With additional reporting from Carmen Paun

TOUGH PILL TO SWALLOW — When a federal judge ruled on Friday that the abortion pill mifepristone has to be pulled off shelves, he threw politicians, regulators and drugmakers into a state of chaos that’s persisted into this week. Congressional Democrats and at least one Republican are suggesting ignoring the ruling entirely. Over 300 pharmaceutical industry executives signed a letter protesting the decision. And experts say the Food and Drug Administration’s authority has been explicitly undermined.

Now, the clock is ticking for the Biden administration, which is intent on keeping the pill — which works in conjunction with misoprostol to induce an abortion — in circulation.

U.S. District Court Judge Matthew Kacsmaryk gave the White House a week until a nationwide ban goes into effect; the administration will appeal the ruling to the generally conservative Fifth Circuit Court, asking for a decision by this Thursday at noon. Since U.S. District Court Judge Thomas O. Rice also ruled Friday in Washington state that the FDA has a legal obligation to continue to allow mifepristone on the market, the conflicting rulings suggest a coming battle at the Supreme Court.

After paying a clear electoral price for the Dobbs decision last November, prominent Republicans have been mostly mum on Kacsmaryk’s decision. The only likely 2024 presidential contender to weigh in immediately was former Vice President Mike Pence, who said, “The FDA acted carelessly and with blatant disregard for human life and the well-being of American women, and [Friday’s] ruling fixed a 20-year wrong.”

To further break down the ruling and its implications on health and politics, Nightly spoke with POLITICO’s Megan Messerly, a health care reporter covering the decision. This interview has been edited.

What’s the practical impact of Judge Matthew Kacsmaryk’s decision?

Medication abortions will still be an option for patients — but they may be harder to access and result in more side effects.

Right now, mifepristone — the drug in question in this lawsuit — is used in conjunction with a second medication, misoprostol, to cause an abortion. Abortion pills are responsible for the majority of abortions in the U.S. and have taken on a key role in aiding abortion access in states where the procedure has been banned since the fall of Roe v. Wade last summer.

While abortions can be performed with just misoprostol — a common method in other countries — using just the one drug on its own does tend to lead to more side effects and has a slightly higher rate of patients requiring follow-up surgery.

It’s important to note, though, that mifepristone is still accessible right now. Kacsmaryk gave the Biden administration seven days to appeal the decision before it takes effect. But if the appellate court does not intervene, access to mifepristone will be blocked until the case is resolved. And, complicating matters, another federal judge in Washington state ruled in a separate case last week that the FDA can’t roll back access to mifepristone in the 17 states that filed that lawsuit.

So what happens next? And how will that conflicting ruling in Washington state play into this week and the continued availability of mifepristone?

Even before the decision came down, some abortion providers announced that they were making preparations to switch to the one-dose regimen if mifepristone were to become unavailable. But not all abortion clinics may be able to change their protocols that quickly.

At the same time, three states with Democratic governors — California, Massachusetts and Washington — have announced that they have secured stockpiles of mifepristone to ensure the two-dose regimen can continue in their states, and other states have indicated that they are exploring their options.

But there’s no getting around the legal uncertainty here: The Washington and Texas rulings are in conflict, and the assumption is that this issue will likely eventually make its way to the Supreme Court. And while Kacsmaryk’s decision was restricted to mifepristone, there’s some thought among legal experts that this could just be the tip of the iceberg and we could see other attempts to challenge the FDA’s approval of vaccines or other drugs.

In the wake of the Supreme Court’s Dobbs ruling, the political ramifications of this ruling are enormous. How have the two parties reacted?

The response to Friday’s decision has, not surprisingly, mirrored the way we’ve generally seen Republicans and Democrats talk about this issue over the last 10 or so months. Democrats continue to see talking about abortion as a critical political opportunity — the results of the Wisconsin Supreme Court election last week proved the issue remains as salient as ever as we creep up on the one-year anniversary of the Dobbs decision — so it’s no surprise that we saw a litany of Democratic lawmakers and governors immediately pounce on the decision and spring into action.

