Several GOP senators are exerting pressure on the Food and Drug Administration to curtail illegal sales of unapproved and misbranded versions of mifepristone sold online, escalating the conflict between anti-abortion Republicans and the Trump administration over the abortion pill.
Sen. Bill Cassidy (R-LA), chairman of the Senate health committee, along with Sen. Lindsey Graham (R-SC) and three others, sent a letter to FDA Commissioner Dr. Marty Makary on Wednesday asking the agency for details on its enforcement actions against illegal sales of abortion pills.
There are three FDA-approved makers of the abortion pill mifepristone: Danco Laboratories, which received approval in 2000 for the brand name Mifeprex; GenBioPro, which received the first generic approval in 2019; and Evita Solutions, which received generic approval in October 2025.
But there are various domestic and international websites that sell unapproved abortion drugs directly to U.S. customers, often without a prescription or medical oversight.
The senators asked the FDA to prioritize oversight of online mifepristone sales and to “fully leverage its authorities to keep women and girls safe from the scourge of illegal chemical abortion drugs being sold into this country.”
“FDA’s core mission is to protect American consumers through the regulation of medical products,” wrote the senators, “and the agency has numerous tools at its disposal to prevent misbranded and unapproved versions of the chemical abortion drugs from being marketed in the U.S. by online retailers in violation of federal law.”
Other signatories of the letters are Sens. Steve Daines (R-MT), James Lankford (R-OK), and Cindy Hyde-Smith (R-MS).
The letter follows a report from the pro-abortion-rights Guttmacher Institute on Tuesday that abortion rates slightly increased in 2025 to roughly 1.13 million and remain higher than before the Supreme Court overturned Roe v. Wade in 2022.
Analysts say the increase in abortion rates nationwide is attributable to the proliferation of online sales of abortion pills, which are now used in roughly two-thirds of all abortions in the United States.
Much of this increase is attributable to online abortion pill sales for women in the 13 states that have prohibited abortion entirely. Roughly 91,000 women from these states received abortion pills through the mail via telehealth in 2025, up from 72,000 in 2024.
Anti-abortion advocates and conservative Republicans have expressed concern that the Trump administration has not taken action to restore in-person screening requirements before a patient can obtain mifepristone, which were eliminated by the Biden administration FDA during the COVID-19 pandemic.
A report from the Ethics and Public Policy Center last spring found that nearly 11% of women who take mifepristone at home suffer from an adverse reaction, which some experts say is likely due to the lack of physician monitoring from online pill sales.
There have also been high-profile cases of pregnant women in abusive relationships being forced to take abortion pills, with or without their knowledge, after the medications were procured online by their abusers.
The letter to the FDA outlined how the Trump administration could take its own oversight actions to curb illegal sales of abortion pills, including through warning letters and abuse complaints.
The senators also said that the FDA could partner with U.S. Customs and Border Protection and the U.S. Postal Inspection Service to “improve the interdiction of unapproved and misbranded chemical abortion drugs that sellers attempt to illegally mail into the U.S.
A spokesperson for HHS told the Washington Examiner that the FDA is “committed to protecting the public from the illegal marketing of drugs and is currently conducting its safety study of mifepristone’s prescribing standards.”
THE NUMBER OF ABORTIONS SLIGHTLY INCREASED IN 2025
Cassidy, Graham, and their colleagues also wrote to the three FDA-approved makers of mifepristone, asking oversight questions about how the companies ensure that they are following FDA safety and informed consent requirements online. The letter also asks where each company produces its products and the country of origin of raw materials.
“Chemical abortion drug makers profit off killing innocent children while putting mothers’ lives at risk,” said Cassidy. “These manufacturers and websites have facilitated the explosion in online sales of these harmful drugs without regard for women’s health and safety while opening the door for coercion and abuse.”
