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Who is Matthew Kacsmaryk, the judge who suspended approval of the abortion pill mifepristone?

In a combined illustration, Matthew Kacsmaryk appears before the Senate Judiciary Committee, and a photo is shown of boxes of mifepristone.
Matthew Kacsmaryk at a Senate Judiciary Committee hearing in 2017; boxes of mifepristone. (Photo illistration: Yahoo News; photos: U.S. Senate via YouTube, Robyn Beck/AFP via Getty Images)

In an unprecedented ruling, a conservative federal judge in Texas on Friday further restricted abortion access nationwide by suspending the Food and Drug Administration’s approval of mifepristone, a widely used abortion drug that was approved over two decades ago.

The judge has decided to suspend the ruling for seven days, giving the Justice Department time to appeal the decision, which leaves the drug available on the market for the time being.

Judge Matthew Kacsmaryk, who was appointed by former President Donald Trump, ruled in favor of the plaintiffs Alliance Defending Freedom, a faith-based organization that has long sought to have abortion outlawed nationwide on the grounds it is harmful.

Pushing back on arguments that it was improper to allow a challenge to a medication that was approved decades ago by the FDA, Kacsmaryk wrote in the 67-page brief that “the FDA stonewalled judicial review,” claiming that the agency had “ignored” petitions from anti-abortion groups to revisit the approval of the abortion drug.

Mifepristone, in combination with a second abortion drug, misoprostol, has become the most common form of abortion in the U.S. It is also used in the treatment of miscarriages.

The delayed ruling could create a significant barrier for women who are seeking to terminate their pregnancies or manage miscarriages without a surgical procedure, even in states where abortion rights are protected.

Alliance Defending Freedom said in a tweet, “This is a significant victory for the doctors and medical associations we represent and more importantly, the health and safety of women and girls.”

Late on Friday, the Biden administration filed its notice of appeal to the U.S. Court of Appeals for the Fifth Circuit, which is considered one of the most conservative in the country.

Vice President Kamala Harris spoke to reporters at an airfield in Nashville, Tenn., on Friday about the judge’s decision, saying, “It is contrary to what makes for good public health policy to allow courts and politicians to tell the FDA what it should do.”

Immediately after Kacsmaryk’s ruling, U.S. District Judge Thomas Owen Rice, an Obama appointee in Washington state, countered the ruling in a separate lawsuit by ordering that the FDA keep the medication abortion pill on the market in 17 states and Washington, D.C., where Democrats sued to keep the pill.

The competing decisions mark some of the most significant abortion-related rulings, adding another layer of complexity to U.S. abortion laws, which vary by state after last year’s Supreme Court decision overturning Roe v. Wade. Before Kacsmaryk arrived on the federal bench, he had sharply criticized abortion.

Who is Judge Matthew Kacsmaryk?

He’s a federal judge for the Amarillo division of the United States District Court for the Northern District of Texas. He’s also the only judge in that federal district, guaranteeing that he will be the one who presides over cases that are filed there.

Trump nominated Kacsmaryk to the District Court in 2017. During his Senate confirmation hearings, Kacsmaryk asserted that he would be fair, separating his religious beliefs from his rulings.

“As a judge, I’m no longer in the advocate role,” Kacsmaryk said at the time. “I’m in the role of reading and applying with all good faith whatever Supreme Court and Fifth Circuit precedent is binding.”

He was confirmed in June 2019 by a Republican majority Senate by a vote of 52-46. Centrist Sen. Susan Collins of Maine was the only Republican who voted against Kacsmaryk’s appointment, citing his “alarming bias against LGBTQ Americans and disregard for Supreme Court precedents.”

Collins was referring to two articles he published in 2015 attacking same-sex marriage and abortion rights.

What have been some of Kacsmaryk's more recent rulings?

In November, Kacsmaryk rejected the Biden administration’s efforts to extend health care discrimination protections to LGBTQ people. His ruling found that a 2020 U.S. Supreme Court decision that bans workplace discrimination doesn’t apply to health care.

In December, Kacsmaryk sided with a Christian father who didn’t want his daughter to have access to birth control without his permission. The judge ruled that Title X, a federal program that provides low-cost or free and confidential contraception access, violated the “constitutional right of parents to direct the upbringing of their children.”

What was his upbringing?

Kacsmaryk, 45, was born in Gainesville, Fla., according to the Federal Judicial Center.

He grew up in the suburbs of Fort Worth, Texas, where religion played a key role in his family of born-again Christians. The family regularly attended West Freeway Church of Christ and were taught at an early age that abortion was wrong, his sister Jennifer Griffith told the Washington Post.

Griffith recalled that their mother was a microbiologist who began to question some of what she was taught after joining the church. She started working with anti-abortion crisis pregnancy centers.

According to the newspaper, Kacsmaryk’s anti-abortion beliefs were ingrained when he was a 22-year-old law student and one of his sisters, 17, became pregnant and chose adoption over abortion. Later on in life, he joined the organization that cared for his sister, Christian Homes and Family Services, and in 2016, became a trustee, according to public records.

How did Kacsmaryk's legal career get started?

Kacsmaryk attended Abilene Christian University, where he led the College Republicans student group. In a letter to the editor in his freshman year, he advocated for the rights of an unborn child, as reported by the Post. In the letter, he wrote, “The Democratic Party’s ability to condone the federally sanctioned eradication of innocent human life is indicative of the moral ambivalence undergirding this party.”

Kacsmaryk received his law degree from the University of Texas School of Law in 2003, and he started his legal career at Baker Botts LLP. He went on to become an assistant U.S. attorney in the Northern District of Texas.

In 2014, he joined First Liberty Institute, a conservative legal group focused on defending the rights of religious people. He represented the defendants in a high-profile case involving two Oregon bakers who refused to make a cake for a lesbian wedding.