The nation’s second-largest pharmacy chain confirmed Thursday that it will not dispense abortion pills in several states where they remain legal — acting out of an abundance of caution amid a shifting policy landscape, threats from state officials and pressure from anti-abortion activists.
Nearly two dozen Republican state attorneys general wrote to Walgreens in February, threatening legal action if the company began distributing the drugs, which have become the nation’s most popular method for ending a pregnancy.
The company told POLITICO that it has since responded to all the officials, assuring them that they will not dispense abortion pills either by mail or at their brick-and-mortar locations in those states.
The list includes several states where abortion in general, and the medications specifically, remain legal — including Alaska, Iowa, Kansas and Montana. For example, Kansas’ law that patients only obtain the pills directly from a physician is blocked in court.
“There is currently complexity around this issue in Kansas and elsewhere,” said Fraser Engerman, Walgreens’ senior director of external relations.
The company stressed that it is not yet distributing the pills anywhere in the country, but is working to obtain certification to do so in some states, though declined to say which.
“In my letter to Walgreens, we made clear that Kansas will not hesitate to enforce the laws against mailing and dispensing abortion pills, including bringing a RICO action to enforce the federal law prohibiting the mailing of abortion pills,” Kansas Attorney General Kris Kobach said in a statement. “Evidently, Walgreens understood that my office was serious about this. I’m grateful that Walgreens responded quickly and reasonably and intends to comply with the relevant laws.”
The decision is the latest to demonstrate how widely abortion access can vary state to state in a post-Roe America even in places where there are no bans in effect — as elected officials tussle with the federal government, activists and corporations to block the availability of services.
E. Michael Murphy, the adviser for state government affairs for the American Pharmacists Association, said his members are struggling to navigate “blatant contradictions between state and federal law that make it very challenging to identify what is legal and what is not legal.”
“We are very concerned with those reports,” he added, “because we as pharmacists want to ensure the patients have access to the best possible care that’s informed by evidence.”
The Biden administration moved in January to allow retail pharmacies to dispense the pills — part of a broader push to preserve and expand access to abortion as more states passed bans on the procedure. That decision followed a multiyear analysis by the FDA that found the pills were safe and effective to use without a doctor’s visit, a conclusion state attorneys general and anti-abortion groups are challenging in court.
Following the release of the FDA’s analysis, several chain pharmacies swiftly announced they would participate, but only in states that hadn’t banned or restricted access to the pills.
The group of Republican attorneys general, who argue that the Biden administration is misinterpreting the laws around mailing and dispensing abortion pills, also wrote to CVS, Albertsons, Rite Aid, Costco, Walmart and Kroger demanding they, too, refuse to dispense the medication.
The six companies did not immediately respond to POLITICO’s questions about their plans in those states.
Though some independent and online pharmacies say they will seek certification to provide the drugs in these states, advocates warn that the impact of Walgreens’ decision could significantly limit access.
“They’re denying people agency over their lives,” said Elizabeth Nash, a state policy expert with the abortion-rights Guttmacher Institute. “When we’re thinking about states that have a lot of their population in rural areas, it’s much more likely that a pharmacy is nearby than a provider’s office, so these pharmacies play an outsized role in patient health and access to health care.”
Over the past few months, anti-abortion rights advocacy groups have also mounted pressure campaigns targeting the pharmacies. This weekend, they plan to picket outside pharmacy locations in dozens of states. Groups including Students for Life and the Family Research Council have also written to Walgreens and CVS threatening “legal ramifications for your pharmacy” should they move ahead with becoming certified to fill prescriptions for abortion pills.
Students for Life spokesperson Kristi Hamrick cheered Walgreens’ decision.
“This response indicates that pro-life concerns are being heard and that corporations are not rushing to take over the abortion business but are proceeding cautiously,” she said.
Daniel Payne contributed to this report.