A new federal rule change could make it easier for Alaskans to access medical abortions, especially in rural communities.
The Food and Drug Administration updated its regulations this month to allow abortion pills to be dispensed at chain and local pharmacies and through the mail.
"It definitely has the potential to expand abortion access in Alaska," said Rose O'Hara-Jolley, director with Planned Parenthood Alliance Advocates of Alaska. "Given the complexity with the health care system, it's not something that's going to happen right away. But this is another very important piece of the puzzle in expanding abortion access across the state."
Advocates and pharmacists reached for this story said the change will not be instantaneous: Individual pharmacies or chains would need to obtain special approval to dispense the medication, a process that can take months.
Not all pharmacies are required to seek that approval, and it's still not clear how many will. Alaskans will also still need to get a doctor's prescription to access a medical abortion.
But it's likely the change could be particularly significant in rural Alaska, where residents seeking abortions until now have been required to travel for in-person procedures at Planned Parenthood, the state's main abortion provider with clinics in Juneau, Fairbanks and Anchorage.
Several of Alaska's tribal health organizations and hospitals, which often act as a primary medication dispenser for many communities off the road system, declined to speak to how the change could impact their patients.
But it's possible the change could allow Alaskans in more remote parts of the state to seek a telehealth appointment with a provider licensed to practice in the state and get a prescription for abortion pills, and have them delivered by mail instead of needing to travel to a clinic.
Abortion pills are already used in more than half of pregnancy terminations in the U.S. In Alaska most recently, it's closer to a third.
The FDA regulatory change reflects growing efforts by the Biden administration to increase access to abortion in the wake of a landmark Supreme Court decision last summer that stripped away the constitutional right to an abortion in the U.S., giving individual states the authority to enact their own laws.
Abortion access in Alaska
In Alaska, abortion services are still legal and protected by the state constitution under the privacy clause and several Alaska Supreme Court rulings.
But that could change if the constitution changes — something abortion opponents in the state have sought, either through an amendment or a constitutional convention.
Abortion has long been a controversial issue in Alaska. More recently, abortion access factored into debates on whether Alaska should call a constitutional convention, a question that appeared on November's ballot and was ultimately rejected when over 70% of Alaska voters voted against it.
Many Alaska Democrats ran on pro-abortion-rights platforms. Last spring, the Alaska House attempted to defund Medicaid abortion services despite court rulings requiring it.
Gov. Mike Dunleavy last year said he planned to introduce a resolution during this legislative session for a proposed constitutional amendment "to answer the question whether abortion shall, or not be a constitutionally protected right."
Dunleavy spokeswoman Shannon Mason said in an email that the governor is "still evaluating his legislative package for the upcoming session."
Sen. Shelley Hughes, a Palmer Republican, has prefiled Senate Joint Resolution 2, which would amend the state constitution to say, "To protect human life, nothing in this constitution may be construed to secure or protect a right to an abortion or require the State to fund an abortion."
Hughes has unsuccessfully proposed similar legislation in the past, and the resolution is unlikely to advance this year. Leaders of the bipartisan majority caucus in the Senate have said they plan to steer away from divisive legislation on social issues, including abortion.
John Coghill, a former longtime state senator who in 2016 sponsored legislation restricting late-term abortions, said he was not surprised by the FDA's latest regulation change, and that he'd continue to fight to limit access to abortion in Alaska.
"We knew this was coming," he said. "I think in Alaska, it's probably not going to change things dramatically because of our own Supreme Court, and its ruling on the right to privacy has made it very difficult for us to change that."
'Not like switching a light switch'
The latest rule change applies to mifepristone, the first pill used in a two-drug medical abortion. The Food and Drug Administration had previously allowed mifepristone to be dispensed only through certain clinics or medical providers' offices, or through a few select mail-order pharmacies. Now Alaskans will be able to send their prescriptions to most local and chain pharmacies that seek certification to do so.
Mifepristone, which blocks a hormone necessary for pregnancy development, is prescribed up to 13 weeks into a pregnancy. Misoprostol, the second pill, is already available at retail pharmacies.
The FDA last week also officially removed an in-person requirement from its regulatory rule book for mifepristone.
In Alaska, it's legal for patients to be prescribed abortion pills via telehealth appointment and then receive the pills by mail, Sylvan Robb, director of the state Division of Corporations, Business and Professional Licensing, said in an email.
But in practice, very few Alaska providers will give prescriptions via telehealth. Planned Parenthood does not currently prescribe abortion pills to pregnant people remotely, but the organization is currently working on making that service available.
Robb said physicians must be licensed to practice in Alaska to prescribe abortion pills to patients in the state.
While the changes will go into effect immediately, it's unclear how many pharmacies will adopt this change or how quickly, said Coleman Cutchins, Alaska's state pharmacist. Each will need to review and agree to an updated Risk Evaluation and Mitigation Strategies agreement that lays out how to safely prescribe and dispense a medication.
"It's not like switching a light switch," Cutchins said last week.
He said he expected most chain pharmacies would take the steps necessary to dispense the pills, but smaller pharmacies might be slightly less likely to because of the staffing required.
So far, both CVS and Walgreens have said they'll seek certification to dispense mifepristone.
Daily News reporter Iris Samuels contributed to this story.