May 30, 2024

Louisiana's abortion pill law.

Image: Robin Marty / Flickr
Image: Robin Marty / Flickr

Plus, how do we determine the bias of a newspaper's editorial board?

I’m Isaac Saul, and this is Tangle: an independent, nonpartisan, subscriber-supported politics newsletter that summarizes the best arguments from across the political spectrum on the news of the day — then “my take.”

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Today's read: 11 minutes.

Today, we're breaking down Louisiana's new law and how it's punishing people who possess abortion pills. Plus, a reader question about determining the biases of news outlets.

I was wrong.

In the last few months, I've realized I was wrong about three major stories we covered:

  1. The Samuel Alito flag controversy
  2. Biden's interview with Robert Hur
  3. Mike Johnson as speaker 

In tomorrow's subscribers-only Friday edition, I'm going to write about what I got wrong, and why I think I screwed up.

Quick hits.

  1. Former President Trump and Elon Musk are speaking several times a month and discussing a potential advisory role for Musk in a second Trump administration, according to a new report from The Wall Street Journal. (The discussions)
  2. Texas Rep. Tony Gonzales (R) narrowly won his primary against gun-rights activist and social-media celebrity Brandon Herrera by 407 votes. (The race) Separately, state House Speaker Dade Phelan (R) also edged out a primary challenger from the right who was backed by former President Donald Trump. (The race)
  3. A jury will begin its second day of deliberations in former President Donald Trump's trial in New York over alleged hush money payments and the falsification of business documents. (The deliberations)
  4. In his lengthiest comments yet since a controversy erupted over a pair of flags hung outside his homes, Supreme Court Justice Samuel Alito said he will not recuse himself from January 6-related cases. (The comments)
  5. Tennessee Gov. Bill Lee (R) signed a bill that bars people from helping minors get an abortion, receive puberty blockers, or have gender-transition surgeries without parental consent. (The bill)

Today's topic.

Louisiana’s abortion pill law. Last Friday, Louisiana Governor Jeff Landry (R) signed a bill classifying two abortion-inducing medications as controlled substances whose possession without a prescription will be punishable by 1-5 years in prison. The measure applies to mifepristone and misoprostol, the drugs used in medication abortions, and will take effect on October 1. In addition to inducing abortions, misoprostol is used to treat miscarriages, prepare patients for endometrial biopsy, and ease IUD insertion. Mifepristone is only used for medication abortions.

The bill, SB276, was introduced by state Senator Thomas Pressly (R) after his sister’s husband repeatedly put misoprostol pills into her drinks to try to induce an abortion, for which he was sentenced to 180 days in jail. During the process of revising the bill, Pressly added an amendment to also reclassify mifepristone and misoprostol as Schedule IV drugs under the state’s Uniform Controlled Substances Law to “control the rampant illegal distribution of abortion-inducing drugs.”

Louisiana banned medical and surgical abortions in 2022 (with exceptions for life-threatening pregnancies), so the new law won’t affect abortion access. It will, however, create new barriers to obtaining abortion drugs. The bill stipulates that mifepristone and misoprostol be stored in designated facilities and requires doctors in Louisiana to obtain a special license to prescribe the drugs. Those prescriptions will be recorded in a state database accessible to doctors, pharmacists, Louisiana’s medical board, and law enforcement agencies with a warrant.

The law will only apply to people who have not been prescribed the medication such as friends of pregnant women, their family, medical providers, and women who are not pregnant but wish to obtain the drugs proactively. Pregnant women who possess the medication for their own use are exempt from criminal prosecution.

Pro-life groups celebrated the passage of the bill. Sarah Zagorski, the communications director for Louisiana Right to Life, praised Pressly for “his courageous persistence with SB 276 despite numerous attacks from abortion proponents who mischaracterized his legislation.”

During the legislation’s consideration, a group of 200 doctors in Louisiana wrote a letter to Pressly criticizing the bill. “Mischaracterizing misoprostol, a drug routinely and safely used on labor units throughout the state, as a dangerous drug of abuse, creates confusion and misinformation and harms women seeking high quality maternal care,” they wrote.

Medication abortions have become more prevalent since Roe v. Wade was struck down, accounting for 63% of all U.S. abortions in 2023. In recent years, the Food and Drug Administration (FDA) scaled back restrictions on access to mifepristone, removing a requirement that healthcare providers dispense the drugs in person. In turn, women have increasingly sought out abortion drugs by mail to circumvent state bans. In March, the Supreme Court heard arguments over the FDA’s approval and regulation of mifepristone in a case that could determine access to the drug nationwide (we previously covered the case here).

