When the U.S. Supreme Court overturned Roe v. Wade in 2022, it made clear that the power to make laws about abortion returns to the people and their elected representatives. But after that ruling—Dobbs v. Jackson Women’s Health Organization—the Biden administration sought to circumvent the Court’s decision.
Since June 2022, the Biden administration and its pro-abortion allies have tried to force emergency room doctors to perform abortions, nullify commonsense protections that states have passed concerning dangerous chemical abortion drugs, strike down a law protecting unborn children from being killed because of genetic abnormalities, create a nationwide abortion-drug scheme that nullifies pro-life state laws and violates federal law, and even force Christian pharmacies to dispense chemical abortion drugs. This last situation is what Kevin Martian of Mayo Pharmacy found himself in.
What is Mayo Pharmacy, and who is Kevin Martian?
Mayo Pharmacy is an independent pharmacy in Bismarck, North Dakota. It is owned by Kevin Martian, a devout Catholic pharmacist who believes that God created human life in His image. For this reason, Kevin knows that all human life is sacred.
Kevin operates Mayo Pharmacy in accordance with his religious beliefs about life, which means that he does not dispense chemical abortion drugs to end an innocent life. But a Biden administration directive would have forced him to start dispensing those lethal drugs or risk losing his business.
HHS rules violated Kevin’s conscience
In its 2022 ruling in Dobbs, the Supreme Court held that the Constitution does not confer a “right” to abortion. As a result, the Court returned the issue of abortion to the people and their elected representatives.
Immediately, the Biden administration went to work trying to evade the Court’s ruling. Just weeks after the Dobbs decision, the Department of Health and Human Services (HHS) issued a letter requiring all pharmacies that serve patients with Medicare, Medicaid, or other federally funded coverage to stock and dispense chemical abortion drugs.
HHS cited the Affordable Care Act (ACA) and disability rights laws as the legal basis for this pharmacy mandate. In reality, the ACA explicitly rejects this interpretation, stating that nothing in the law “shall be construed to preempt or otherwise have any effect on State laws regarding the prohibition of (or requirement of) coverage, funding, or procedural requirements on abortions.” And disability rights laws have never mandated abortion drugs.
Texas and Kevin challenge Biden-era HHS rules
In Texas, multiple laws protect unborn life, so the state filed a lawsuit against the Biden administration for illegally attempting to preempt its laws and force pharmacies to dispense chemical abortion drugs.
But the Biden administration’s pharmacy mandate didn’t just affect states like Texas; it also applied to private pharmacies across the country. That’s where Kevin Martian and Mayo Pharmacy came in. If any pharmacies that received Medicare and Medicaid payments declined to dispense chemical abortion drugs to end innocent lives, the Biden administration threatened to take legal action against them.
In February 2023, Mayo Pharmacy joined Texas’s lawsuit to defend Kevin’s right to operate Mayo in line with his religious beliefs. And in July 2023, the federal court rejected the Biden administration’s motion to dismiss the case, agreeing with Texas and Mayo Pharmacy that the mandate requires dispensing abortion drugs in an attempt to circumvent Dobbs, and that federal agencies cannot avoid judicial review of that mandate.
Subsequent to this ruling, HHS then partially removed its pharmacy abortion guidance in response to pressure from Kevin’s case. This led to the dismissal of the case in 2024. Later, in January 2026, the Trump administration’s HHS rescinded the unclear guidance.
“We are grateful to the Trump administration for rescinding Biden-era guidance that forced Americans to dispense abortion-inducing drugs against their conscience,” said ADF Senior Counsel Matt Bowman. “The Biden administration’s HHS had issued its pharmacy abortion mandate in 2022 and partially changed it after a court ruled in favor of religious pharmacies in 2023. But the guidance it left in place still subjected pro-life pharmacies across the country to a looming threat from federal bureaucrats. Now, we are grateful to the current administration for eliminating the remnants of this Biden-era abortion mandate by repealing it entirely. HHS’s decision will protect our former client and pharmacies around the country who are fully within their rights to decline to stock or dispense abortion drugs.”
What’s at stake?
The Biden administration had twisted federal law and trampled state laws by attempting to force pharmacies to dispense chemical abortion drugs even after the Supreme Court’s clear ruling in Dobbs. Not only that, it was also violating the Constitution by trying to force private pharmacies and their owners to prescribe drugs for purposes that conflict with their beliefs.
Americans are free to exercise their religious beliefs without government interference, and the Biden administration had no right to mandate abortion nationwide.
Pharmacies should not be subject to illegal abortion mandates from federal agencies.
State of Texas and Mayo Pharmacy v. Becerra
- January 2026: The HHS, under the Trump administration, rescinded the unclear guidance on whether pharmacists are required to keep harmful abortion drugs in stock and dispense them.
- July 2022: The Biden administration issued a mandate attempting to force pharmacies nationwide to dispense chemical abortion drugs.
- February 2023: ADF attorneys filed an amended complaint adding Mayo Pharmacy to a lawsuit Texas had filed against the Biden administration’s pharmacy abortion mandate.
- July 2023: The court denied the Biden administration’s motion to dismiss, ruling that the pharmacy abortion mandate is subject to judicial review and Texas and Mayo Pharmacy can litigate their Administrative Procedure Act claims.
- September 2023: After the court’s ruling, the HHS partially removed its pharmacy abortion guidance in response to pressure from Kevin’s case.
- January 2024: ADF attorneys presented oral arguments at the U.S. District Court for the Western District of Texas, Midland-Odessa Division.
- April 2024: A federal district court dismissed the case as moot, affirming that HHS’s new guidance doesn’t require pharmacies to dispense abortion drugs or violate their religious beliefs.
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