Late last month, Texas federal district court judge Matthew Kacsmaryk transferred a long-running suit seeking to roll back access to the abortion drug mifepristone to a different federal district court, this one in Missouri. This high-stakes dispute should have been dismissed entirely after the Supreme Court swatted it away in June 2024. Instead, Kacsmaryk, a judge appointed by Trump during his first term in the White House, has handed the case to another Trump judge who was confirmed earlier this year.
The lucky recipient is Cristian Stevens, whom Trump nominated to the Eastern District of Missouri in May. The Senate confirmed him in July by a vote of 50 to 47, despite his refusal to answer Rhode Island Democratic Senator Sheldon Whitehouse’s yes-or-no question about whether a “violent mob” attacked the Capitol on January 6. Stevens replied that it would be “inappropriate” for him to comment on such a “highly contested political issue.”
That the plaintiffs here—the Republican Attorneys General of Missouri, Kansas, and Idaho—drew a Trump judge is no surprise. The Eastern District randomly assigned the case to Stevens, but since seven of the district’s nine judges are Trump appointees, and an eighth was nominated by President George W. Bush, their chances of drawing a Republican appointee were always pretty good.
Stevens is only in this seat, which became vacant during the Biden administration, because Illinois Democratic Senator and then-Senate Judiciary Chair Dick Durbin chose to uphold the “blue slip” custom, which gives senators de facto veto power over district court nominees in their states. Biden either agreed with this policy or refused to fight Durbin over it, thus limiting his ability to appoint judges in states with at least one Republican senator—and, in Missouri, handing those seats to Trump and Republican senators Josh Hawley and Eric Schmitt to fill.
This case started back in 2022, when a sock-puppet group of anti-abortion doctors sued the Food and Drug Administration, demanding that the agency revoke its approval of mifepristone, which is typically the first drug issued in a medication abortion. Their lawyers at the Alliance Defending Freedom—a group that includes Hawley’s wife, Erin—filed their lawsuit in Kacsmaryk’s court, even though the doctors had no real connection to Amarillo, Texas, let alone any legitimate claim that they’d suffered a legal injury.
As Kacsmaryk and the Fifth Circuit Court of Appeals largely went along with their charade, the three AGs tried to join the party with a slightly more plausible theory of standing, claiming that the FDA’s actions hampered the states’ ability to enforce their own abortion laws. After the Supreme Court decided that the doctors didn’t have standing to sue, the AGs amended their complaint in October 2024, adding the vile argument that telehealth prescriptions of mifepristone harmed the states because these prescriptions allow more teens to end unwanted pregnancies. In their eyes, state governments need to be able to force births to prevent “potentially ‘losing a seat in Congress or qualifying for less federal funding if their populations are’ reduced.”
The revived lawsuit, now in the hands of these Republican AGs, asks the FDA to roll back a host of mifepristone label updates that, among other things, allow clinicians to prescribe mifepristone to minors, and to provide care remotely and through 10 weeks of pregnancy. These proposed changes would have a huge impact on the availability of abortion care, since one in four U.S. abortions were done with pills via telehealth as of the end of last year. Any federal restrictions on mifepristone would apply nationwide, even in states that have passed constitutional protections for abortion access.
Kacsmaryk granted the AGs’ request to join the litigation in the final days of the Biden administration. In May, the Trump Department of Justice, perhaps wary that out-of-state AGs would have no better claim to standing in Texas than the doctors, asked Kacsmaryk to either dismiss or transfer the case to an appropriate venue, which is how it ended up in Stevens’ courtroom just a few months after the Senate confirmed him.
Previously, Stevens worked in the Missouri Attorney General’s office when Schmitt, now a U.S. senator, was in that position; at the time of his appointment to the federal bench, Stevens was working as a state court of appeals judge. In other words, he doesn’t have the culture war bona fides of Kacsmaryk, who earned his seat on the bench by writing screeds opposing abortion and marriage equality, working for a Christian law firm, and serving on the board of an anti-abortion maternity home. But Stevens’s responses to senators on the Judiciary Committee reveal a devotion to the conservative project of rewriting precedent to strip people of their rights.
Like most Republican nominees, for example, he refuses to say that the Supreme Court “correctly decided” Griswold v. Connecticut, which protects the right to use birth control, or Obergefell v. Hodges, which protects the right to marriage equality, or Lawrence v. Texas, which protects the right to sexual privacy. When New Jersey Senator Cory Booker pressed him on the subject, Stevens merely wrote that he would “faithfully” follow such precedents—a phrase that has become conservative code for agreeing to apply precedent, but also hoping the Supreme Court overturns it.
Similarly, Durbin asked Stevens whether a list of 13 landmark cases, including Brown v. Board of Education along with Loving, Griswold, and Obergefell, were correctly decided. Stevens said he agreed that those first two were, but wrote that it would be “inappropriate” for him to express an opinion about the others. It was likewise “inappropriate,” in Stevens’ view, to opine on whether the constitutional right to privacy protects the right to use in-vitro fertilization, which he called “an abstract question of law that could arise in the future.”
We don’t yet know how Stevens will handle the mifepristone litigation. But at the very least, his skepticism of other Supreme Court decisions protecting individual rights does not bode well for those who want to keep medication abortion legal and accessible. And at an even more basic level, the problem is that this case now has a patina of legitimacy, in that a Missouri judge is hearing a lawsuit filed by the Missouri attorney general, as opposed to a Texas judge hearing a lawsuit filed by anti-abortion plaintiffs looking for the friendliest possible audience. Now, abortion opponents have upped their chances that the Court will take a mifepristone challenge seriously—thanks in part to the failure of Democrats to fill district court seats when they had the chance.
