State and federal proposals to regulate medication abortion are set to intensify in 2026. This follows ongoing litigation surrounding the abortion drug mifepristone and claims by opponents that it poses risks to both patients and the environment, despite evidence supporting its safety. Activists and lawmakers aiming to restrict access to abortion pills are expected to introduce new legislation as they continue to navigate a landscape that has shifted significantly since the overturning of Roe v. Wade.
Abortion bans have generally met with public disapproval, yet as the midterm elections approach, some lawmakers in states with stringent abortion restrictions are advancing new bills. A closer look reveals early trends in legislation focused on medication abortion and environmental safety.
New Legislative Proposals on Abortion Pills
In recent years, the national anti-abortion organization Students for Life of America has propagated unsubstantiated assertions that mifepristone contaminates U.S. waterways. This group has drafted model legislation aimed at establishing protocols for the disposal of abortion medications and has called for environmental studies at both state and federal levels.
In 2025, legislators in at least seven states proposed bills to impose environmental regulations on mifepristone. Proposals in Texas, Wisconsin, and Wyoming suggested testing community water systems for traces of the drug. Similar measures in Maine, Montana, Pennsylvania, West Virginia, and Wyoming aimed to mandate that healthcare providers supply patients with medical waste kits for the disposal of tissue following medication abortions. Most women typically dispose of this tissue by flushing it, a common practice during early-stage miscarriages.
Although none of these proposals advanced, they are likely to be reintroduced in 2026 as abortion opponents persist in their efforts to regulate abortion pills, including discussions at the federal level. In June, a group of 25 Republican members of Congress reached out to the Environmental Protection Agency (EPA) to explore potential regulatory pathways for mifepristone. Reports indicate that the agency has advised activists to utilize an upcoming public comment period to advocate for the inclusion of mifepristone’s active metabolites on a list of contaminants monitored in drinking water.
Emerging Trends in Abortion Legislation
In Florida, where abortion is restricted after six weeks of gestation, lawmakers have advanced HB 289. This bill would allow parents to file wrongful death lawsuits for the loss of a fetus, potentially claiming damages for emotional distress. Its counterpart, SB 164, reintroduced by Republican Senator Erin Grall, faces significant challenges in the Senate, as it seeks to broaden civil remedies for parents whose pregnancies end due to abortion.
Meanwhile, another bill, HB 663, would permit family members to sue individuals for providing or attempting to provide an abortion up to two years post-procedure, with damages reaching $100,000, regardless of consent or legality in the jurisdiction where the abortion occurred.
Despite a voter-approved amendment in 2024 to protect abortion rights in Missouri, access has not returned to its previous state. Between January and October, only 80 in-clinic abortions were performed, as documented by state data. A trial set for January could determine if the state’s anti-abortion laws violate the newly established amendment.
Additionally, in Ohio, where voters approved an amendment protecting abortion rights through fetal viability, Republican lawmakers have introduced measures to complicate access to medication abortions. For instance, SB 309 mandates that doctors provide patients with a state-mandated script detailing the risks of mifepristone, while HB 485 requires students in grades five through twelve to watch a video promoting fetal development, raising concerns about the accuracy of the information presented.
Concerns surrounding privacy in reproductive health care have also emerged in the post-Roe landscape. In Indiana, Senator La Keisha Jackson has introduced SB 109, aiming to ensure that abortion reports submitted by healthcare providers remain confidential and not subject to public disclosure. This move follows a state court decision that upheld the privacy of terminated pregnancy reports.
In a controversial legislative proposal from Alabama, Democratic Representative Juandalynn Givan has prefiled HB 46, which would require men convicted of rape or incest leading to pregnancy to undergo either a vasectomy or castration, in addition to financing the abortion. Givan emphasizes that this proposal is intended to spark a broader conversation about bodily autonomy and the differing standards applied to men and women in discussions of reproductive rights.
As the political landscape shifts, significant federal policy decisions regarding abortion are anticipated as President Donald Trump embarks on his second term. Following his administration’s rescission of multiple Biden-era policies aimed at expanding abortion access, new challenges may arise. The Food and Drug Administration (FDA) has agreed to review mifepristone’s safety, but abortion opponents have called for the dismissal of FDA Commissioner Martin Makary, alleging delays in the review process.
The expiration of a controversial Medicaid policy in July—which effectively defunded clinics such as Planned Parenthood—is also a critical issue. The decision to renew this funding restriction will be pivotal in determining the future of reproductive health services in the United States, particularly for those relying on Medicaid for essential health care.
As these legislative and regulatory actions unfold, the ongoing impact on access to abortion and reproductive health services will continue to generate significant public interest and debate.
