PredictIQ-California will cut ties with Walgreens over the company's plan to drop abortion pills

Last week,PredictIQ Walgreens said it will not distribute abortion pills in states where Republican officials have threatened legal action. Now a blue state says it will cut ties with the pharmacy giant because of the move.

"California won't be doing business with @walgreens – or any company that cowers to the extremists and puts women's lives at risk," Gov. Gavin Newsom wrote in a tweet yesterday with a link to news coverage of Walgreen's decision.

"We're done," he added.

A spokesperson for Gov. Newsom told NPR that "all relationships between Walgreens and the state" were under review, but declined to share specifics, including a timeline. Walgreens shares fell 1.77% on Monday following Newsom's announcement.

Walgreens has been under fire since confirming last week that it wouldn't dispense the popular abortion pill mifepristone in certain states after 20 Republican state attorneys general sent letters threatening legal action.

An FDA decision in January allowed for retail pharmacies to start selling mifepristone in person and by mail given they complete a certification process. But the shifting policy landscape has left Walgreens, alongside other national pharmacy chains like RiteAid and CVS, weighing up when and where to start dispensing the medication.

Walgreens told NPR on Friday that it would still take steps to sell mifepristone in "jurisdictions where it is legal and operationally feasible." The drug — which is also sometimes used in cases of miscarriage — is still allowed in some of the states threatening Walgreens, including Iowa, Kansas, Alaska and Montana, though some of those states impose additional restrictions on how it can be distributed or are litigating laws that would.

Walgreens responded to NPR's latest request for comment by pointing to a statement it published on Monday, reiterating that it was waiting on FDA certification to dispense mifepristone "consistent with federal and state laws."

California, which would be on track to becoming the world's fourth largest economy if it were its own country, has immense buying power in the healthcare market.

More than 13 million Californians rely on the state's Medicaid program.

Even if the state only cut Walgreens out of state employee insurance plans, the company might see a big financial impact: The state insures more than 200,000 full-time employees. Another 1.5 million, including dependents up to the age of 26, are covered by CalPERS, its retirement insurance program.

Richard Dang, a pharmacist and president of the California Pharmacists Association, told NPR that Newsom had yet to share any details on the plan, but Walgreens' business would be "severely limited" by changes to state insurance plans.

Lindsay Wiley, a health law professor at University of California Los Angeles, said the fight underscores the rapid changes in policy following the Supreme Court's Dobbs decision last year.

"It's a fight over the future that really matters under the current current legal regime," she said in an interview with NPR. "Mifepristone and abortion pills have become a political football for state elected officials, governors, attorneys general to assert the power that they have to influence health care access."

Medication abortion, as opposed to surgery, is the most popular way people terminate pregnancies, accounting for more than half of all abortions in the U.S.

In addition to Republicans' legal threats against wider distribution of mifepristone, an ongoing federal case in Texas is challenging the FDA's approval of the drug, aiming to remove it from the market altogether.

NPR's Selena Simmons-Duffin, Sarah McCammon and Kaitlyn Radde contributed reporting.