Behind the anti-choice movement’s latest attempt to rig the game and attack reproductive freedom is the Alliance for Hippocratic Medicine (AHM)—a right-wing organization cooked up to push for a national backdoor ban on medication abortion. But how did a lawsuit from this cadre of extremists end up in front of an anti-choice judge in Amarillo, Texas, that could take away the most commonly used form of abortion care from people across the country, even in states where the right to abortion is protected?

Just days after voters resoundingly demonstrated in the midterms that they support reproductive freedom, anti-choice leaders brazenly maneuvered to thwart the will of the American people and undermine access to abortion care in Alliance for Hippocratic Medicine v. FDA. AHM filed an unfounded federal lawsuit in Amarillo seeking to revoke the FDA’s approval of mifepristone, one of two medications typically used in a medication abortion, despite the medication’s proven safety and effectiveness. However, AHM did not even exist until late 2021 and has a curiously short and checkered history. The anti-choice movement strategically designed and deployed AHM to carry out its baseless campaign to block access to mifepristone nationwide:

• Anti-choice groups—including the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), a group of anti-choice doctors founded to legitimize anti-choice policies and disinformation—previously filed citizens petitions challenging the FDA’s approval of mifepristone, which were denied. These groups built out AHM as an umbrella organization to pursue a medication abortion ban again, through a new channel. And the coalition—including AAPLOG, the American College of Pediatricians, the Christian Medical and Dental Associations, the Coptic Medical Association of North America, and the Catholic Medical Association—sought to game the system.
• Anti-choice groups zeroed in on the U.S. District Court for the Northern District of Texas Amarillo Division after scouting out a legal venue primed to deliver outcomes favorable to conservatives. In Amarillo, 95% of cases filed in federal district court are automatically assigned to Judge Matthew J. Kacsmaryk—an anti-choice, Trump-appointed judge with a record of extremist rulings on a range of fundamental rights, including reproductive freedom. Anti-choice leaders thereby sought to install AHM as a proxy in Amarillo to put their plan in motion. 
• AHM was deliberately engineered to execute anti-choice legal scheming and score Amarillo as a legal venue. The organization chose to incorporate in Amarillo, Texas, in August 2022, likely in an attempt to establish standing in this specific courtroom—even though it has a Tennessee mailing address and none of its member organizations are based in Texas. It largely operates in the shadows, with no digital footprint before November 2021 and a bogus website recently launched in 2023. AHM is a sham whose incorporation helped the anti-choice movement skirt the rules.
• AHM is working hand-in-hand with other anti-choice actors to eliminate abortion access. The individuals pulling the strings for AHM—including AHM’s registered agent in Amarillo who is a member of the Christian Legal Society and partner at her law firm, which shares an address with AHM—have a history of funding Republican campaigns. The Christian Legal Society filed an amicus brief in Dobbs v. Jackson Women’s Health Organization, urging the Supreme Court to overturn both Roe v. Wade and Planned Parenthood v. Casey. Christina Francis, the CEO-elect and previous chair of the board of AAPLOG, was listed as President of AHM. Furthermore, Alliance Defending Freedom, a Southern Poverty Law Center-designated hate group that drafted and defended Mississippi’s abortion ban in Dobbs, is representing AHM in Alliance of Hippocratic Medicine v. FDA.

The anti-choice movement’s extensive plotting behind Alliance for Hippocratic Medicine v. FDA constitutes a calculated attempt to ban medication abortion—and it tracks with the movement’s cruel and disciplined playbook. Because they know they don’t have majority support on abortion, the Republican Party and the Radical Right have long worked to control the courts and subvert our democracy. Trump and Mitch McConnell spent four years stacking the federal judiciary with ideologues like Kacsmaryk to advance their out-of-touch agenda of power and control. The Supreme Court leaks in Dobbs and Burwell v. Hobby Lobby Stores are proof that the anti-choice movement’s long campaign to influence the judiciary is working.

• The judicial arm of the anti-choice movement works from all angles to build influence within the courts: the Federalist Society—with which Kacsmaryk has been affiliated—trains and elevates the next generation of anti-choice lawyers and judges; the Judicial Crisis Network and the Judicial Education Project help fund efforts to install conservative ideologues in positions of influence within the federal judiciary, including the Supreme Court; Americans United for Life drafts model legislation designed to provoke specific legal challenges; and conservative legal organizations like Alliance Defending Freedom and the Thomas More Society file, argue, and work to deliver to conservative courts strategically chosen anti-choice cases.

On the precipice of Kacsmaryk handing down his ruling in a case devised and delivered by this well-funded, secretive anti-abortion network to eliminate medication abortion across the country, it is clear that the anti-choice movement’s schemes are putting the rights and freedoms we hold dear on the line like never before.