Today, we’re going to explore arguments from the left and right about Louisiana’s new law. Then, my take. 

What the left is saying.

  • The left strongly opposes the bill, saying it’s out of step with views on abortion even in conservative states.
  • Some say the law has no medical justification.
  • Others suggest it's designed to frighten women — and intimidate their support networks — who are considering an abortion.

The Times-Picayune editorial board said the lawmakers practiced “bad medicine.”

“In Louisiana, it seems there is almost no scenario where lawmakers don’t feel the need to insert themselves into the conversation between a woman and her doctor,” the board wrote. “It isn’t enough that our state has outlawed abortions in virtually all situations but the most life-threatening. Many doctors remain unsure if their definition of ‘life-threatening’ matches that of the state… Meanwhile, terrified women carrying babies with no chance of survival feel pressed to seek out-of-state care.”

“After getting exactly what they sought in the Dobbs decision — overturning Roe v. Wade — abortion opponents are still not satisfied, and it's hurting their cause. Louisiana is in the midst of a crisis in maternal and fetal health care. Now isn't the time to give doctors reason to abandon our state,” the board said. “A majority of Louisiana voters favor loosening restrictions to allow for abortion up to the 15th week of pregnancy. From the Capitol, however, lawmakers keep prescribing the opposite.”

In The Guardian, Moira Donegan called the bill “cruel and medically senseless.”

“Under both state and federal classifications, the category of controlled substances includes those medications known to cause mind-altering effects and create the potential for addictions, such as sedatives and opioids; abortion medications carry none of this potential for physical dependence, habit-forming or abuse,” Donegan said. “Louisiana lawmakers are pursuing this new additional criminalization measure because while abortion bans are very good at generating suffering for women, they are not very good at actually preventing abortions.”

“The criminalization measure, then, is part of an expanding horizon of invasive, sadistic and burdensome state interventions meant to do the impossible: to stop women from trying to control their own lives. The Louisiana bill nominally will not apply to pregnant women – they’re exempted from criminal punishments for possession of the medications. But it will take square aim at the vital, heroic efforts of feminists, medical practitioners and mutual aid networks that have been distributing the pills in Louisiana: the people who have adhered to the principles of bodily autonomy and women’s self-determination even amid a hostile climate.”

In MSNBC, Mary Ziegler wrote about “the chilling motive” behind the law.

“The new bill recognizes that existing bans have not been enough to stop the flow of drugs and patients across state lines — and develops new tools to track the use of these critical medications and frighten anyone who might prescribe them,” Ziegler said. “Equally important is the bill’s creation of a new crime: the possession of these abortion drugs without a prescription… it is intended to crack down on a group antiabortion advocates have targeted since the reversal of Roe: ‘aiders and abettors.’”

“Antiabortion groups have vowed — in the face of dissension from so-called antiabortion abolitionists — not to punish women. Physicians, for their part, often prove unwilling to run the grievous legal risk involved in violating a criminal ban. That leaves others willing to help patients. This bill gives prosecutors a new tool: If anyone possesses mifepristone or misoprostol without a prescription, it does not matter whether they ever perform an abortion,” Ziegler wrote. “The chilling effect is unlikely to be limited to physicians. Those in a patients’ support network — the most likely targets of the bill — will be affected.”

What the right is saying.

  • The right is mixed on the bill, with supporters praising it as a measure of protection for women’s health.
  • Some question the logic behind reclassifying mifepristone and misoprostol.
  • Others say anti-abortion laws have become increasingly prone to government overreach. 

In The Federalist, Jordan Boyd criticized Democrats and the media for their “freak out” over the bill.

“Poisoning an expectant mother, especially without her knowledge, the bill notes, ‘substantially increases the pregnant woman’s risk of death or serious bodily harm.’ Mifepristone and misoprostol together are responsible for a 500 percent increase in abortion-related emergency room visits for side effects such as hemorrhage, ‘fast, weak pulse,’ ‘shortness of breath,’ diarrhea, dizziness, headache, nausea or vomiting, ‘pain’ across the back, arms, neck, and abdomen, a myriad of other risks, and sometimes fatal complications,” Boyd wrote. “Protecting women and their unborn babies is a proven bipartisan issue that should be uncontroversial.”

