Fast Facts Medicaid programs that cover prescription drugs are generally required to cover drugs that are (1) FDA approved and (2) made by a manufacturer that participates in the Medicaid Drug Rebate Program. 13 Medicaid programs didn’t cover Mifeprex and its generic equivalent, Mifepristone Tablets, 200 mg, when required. These drugs are used for medical abortion. We recommended the Centers for Medicare & Medicaid Services ensure Medicaid programs comply with federal requirements for covering Mifepristone Tablets, 200 mg. We also reiterated our 2019 recommendation on Mifeprex, which hasn’t been implemented. White pills spilling from a pill bottle. Skip to Highlights Highlights What GAO Found Medicaid programs that choose to cover outpatient prescription drugs are required to cover all Food and Drug Administration (FDA) approved drugs for their medically accepted indications when those drugs are made by a manufacturer that participates in the Medicaid Drug Rebate Program (MDRP), except as outlined in federal law. The FDA has approved two drugs—Mifeprex in 2000 and its generic equivalent in 2019, referred to as Mifepristone Tablets, 200 mg—for the medical termination of an intrauterine pregnancy, known as a medical abortion. Danco Laboratories and GenBioPro are the exclusive manufacturers of Mifeprex and Mifepristone Tablets, 200 mg, respectively, and both manufacturers participate in the MDRP. Medicaid programs in all 50 states, the District of Columbia, and Puerto Rico cover prescription drugs and participate in the MDRP. According to officials from the Centers for Medicare & Medicaid Services (CMS)—the federal agency within the Department of Health and Human Services (HHS) responsible for ensuring Medicaid programs’ compliance—none of the MDRP’s statutory exceptions apply to Mifeprex or Mifepristone Tablets, 200 mg. Thus, these 52 Medicaid programs must cover these drugs when prescribed for medical abortion in circumstances eligible for federal funding, such as when the pregnancy is the result of rape or incest. GAO identified gaps in Medicaid programs’ coverage of Mifeprex and Mifepristone Tablets, 200 mg. Officials from 35 of the 49 programs who responded to GAO questions said their programs covered Mifeprex and Mifepristone Tablets, 200 mg for medical abortion, as of December 31, 2024. In contrast, officials from 13 programs told GAO their programs did not cover either drug for medical abortion. An official from the remaining program did not specify the medical indications for which its program covered the drugs. Medicaid Programs’ Coverage of Danco Laboratories’ Mifeprex and GenBioPro’s Mifepristone Tablets, 200 mg, as of December 31, 2024 Note: For more details, see fig. 1 in GAO-25-107911. State officials’ responses to GAO’s questions indicated that some states may not be complying with the MDRP requirements for covering Mifeprex and Mifepristone Tablets, 200 mg. However, CMS has not determined the extent to which states comply with the MDRP requirements for these drugs. CMS officials told GAO they were not aware of the following: Nine programs did not cover Mifeprex and Mifepristone Tablets, 200 mg for any medical indication, as of December 31, 2024; GAO reported four of these programs did not cover Mifeprex in 2019. Mifepristone Tablets, 200 mg was not available at the time of GAO’s 2019 report. Four additional Medicaid programs did not cover either drug when prescribed for medical abortion, as of December 31, 2024. CMS was not aware of these coverage gaps, in part, because it had not implemented GAO’s 2019 recommendation to take actions to ensure Medicaid programs comply with MDRP requirements to cover Mifeprex. CMS also has not taken actions related to the coverage of Mifepristone Tablets, 200 mg, as of August 2025. Without such actions, CMS lacks assurance that Medicaid programs comply with MDRP requirements and Medicaid beneficiaries may lack access to these drugs when appropriate. Why GAO Did This Study GAO was asked to describe Medicaid programs’ coverage of mifepristone. This report examines Medicaid programs’ coverage of Mifeprex and Mifepristone Tablets, 200 mg, among other things. GAO reviewed laws and CMS guidance on the MDRP, and coverage of Mifeprex and Mifepristone Tablets, 200 mg. GAO also sent written questions to officials from the 52 Medicaid programs that participate in the MDRP regarding their coverage of these drugs, and reviewed officials’ responses from the 49 programs that provided GAO information. Recommendations GAO reiterates its 2019 recommendation that CMS take actions to ensure states’ compliance