In 2026, the biggest battles over abortion will not be at the polls.

There will be a few contested measures on state ballots. Next year, Nevada’s government will ask residents to approve constitutional protection for abortion rights for the second time, as required by state law. The same measure passed in 2024 with just over 64 percent of the vote.

Virginians will likely see a similar ballot initiative. In November 2025, voters there cemented a majority for Democrats in the state legislature, and the House of Delegates is expected to put forth an abortion rights ballot measure to voters in 2026.

Anti-abortion proponents in Missouri want to undo an amendment protecting abortion rights that voters passed in 2024. They’re advancing a new measure that could strip residents of the reproductive rights that are now constitutionally enshrined.

However, the most consequential questions about abortion in 2026 could be answered at the federal level, by the Trump administration or in the courts. As a scholar of reproductive health law, I’m watching how federal judges and agencies respond to conservative efforts to restrict or end people’s access to mailed abortion medication.

Over 25 years ago, the Food and Drug Administration approved mifepristone—one of two drugs commonly paired together to end a pregnancy. Since that time, medication abortion has been closely regulated by the FDA and is under attack.

In 2022, the Alliance for Hippocratic Medicine, a coalition of anti-abortion physicians, sued the FDA for approving mifepristone in 2000 and for each time the agency eased a restriction on mifepristone thereafter, in 2016 and 2021. The complaint argued that the FDA failed to consider evidence establishing the harm caused by medication abortion—claims roundly rejected by decades of rigorous, peer-reviewed research.

The Supreme Court in 2024 ruled that the Alliance for Hippocratic Medicine lacked standing to sue because FDA regulation of medication abortion caused no actual injury to the doctors it represented, who do not prescribe mifepristone or perform........

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