“Pro-life laws in Louisiana, even with the introduction and passage of the new abortion pill bill, explicitly exempt pregnant women who have a prescription for abortifacients from the new fines and jail time,” Boyd said. “Not even that truth, however, stopped the corporate media from joining the misinformation dogpile… The fearmongering by abortion activists about the Louisiana bill is a direct attempt to dredge up public contempt for Republicans who act on voters’ wishes about life in the womb.”

In Hot Air, Jazz Shaw said the bill has “problematic” elements.

“Returning these questions to the states was the right thing to do. If the voters of Louisiana do not wish to allow abortions in their state and they elect representatives who impose restrictions, I don't see any problem with it,” Shaw wrote. “With all of that said, however, this approach to dealing with medications like mifepristone and misoprostol seems problematic to say the least. First of all, under the restrictions that were already passed, if someone were found to have used the drugs in the state, they would already be violating the law… The act would absolutely qualify as ‘an abortion’ and should already be covered.

“How does the state justify criminalizing the possession of the drugs, though? The drugs don't even require a prescription in most cases. They are obviously dangerous (lethal) to an unborn baby but they seem to have been deemed to pose minimal risks to the mother,” Shaw said. “This all seems to be rather redundant and, frankly, over the top. It feels as if Louisiana has been watching other states impose restrictions on abortions and decided to say, ‘Hold my beer.’ Classifying these drugs in the same category as potentially addictive narcotics or antidepressants seems to be a serious step too far.”

In Reason, Elizabeth Nolan Brown wrote “the war on drugs meets abortion.”

“With or without this new crime, there is no reason the state needs to make abortion pills a Schedule IV controlled substance in order to target someone who secretly slips them into his pregnant wife's drink. But this is a common tactic used by lawmakers trying to grant the state new power: using an extreme and sympathetic example of wrongdoing to justify a wide-reaching change that will be used in matters way beyond that example,” Brown said. “In this case, the most likely target is doctors who prescribe mifepristone and misoprostol.”

“The bill explicitly exempts pregnant women who have misoprostol or mifepristone for their own use from prosecution—another example of the weird paternalism involved in anti-abortion laws. I'm certainly glad most states don't want to criminalize women for attempting or having abortions, but it's also somewhat crazy to act like the woman here is not culpable for her actions but someone who helped her get abortion pills is,” Brown wrote. “Doctors are likely to be leery of prescribing these medications for people who need them, much in the same way that crackdowns on pain pills and ADHD medications have harmed people who legitimately need these medicines for health conditions.”

My take.

Reminder: "My take" is a section where I give myself space to share my own personal opinion. If you have feedback, criticism, or compliments, don't unsubscribe. Write in by replying to this email, or leave a comment.

  • This bill restricts doctors and family and everyone except the actual people committing the state crime of abortion — pregnant women.
  • It’s bad policy because it adds an excessive layer of mandatory punishment to what was already a crime.
  • It’s bad politics because Republicans will all now have to defend another piece of unpopular legislation.

This bill is bad policy and even worse politics.

Let's start with the policy. Simply put, there is no world where possessing drugs like mifepristone and misoprostol should land you in prison for up to five years. When the Supreme Court rejected a Texas judge's attempt to suspend the Food and Drug Administration's mifepristone approval last year, I focused on how the drug is only available thanks to the FDA’s gold standard approval. Similarly, and contrary to the alarm bells being rung by writers like Jordan Boyd (under "What the right is saying"), every indication we have is that misoprostol is also safe. And, by the way, it is used for other purposes besides abortion — including as a way to decrease the risk of bleeding ulcers.

So that's one obvious point. Another is the impact on the medical profession. If legislators are going to pass laws that remove or restrict options doctors have at their disposal for care, they should be consulting those doctors about how to navigate it — not acting on anecdotal personal experience. In this case, rather than doctors working with legislators, explaining how they use these drugs, or asking them to take action on drugs they are seeing damaging their community, doctors are writing to legislators after the legislation has already been passed, informing them that their action is going to make it harder and less safe to treat their patients. Sorry, but I’ll take the word of Louisiana's medical professionals on this drug’s use cases over the word of the state’s lawmakers.

