Texas Ban Collides with Out-of-State Providers as Abortion Pills Keep Flowing

Although Texas has implemented some of the strictest abortion laws in the country, out-of-state providers continue to mail abortion pills to Texans, creating a legal standoff that could eventually reach the U.S. Supreme Court.

As reported by The Austin Chronicle, organizations such as Plan C, Her Safe Harbor (Delaware), and an affiliate of Aid Access (California) are actively mailing abortion-inducing medications to Texas residents. These providers are operating from states with so-called “shield laws,” which protect health care workers who provide legal services in their home states, even if those services are illegal elsewhere.

The gray area between Texas’s new abortion ban and out-of-state laws limits the ability of Texas officials to take legal action against providers operating from states like New York, California, and Washington. According to The Austin Chronicle, these shield laws allow for the continuation of telehealth-based abortion care, even in states with near-total bans.

On August 14, Texas Attorney General Ken Paxton sent letters to multiple out-of-state organizations mailing abortion pills to Texas, urging them to desist. He warned that noncompliance could result in civil penalties of at least $100,000 per violation under Texas law.

However, officials like New York Attorney General Letitia James have pushed back. “Texas has no authority in New York, and no power to impose its cruel abortion ban here,” James wrote in a statement. “Our shield law exists to protect New Yorkers from out-of-state extremists.”

Under Texas law, abortion is banned in nearly all cases, and a new piece of legislation, House Bill 7, extends enforcement powers. HB 7 creates a “civil liability” system allowing private citizens to sue anyone who “manufactures, distributes, mails, transports, delivers, prescribes, or provides” abortion medication to a Texan. The law specifically names misoprostol and methotrexate, two commonly used medications in abortion care.

“It will fuel fear among manufacturers and providers nationwide, while encouraging neighbors to police one another’s reproductive lives,” said Blair Wallace of the American Civil Liberties Union of Texas, in comments to The Austin Chronicle.

Medication abortion remains the most common method of abortion in the U.S. According to data from the Society of Family Planning, 63% of abortions now occur via medication. Since 2022, the number of abortions provided through telehealth services has increased, with an average of 12,330 abortions per month reported in 2024.

Nancy Northup, president of the Center for Reproductive Rights, noted that for many Texans, telehealth has become the only viable option. “For the many women who are unable to leave Texas for abortion care, using telehealth to get abortion pills has been a lifeline,” she said, as reported by The Austin Chronicle.