Republicans, by contrast, have been pretty quiet, which, again, parallels the way we saw the GOP talk about the issue during the midterms — that is to say, not very much. It’s a difficult issue for Republicans who have seen, based on polling, that a large majority of people believe medication abortion should remain legal, and that even most members of their party support some, limited access to abortion.

Perhaps the most interesting thing about the overall lack of reaction from Republicans is that it flies in the face of what anti-abortion groups have been urging them to do: talk about the issue more.

Some lawmakers have suggested publicly that the FDA should simply ignore Kacsmaryk’s decision. What would that look like in practice, and how surprising might such a move be?

The FDA could issue guidance saying it will use its enforcement discretion to choose to not go after companies that distribute mifepristone. But doing so poses a couple of problems. One, it’s not clear that would be enough legal assurance for manufacturers, abortion clinics or doctors fearful of prosecution. And two, the FDA under a new administration could change its mind and start prosecuting over abortion pills.

At this point, it would be surprising for the FDA to take such a move — just because the Biden administration has signaled it wants to take a more cautious, wait-and-see approach, with litigation in its early days — but some attorneys are still urging the administration to move in that direction.

Do you have a sense of the timeline? How soon could this issue come before the Supreme Court and be decided?

If the conservative-leaning 5th U.S. Circuit does not grant the Biden administration its requested stay by Friday, it’s likely the FDA will immediately appeal to the Supreme Court and ask it to block Kacsmaryk’s ruling as litigation continues. If the Supreme Court denies that request, mifepristone will lose its FDA approval until the case is resolved.

At the same time, the Washington state case may also be appealed — to the more liberal-leaning 9th U.S. Circuit. If the outcomes of both cases continue to conflict at the appellate level, it’s likely the issue will eventually wind up before the Supreme Court.

Welcome to POLITICO Nightly. Reach out with news, tips and ideas at [email protected]. Or contact tonight’s author at [email protected] or on Twitter at @calder_mchugh.

— Casey running for Senate reelection: Sen. Bob Casey will run for reelection in 2024, the Pennsylvania Democrat announced today. Casey’s decision to seek a fourth term in a critical swing state is welcome news to Senate Democrats, who face a difficult electoral map next year that puts them on defense in 23 states. Casey has over $3 million in cash in his campaign coffers, according to his latest FEC filings.

— Nashville Council reinstates exiled Tennessee lawmaker: Ousted Tennessee state Rep. Justin Jones is headed back to the statehouse after the Nashville Metro Council overwhelmingly voted to reinstate the freshman Democrat to his former seat. Jones will return to the state legislature immediately following his reinstatement.

— Four killed in shooting at downtown Louisville building: A shooting today at a bank in downtown Louisville killed at least four people and wounded at least eight others, police said. The suspected lone shooter was also dead. The shooting, the 15th mass killing in the country this year, comes just two weeks after a former student killed three children and three adults at a Christian elementary school in Nashville, about 160 miles to the south.

— Biden eyes seasoned Dem operative to be State spokesperson: Matthew Miller, a veteran Democratic communications operative, is the top contender to be the spokesperson for the State Department, according to three people familiar with the matter. Miller led the effort to confirm Antony Blinken to be secretary of State earlier in the Biden administration and had a more recent stint last year as a special advisor to the National Security Council at the White House to lead communications and legislative work on the Ukraine invasion.

— Trump appeals order for Pence to testify in Jan. 6 probe: Donald Trump has appealed a judge’s order requiring his former vice president, Mike Pence, to testify to the grand jury probing the effort to subvert the 2020 election, reports POLITICO’s Kyle Cheney. Trump’s appeal, filed under seal, was lodged on the court docket this morning. The former president had challenged the bid by special counsel Jack Smith to compel Pence’s testimony earlier this year, claiming it would intrude on conversations protected by executive privilege.