My next concern is over the "weird paternalism" of anti-abortion laws, as Elizabeth Nolan Brown put it. I can't think of any other crime (in this case, abortion) in which the central perpetrator (in this case, the mother) is automatically absolved while all the people around them are criminalized. If abortion is murder, as these lawmakers say, they are effectively absolving the murderer while throwing the book at their various accomplices. It makes absolutely no sense, except when you realize that lawmakers were not prepared to deal with the obvious implication of criminalizing abortion. It is totally nonsensical not to punish pregnant mothers for what they have now defined as crime.

I don’t want to be misunderstood, here: I’m all for finding ways to increase the number of planned and wanted pregnancies and reduce the number of unplanned and unwanted pregnancies, but I am not advocating for punishing women for abortion — the obvious implication being that I am against abortion criminalization. Abortion is both a policy and a moral question. I’ve written a lot about my view on the morals, which you can go read if you want, but I think you can even leave that aspect aside to focus on the policy: Because of the nature of abortion — a choice that is deeply personal and often directly intertwined with health risks, medical care, and necessity — stringent government oversight becomes very complicated and very dangerous very quickly, often resulting in the same number of abortions or fewer planned pregnancies. 

Even leaving all that aside, Louisiana lawmakers simply didn't have to do this. They've won on Roe v. Wade, they've banned medical and surgical abortions, and it is illegal in the state to use either drug to induce an abortion without a prescription. All this policy does is create an excess layer of criminality to possessing mifepristone and misoprostol and add another hoop for doctors to jump through to get the drugs, which have all sorts of uses — including helping women safely navigate a miscarriage.

Which, finally, brings me to the politics. Let me start by giving state Senator Thomas Pressly (R) some grace. I think he is actually a more sympathetic character than a lot of people are letting on. His sister was newly pregnant when her husband tried to secretly kill their child by spiking her drinks with abortion drugs. I write often about the fact that politics are personal, and I can't imagine many things more horrifying and personal for Pressly and his family than that. So I understand his desire to use his position to act, and even his inclination to respond to this very bizarre and unusual instance by passing a very bad piece of legislation that will impact millions of people. Still, it's worth emphasizing that his sister's story — which took place in Texas — was the single example they cited of anything like this happening anywhere in the country.

Simply put, the political ramifications of this bill’s passage are bad optics for Republicans. I don’t see a way of viewing this other than as a case of Republican extremism on abortion that will hurt them electorally. So, aside from being bad policy that will do very little to move the needle on ending abortions (if anything, it is likely to ensure a bigger black market of underground and unsafe abortions, as most drug restrictions do — sorry, I can’t stop criticizing this bill as bad policy), it's also going to hurt the anti-abortion movement and hurt Republicans nationwide. 

The story should now be about how Louisiana lawmakers are ignoring doctors in their own state telling them that this bill is going to make pregnancy less safe for expectant mothers — even the ones who have no intention of seeking out an abortion. It is, simply put, a fringe and radical position to want to throw people in prison for possessing these drugs, and now it’s a position that the entire party is going to be forced to defend.

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Your questions, answered.

Q: How do you decide to put opinions from institutional editorial boards in either the “from the right” or “from the left” section? I was a bit surprised to see “The Economist” included in the “from the left” section. In many circles, “The Economist” would be described as “from the right.” Similarly, I have been surprised in the past to see local newspapers included in the “from the left” section as well - and I wonder how someone decides whether the editorial board of the New Orleans Times-Picayune, or any other local paper, is more “from the left” or “from the right.”

It seems that in practice, the Wall St. Journal editorial board is always listed as “from the right” and all other institutional editorial boards are listed as “from the left” — but doesn’t that just perpetuate the “liberal media bias” narrative of always listing institutional editorial boards as coming “from the left”?

— John from Glenmont, MD

Tangle: Those are really good questions, and I have some simple answers. 

First off, yes, every editorial board has a general lean or bias. You can see that with your own two eyes or can find bias ratings from firms like AllSides or Ad Fontes. And that’s the answer to your first question: If we want to see the bias of a local paper like the New Orleans outlet The Times-Picayune (which, coincidentally, we cited under “What the left is saying” in today’s main story), bias rating websites can paint a reliable picture of general bias

But those general biases are just that — general. While the editorial boards of a paper can reliably slant one way or the other (and it’s more than just the Wall Street Journal who lists to starboard, by the way — the New York Post and National Review and Washington Examiner and Chicago Tribune and many others all have reliable conservative bents), each author is their own person. For instance, Ross Douthat at the New York Times is a reliably conservative author, and you’ll find his writings from The Times listed under “What the right is saying” in Tangle. 

