Ban Abortion by Mail Act

The American Council supports HB9421, the Ban Abortion by Mail Act, and calls on every member of Congress to vote yes. This bill addresses a straightforward accountability gap: REMS-certified providers who knowingly prescribe, dispense, or administer mifepristone or any other abortion drug without an in-person visit with the patient lose their REMS-certified status with respect to that drug for a period of not less than two years. We believe that direct, physical accountability between a provider and a patient is a minimum threshold of responsible medical practice, and that removing it for abortion drugs in particular treats the ending of a human life as something that can be managed at arm's length, through the mail, without the provider ever looking the patient in the eye.

The bill also addresses cross-state prescription without licensure. Any REMS-certified provider who knowingly prescribes, dispenses, or administers mifepristone or any other abortion drug to a patient residing in a state where the provider does not hold a medical license likewise loses REMS-certified status with respect to that drug for not less than two years. This is not a novel principle. Licensure requirements exist to ensure that providers are accountable to the laws and standards of the jurisdiction where their patients live. When those requirements are circumvented to deliver abortion drugs across state lines, it is not innovation in patient care; it is an evasion of democratically enacted law. We support closing that evasion.

The bill also requires the Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, to submit to Congress an annual report listing each REMS-certified provider who lost REMS-certified status due to a violation of this section, as well as each provider who lost status due to improper or unsafe prescribing of mifepristone or any other abortion drug. Transparency of this kind is a proper function of federal oversight. Congress and the public deserve to know when the REMS certification system has had to act, and this reporting requirement makes that record visible.

The bill's definition of 'abortion drug' is careful and principled. It excludes drugs used to produce a live birth, drugs used to remove a dead unborn child, and drugs used to treat an ectopic pregnancy. We find this precision important. The bill does not sweep broadly into ordinary obstetric or emergency care. It is targeted at what it says it targets: the intentional termination of the life of an unborn child. We appreciate that the drafters made these carve-outs explicit, and we note them clearly so that no one can claim this bill restricts care that falls outside its plain text.

At its foundation, this bill rests on a conviction the American Council holds without apology: that every unborn child possesses inherent dignity and that the law should reflect that reality. Allowing abortion drugs to be prescribed without ever meeting a patient, or dispensed into states whose laws do not authorize such prescriptions, treats the taking of a human life as a transaction to be optimized for convenience. HB9421 says no. We urge every member of the House to say yes alongside it.