FAILURE TO LAUNCH — In the span of a week, Nikki Haley, former United Nations ambassador, campaigned at the U.S.-Mexico border, complained that “no one is talking about” immigration because of the focus on Trump’s “political drama.” Former Secretary of State Mike Pompeo’s trip to Ukraine was reduced to a blip on the media landscape, while Gov. Ron DeSantis avoided the spectacle and instead revived his war with Disney. The Republican presidential primary was always expected to revolve around Trump. But post-indictment, as Republicans rally to his defense — including, crucially, conservative talkers on Fox News — Trump’s opponents are confronting an even more damaging dynamic in race: Their inability to break through at all, report POLITICO’s Sally Goldenberg and Natalie Allison.

UNOFFICIAL — POLITICO’s Myah Ward writes that President Joe Biden said today he plans to run again in 2024 but that he’s not ready to make it official, as questions continue to swirl about the timing of his reelection campaign. “I plan on running,” Biden told “Today” co-host Al Roker during a quick chat at the annual White House Easter Egg Roll. “But we’re not prepared to announce it yet.”

GRAIN GRIEVANCES — Farmers in countries neighboring Ukraine are pressuring their governments and the European Union to regulate grain exports from Ukraine that they say are putting them on the brink of bankruptcy, reports Carmen Paun for Nightly.

Romanian and Bulgarian farmers drove their tractors Friday to border crossings to protest Ukrainian grains flooding their markets and leaving them unable to sell their products above production costs.

“We want to be clearly understood that we’re not against Ukraine. But people are in such a difficult and bad situation” that they decided to go out in protest, said Alina Crețu, the executive director of the Romanian maize growers association APPR Forum.

Duty-free grains from Ukraine, one of the world’s biggest producers, are coming into Romania and other neighboring countries duty-free since the Russian invasion, Crețu said.

The European Commission, the EU’s executive arm which controls trade policy for the 27 EU members, lifted import duties to help Ukraine and to allow an easier transit of Ukrainian grains to countries in Africa and the Middle East that depend on them.

But some of them end up being bought in Romania, Bulgaria, Hungary or Poland, leading to a massive drop in prices, Crețu told Nightly. Ukrainian grains were up to 60 percent cheaper last summer than those produced in Romania, she said.

“For the neighboring countries this is a totally unfair competition, because there are no custom duties, even if it comes from a non-EU country, and is putting pressure on Romanian farmers, who followed the rules of the EU agriculture policy, and cannot compete with the Ukrainian products,” Crețu said.

Meanwhile, the prices to transport grains through Romania has increased substantially because of the high demand from Ukrainian producers. And things in the Romanian Black Sea port of Constanța “are crazy” because of the high amounts of grains coming from Ukraine that need to be shipped elsewhere, making it difficult again for Romanian grain exporters to ship their own products, Crețu said.

The European Commission offered some $61 million in compensation to farmers in Poland, Romania and Bulgaria. But the nearly $11 million allocated to Romania, which has nearly 25 million acres of agricultural land, “is absolutely offensive,” Crețu said, dismissing the amount as not nearly enough to cover farmers’ losses.

The solution is for the Romanian government to agree with Ukraine that grains produced in the war-torn country can transit Romania, but not stay in the country, and to designate separate land transport and shipping lanes for Romanian and Ukrainian grains, she said.

There’s already a model for it. The Polish and Ukrainian governments said Friday that Poland will temporarily stop all import grains from Ukraine and only allow their transit, days after the Polish agriculture minister resigned amid mass farmers’ protests on the issue.

SWIMMING IN CASH — As cities around the world deal with escalating water crises thanks to climate change, wealthy city-dwellers are still finding ways to fill their swimming pools, water their gardens and clean their cars. These behaviors, added up, are making water shortages worse. In Cape Town, South Africa, which reached “Day Zero” in which people were left without water for their basic needs in 2018, the wealthiest residents used on average 50 times more water than the poorest. And as urban water crises get more common, that gap could widen, according to new research. Damian Carrington reports for The Guardian.