Updated at 6:58 p.m.
With future access to a widely used abortion medication in the hands of federal courts, Vermont officials are putting together a plan to stockpile the contested pill.
An internal memo obtained by VTDigger, dated April 20 and signed by Health Commissioner Mark Levine, laid out a plan to stockpile a two-year supply of mifepristone, one of two pills taken in tandem to induce an abortion.
In the memo, Levine reiterated that access to the standard, two-step medication abortion regimen — mifepristone, followed by misoprostol — remains status quo for the time being. On Friday night, the U.S. Supreme Court ruled that access to the medication will be unchanged pending the federal appeals process.
“(A)ny actions Vermont takes at this time should incorporate a long-range view,” Levine said.
Jason Maulucci, a spokesperson for Gov. Phil Scott, confirmed the plan to VTDigger Friday afternoon and said it has the governor’s approval.
Officials from Vermont’s executive and legislative branches have been working together to devise a procurement and stockpiling plan since April 14, according to emails obtained by VTDigger. The internal conversations have involved legislative leadership, the governor’s office, the Attorney General’s Office, the Department of Health, Planned Parenthood of Northern New England and the University of Vermont Medical Center.
“If mifepristone retains its place in the armamentarium, a modest two-year reserve supply would be adequate to address clinician’s desire to protect women’s reproductive rights, ensure continued access to the safest and most well-tolerated form of medication abortion, and respect the two-year shelf-life of the medication,” Levine wrote in Thursday’s memo. “This is especially important for the providers of the vast majority of such non-surgical abortions in Vermont, (Planned Parenthood of Northern New England), who have voiced support for just such a proposal.”
According to the memo, Planned Parenthood, UVM Medical Center and other hospitals in Vermont currently have a six-month supply of mifepristone. The regional Planned Parenthood arm — which provides abortion care across Vermont, New Hampshire and Maine — is seeking to purchase 2,000 additional doses.
At roughly $42 per dose, this would cost the organization more than $83,000, and it is requesting state funds to help cover the expense. Planned Parenthood is able to store the stockpile, Levine wrote.
For UVM Medical Center and other abortion providers throughout Vermont, Levine said 500 doses “at most” will be sufficient for two years. The medical center is able to cover the estimated $21,500-$25,000 price tag, store the medication and distribute it as needed, he wrote.
Kendal Smith, the governor’s policy and legislative affairs director, wrote in a Friday morning email to legislative leadership that the administration believes the cost of stockpiling the medication could be covered with existing state funds. She added that Levine would offer Planned Parenthood and UVM Medical Center the administration’s blessing to “move forward on an expedited timeline” Friday.
According to the Vermont Department of Health, 926 abortions were carried out with medicine in Vermont in 2020, accounting for more than 75% of all abortions performed that year.
Spurred by an unprecedented decision issued two weeks ago by U.S. Judge Matthew Kacsmaryk — a Trump appointee based in Amarillo, Texas — that threatened to pull the pill entirely off the market, lawmakers, health care providers and stakeholders have rushed to craft a safety net for the safest and least invasive method to carry out an abortion.
Earlier this week, Vermont legislators amended this year’s two major abortion bills — H.89 and S.37 — to add legal and professional protections for Vermont doctors who continue to prescribe and distribute mifepristone. The bills, which have passed both the House and Senate, are expected to reach Scott’s desk soon for his anticipated signature.
A typical medication abortion regimen takes two steps: first mifepristone, then misoprostol. Misoprostol-only medication abortions are widely used in other countries, but they are slightly less effective and are typically associated with greater, more uncomfortable side effects, though serious complications are rare for both regimens.
Maulucci said Friday afternoon that officials settled on a two-year stockpile based on mifepristone’s shelf life. When asked about the possibility of stockpiling in the immediate aftermath of Kacsmaryk’s decision, Planned Parenthood representatives initially advocated for a cautious approach, expressing concern that this could interfere with access to the drug in states where it’s more urgently needed.
That was taken into consideration when crafting the state’s stockpiling plan, Maulucci said. “I think given the relatively small nature of the acquisition, it isn’t as much of a concern,” he said.
Mifepristone’s ultimate fate remains unknown, with federal courts having issued a flurry of contradictory decisions in the past two weeks. But the latest ruling from the U.S. Supreme Court on Friday will preserve access to the medication as the appeals process plays out.
“If Vermont clinicians should legally find themselves unable to use mifepristone, they would still provide this clinical service by adopting a misoprostol-only protocol,” Levine wrote in the April 20 memo.