And within “left or “right” are other unique worldviews that take on subtly different flavors. The Economist is a good example. Executive Editor Zanny Minton Beddoes demonstrates a general “neoliberal” slant, wherein she has a pretty middle-of-the-road status quo perspective that may not be aligned with U.S. progressivism, but that same worldview is very oppositional towards global conservatism. And for whatever it’s worth, AllSides and Ad Fontes both rate The Economist as a left-leaning outlet, too.

Lastly, each person will judge an organization’s bias based on their own existing biases. I’ll never forget the reader who chastised me for putting the famously conservative site The Federalist under “What the right is saying” because they weren’t as conservative as the places they got their information, which provided their frame of reference. And that’s not to denigrate that reader, either — it’s just an example of how we all have our own ideas of what “neutral” means, and very few of those ideas may be truly neutral.

Discussing bias is complicated. Even with Tangle, it can be hard. I never say we are “unbiased,” but sometimes will say that we are “nonpartisan” because we don’t favor any particular political group (and because media bias analysts back us up on that). Yet, every day, we share views from explicitly partisan writers, and sometimes I’ll give my support for their commentary in “my take.” Anybody could read us as biased or partisan in one issue, but I think our balance and partisanship become apparent over time.

In other words: Everybody has biases, political or otherwise. And it’s not always easy to categorize individual writers or specific news outlets.

Want to have a question answered in the newsletter? You can reply to this email (it goes straight to my inbox) or fill out this form.

Under the radar.

This weekend, Mexico is holding a historic election that could affect the United States dramatically. Mexico is the United States' largest trading partner, and right now the countries are working on bilateral collaborations to stem the flow of migrants coming through Mexico into the U.S.. This weekend, Mexican voters appear poised to elect their first woman president — either Claudia Sheinbaum from the ruling Morena coalition or Xóchitl Gálvez, a former senator from the opposition. The focus of the election has been on domestic issues, but Mexico’s next president will have a major role in issues directly impacting the U.S. Axios has more.


  • 2000. The year mifepristone was first approved for use in the United States by the U.S. Food and Drug Administration (FDA). 
  • 72%. The percentage of Americans who support women obtaining the pills needed for a medication abortion from their doctor or a clinic, according to a March 2024 poll from Axios/Ipsos. 
  • 50%. The percentage of Americans who support women obtaining the pills needed for a medication abortion through the mail.
  • 54%. The percentage of Louisiana voters who believe the state should allow women to access abortion services during the first 15 weeks of pregnancy, according to a May 2024 poll from the The Times-Picayune. 
  • 642,700. The number of medication abortions in the United States in 2023, accounting for 63% of all abortions, according to The Guttmacher Institute.
  • +11%. The increase in abortions performed between 2020 and 2023.
  • 22. The number of states that signed an amicus brief supporting the plaintiffs in FDA v. Alliance for Hippocratic Medicine challenging the FDA's approval of mifepristone. 

The extras.

  • One year ago today we had just published a Friday edition asking if we were wrong about greedflation.
  • The most clicked link in yesterday’s newsletter was the under-the-radar story about the INR.
  • Nothing to do with politics: House sizes in the U.S. compared to Europe.
  • Yesterday’s survey: 753 readers answered our survey on the Supreme Court’s ruling on South Carolina’s redistricting with 44% saying the legality and outcome were both bad. “The construction of districts for state and federal representation should be determined by a nonpartisan commission to create reasonable districts with reasonable criteria, not by politicians who want to insure their jobs,” one respondent said.

Have a nice day.

A group of British tourists were enjoying the bioluminescent waters of a river off the Manialtepec Lagoon in Mexico, a location deemed safe by locals, when the moment was shattered; a crocodile attacked Melissa Laurie suddenly, dragging her underwater. That’s when her twin sister, Georgia, sprang into action. With one hand Georgia kept her sister's head above water, while with the other she fiercely punched the crocodile, somehow fending it off and saving her sister’s life. "I just punched the heck out of it," Georgia said. For her bravery, Georgia was awarded the prestigious King's Gallantry Medal. Sunny Skyz has the story.

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Isaac Saul
I'm a politics reporter who grew up in Bucks County, PA — one of the most politically divided counties in America. I'm trying to fix the way we consume political news.