with MDRP requirements to cover Mifeprex. GAO also recommends that CMS determine the extent to which states comply with federal Medicaid requirements regarding coverage of GenBioPro’s Mifepristone Tablets, 200 mg, and take actions, as appropriate, to ensure compliance. In response to the recommendation, HHS noted it is reviewing applicable law and will determine the best course of action to address it moving forward. Recommendations for Executive Action Agency Affected Recommendation Status Centers for Medicare & Medicaid Services The Administrator of CMS should determine the extent to which states comply with federal Medicaid requirements regarding coverage of GenBioPro's Mifepristone Tablets, 200 mg, and take actions, as appropriate, to ensure compliance. (Recommendation 1) Open Actions to satisfy the intent of the recommendation have not been taken or are being planned. When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information. Full Report Full Report (11 pages)

Australia to lead first-ever United Nations indoor air quality global pledge September 18, 2025 The Australian Academy of Science and Burnet Institute are leading global efforts at the United Nations, to declare healthy indoor air a human right. More than 300 leaders will come together to make history at the high-level event taking place on the sidelines of the 80th UN General Assembly on 24 September (AEST). The UN event is being co-sponsored by France and Montenegro. Brown University’s School of Public Health and the OSLUV Project are joint co-convenors alongside the Academy and Burnet Institute. The global pledge, already signed by over 150 organisations, is the first international effort to formally recognise clean indoor air as essential to health and well-being. Chief Executive of the Australian Academy of Science, Anna-Maria Arabia OAM, said the Academy is proud to be collaborating with global leaders at the UN to galvanise global action to improve indoor air quality. “The science of indoor air quality is well understood and the solutions to address poor air quality are available. Political leadership is required to prioritise action that will make every workplace safer and healthier, and that will better prepare Australians when bushfires and pandemics impact our country,” Ms Arabia said. This effort builds on the Academy’s sustained advocacy to reduce the negative impacts of airborne transmission of viruses and pollutants in indoor spaces. Most recently, the Academy’s submission to the Productivity Commission’s review recommends establishing indoor air quality standards, underpinned by guidelines aligned with World Health Organization recommendations. Such measures can improve overall health, reduce absenteeism and improve performance in childcare settings, schools, hospitals, aged care settings, and all workplaces. “If you don’t measure it, you can’t fix it. The collective cost of inaction in loss of health and productivity is in the billions in Australia alone,” said Ms Arabia. The Australian delegation to the UN event includes Academy Fellow Professor Lidia Morawska FAA, Director, Thrive - Queensland University of Technology, and Professor Bronwyn King AO, Special Advisor – Clean Air at Burnet Institute, who conceived the idea for the UN side event. Professor Morawska recently questioned why Australian schools have lower standards for air quality monitoring, ventilation and filtration than many greenhouses and pet shelters. “Indoor air quality is a glaring gap in Australia’s approach to public health. A nationally coordinated process of reform is required to ensure all Australians receive the benefits of cleaner indoor air,” Professor Morawska said. Professor King said Australians spend 90% of their time indoors, yet schools, hospitals, workplaces and transport are not guaranteed to have clean, healthy air. “In fact, indoor air is commonly found to be of poor quality, containing many hazards detrimental to health. The good news is that practical solutions already exist. Uplifting indoor air quality offers an extraordinary opportunity to improve health for all,” Professor King said. “This event will mark the first time the global indoor air community has convened at the United Nations, the rightful platform for such a crucial global issue that, if addressed, offers an extraordinary opportunity to improve health for all. Attention to indoor air quality is a gap in our public health frameworks. We need to close that gap.” The UN event will be livestreamed via UN Web TV from 3:30pm EDT 23 September/ 5:30am AEST 24 September. Partnering organisations