patient to travel to pick up their prescription in person at a health center, which may be hundreds of miles away. Recent data show that, by June 2025, more than 1 in 4 U.S. abortions were provided via telemedicine using mifepristone. “These lawsuits have nothing to do with the safety of this medication and everything to do with making it harder for people to get an abortion,” said Julia Kaye, senior staff attorney with the ACLU’s Reproductive Freedom Project. “Politicians in Texas and Florida are asking for a nationwide ban on a safe and effective medication that millions of Americans have used since the FDA first approved it 25 years ago. Anyone who believes that our access to essential medicines should be based on science, not political ideology, should be disgusted by these legal attacks.” Mifepristone’s excellent safety record has been confirmed by more than a hundred peer-reviewed studies and leading medical authorities like the American Medical Association and the American College of Obstetricians and Gynecologists. Florida and Texas’s new lawsuit comes as the Trump administration appears to be gearing up to make it even harder for people to access the medication nationwide. Earlier this year, the Trump administration announced that the FDA is conducting a new review of its mifepristone regulations prompted by a report from a Project 2025 sponsor that purposefully distorts the safety record of medication abortion. This paper is a six-page, non-peer-reviewed document that has been denounced by more than 260 expert researchers for its lack of transparency and gravely flawed methodology. Nevertheless, in a letter to anti-abortion state attorneys general on Sept. 19, 2025, Secretary Kennedy doubled down on the publication’s importance, citing this propaganda as a “recent stud[y] raising concerns about the safety of mifepristone as currently administered.” Secretary Kennedy also stated that the FDA’s “policy changes will ultimately go through the White House, through President Trump.” Polling consistently shows that American voters support access to abortion, including medication abortion via mail and telemedicine. At the same time, voters worry that access to abortion remains under threat: a June 2025 poll by Navigator Research showed that nearly seven in ten voters believe abortion will be harder to access in the next five years.