Any Day Now, Extremist Trump-Appointed Judge Matthew Kacsmaryk Could End a Critical Abortion Option for People Nationwide

Any day now, an extremist judge who is openly and staunchly opposed to abortion could impose a nationwide ban on abortion medicationeven in states where abortion is protected. 

Yep, you read that right.  

In the Northern District of Texas, Judge Matthew Kacsmaryk is presiding over the case Alliance for Hippocratic Medicine v. FDA, where he has been asked to withdraw approval of mifepristone, a safe and effective drug and one of two medications most commonly used in medication abortion. The Food and Drug Administration (FDA) approved mifepristone over 20 years ago, and it is used in over half of all abortions in the United States.  

The case was filed by a group of anti-abortion activists and organizationssuing to force the FDA to rescind its approval of mifepristone in order to remove it from the market. This case was deliberately filed in the Amarillo division of the Northern District of Texas, a single-judge division where the cases are automatically assigned to Judge Matthew Kacsmaryk. 

There’s every reason to believe Judge Kacsmaryk will issue a decision based not on the law but on his own personal biases, which is the very reason these anti-abortion activists brought this case to him. Indeed, his recordbefore and since becoming a judgemake clear that he allows his own harmful views on LGBTQIA+ rights and access to abortion to dictate the law.  

Just a sample of some of Judge Kacsmaryk’s past (and terrible) statements telling us what he really thinks about our fundamental rights: 

Before he was a federal judge, Kacsmaryk made his damaging views on fundamental rights widely known. Responding to the Supreme Court’s Obergefell v. Hodges decision guaranteeing marriage equality in 2015, Kacsmaryk mocked the decision, saying the Court had somehow found “an unwritten fundamental right” that had been “so cleverly concealed… that it took almost 150 years to find.” 

That same year, Kacsmaryk blathered similar sarcasm while describing Roe v. Wade, stating that “[o]n January 22, 1973, seven justices of the Supreme Court found an unwritten ‘fundamental right’ to abortion hiding in the due process clause of the Fourteenth Amendment and the shadowy ‘penumbras’ of the Bill of Rights, a celestial phenomenon invisible to the non-lawyer eye.” This view is not a one-off; the Washington Post has documented how Kacsmaryk’s contempt for abortion is longstanding and runs deep.

In 2016, Kacsmaryk disparaged Affordable Care Act regulations that prohibit discrimination in health care based on gender identity as “radicalism.”  

Past (and terrible) rulings demonstrating how Judge Kacsmaryk allows his harmful beliefs to shape the law: 

Since becoming a federal judge in 2017, Kacsmaryk has unfortunately—but predictably— incorporated his bigoted beliefs into his decisions, making his jurisdiction an ideal venue for extremist organizations to file lawsuits seeking to block access to our rights and health care. 

Texas v. Equal Employment Opportunity Commission (2022) 

In 2020, in Bostock v. Clayton County, the Supreme Court held that Title VII’s prohibition against sex discrimination in employment includes, by its very definition, discrimination based on sexual orientation and gender identity. A.k.a. anti-discrimination protections for LGBTQIA+ individuals in the workplace were recognized by the Supreme Court. 

In the wake of that decision, both the Equal Employment Opportunity Commission (EEOC) and the Department of Health and Human Services (HHS) issued guidance on how to enforce this ruling, in both employment and health care settings where discrimination based on sex was prohibited. Texas quickly—of course—sued, asking Kacsmaryk to vacate both the EEOC and HHS guidelines as “unlawful” interpretations of Bostock. Completely contrary to law, Judge Kacsmaryk agreed with Texas, vacating both agencies’ guidance. Although the underlying laws remain in place and continue to prohibit discrimination, decisions like this make LGBTQIA+ people less safe in the workplace and when seeking health care. 

Alexander R. Deanda v. Becerra (2022) 

In December 2022, a Texas father sued HHS because the nation’s Title X family planning program protects youths’ ability to access contraception without parental consent. The Texas father claimed to be “raising each of [his] daughters in accordance with Christian teaching on matters of sexuality, which requires unmarried children to practice abstinence and refrain from sexual intercourse until marriage.”  

When the case came before Kacsmaryk, he sided with the Texas father, once again contradicting Supreme Court precedent and defying principles of federalism by upholding a Texas state law regarding parental rights over a federal law providing contraceptive access. In the decision, Kacsmaryk goes out of his way to insert biased descriptions of youth access to birth control, throws in degrading attacks on gender-affirming care, and manages to talk about book banning too. His inclusion of these pointswhich read more like a diatribe in a blog than a judicial opinion from a federal judgereflects just how much Kacsmaryk does not feel beholden to principles of law and decorum when ruling from the bench. It’s almost like he has never heard of his constitutional duty to interpret the law fairly and impartially.  

And now Judge Kacsmaryk has a chance to devastate abortion access.   

If Judge Kacsmaryk’s past statements and decisions are any forewarning, the most commonly used form of abortion care is at serious risk in Alliance for Hippocratic Medicine v. FDA

Judge Kacsmaryk is considering whether to force the FDA to withdraw its 20-year approval of mifepristone. If he were to issue that opinion, mifepristone could be taken off the market nationwide, meaning every state would lose access, including in states where abortion is protected. Five million people have safely used mifepristone to end their pregnancies, but Kacsmaryk could take it all away.  

Anti-abortion rights activists and politicians have not stopped at overturning Roe, they want a nationwide abortion ban. And this case is one of the ways they want to get there. They want judges like Kacsmaryk to set aside the rule of law and create dangerous precedent of overturning the experts at the FDA purely based on ideology, not facts. This is extremely dangerous for abortion access, yes. But it is also frightening to imagine what it could mean for our democracy, the overall health of our federal judiciary, and the role of expert agencies that rely on science to make decisions.  

No matter how Kascmaryk rules, we know the truth: Abortion access is freedom, mifepristone is safe and effective, and advocates will never stop fighting for our rights and access to abortion.