As Texas attorney general, Ken Paxton sued in July 2022 to block federal guidance that protected doctors who perform an abortion to stabilize a patient in an emergency, and he won: a federal appeals court affirmed the ruling in January 2024. ProPublica has documented pregnant Texas women who died without what experts said was appropriate emergency care, and Paxton did not respond to its questions about them.
Paxton also defended Texas's six-week abortion ban at the Supreme Court in 2021, led a multistate brief asking the Court to overrule Roe v. Wade, fought in December 2023 to stop Kate Cox from ending a pregnancy with a fatal fetal diagnosis, and became the first attorney general to criminally prosecute a provider under an abortion ban. He has sued doctors in other states who mail abortion pills to Texans and ended San Antonio's abortion travel fund.
Ken Paxton's Lawsuits, Prosecutions and Statements on Abortion
- Paxton Won a Lawsuit That Blocked Federal Emergency-Abortion Guidance in Texas. On July 14, 2022, Ken Paxton sued the Biden administration over guidance telling hospitals that federal emergency-care law protects doctors who perform an abortion to stabilize a patient, saying it would "transform every emergency room in the country into a walk-in abortion clinic." A federal judge sided with him in August 2022, and the Fifth Circuit affirmed the decision in January 2024. ProPublica reports that the win kept the federal government from enforcing its emergency-care interpretation in Texas and gave Idaho's ban "a lifeline" in court. Once Idaho could enforce its ban, its largest hospital system, St. Luke's, said it had to airlift six patients out of the state for abortions in three months. After Trump took office, his administration dropped the suit and rescinded the EMTALA guidance in June 2025. In Texas, ProPublica has identified Tierra Walker and at least two other pregnant Texas women who died without what experts said was appropriate emergency care.
- Paxton Defended Texas's Six-Week Abortion Ban at the Supreme Court in 2021. When abortion providers challenged Senate Bill 8, Texas's 2021 law banning abortions after about six weeks, Ken Paxton's office told the Supreme Court that "there is nothing for a federal court to enjoin" because only private citizens could enforce it. On December 10, 2021, the Court held that the providers could not sue him to block the law. The law remained in effect, becoming the first enforceable six-week ban under Roe, and Idaho and Oklahoma passed similar laws. Dr. Sam Dickman, who worked at a San Antonio Planned Parenthood, told ProPublica he had to change the medicine he practiced or leave the state, and he moved to Montana.
- Paxton Led a Multistate Brief Asking the Supreme Court to Overrule Roe v. Wade in 2021. In July 2021, Ken Paxton's office led a multistate friend-of-the-court brief in Dobbs v. Jackson Women's Health Organization, with his name on the cover, arguing that "The Court should overrule Roe and Casey." On June 24, 2022, the Supreme Court ruled that "Roe and Casey are overruled." A Texas abortion ban that went into effect shortly after the ruling threatens doctors with up to 99 years in prison, ProPublica reports.
- Paxton Fought to Stop Kate Cox From Ending a Pregnancy With a Fatal Diagnosis in 2023. On December 7, 2023, after a Travis County judge ruled that Kate Cox could end a pregnancy with a fetus diagnosed with trisomy 18, Ken Paxton petitioned the state's highest court to halt the ruling and sent letters to three hospitals threatening legal action if they allowed the abortion to be performed at their facility. Cox was 20 weeks pregnant and had already had two cesarean sections, and her doctor argued that continuing the pregnancy could imperil her ability to get pregnant again. The Texas Supreme Court agreed with Paxton and reversed the lower court's ruling, and by that time Cox had sought an abortion out of state. "We saw in my case that Texas will go after doctors," Cox told ProPublica.
- Paxton Ended San Antonio's $100,000 Abortion Travel Fund in January 2026. In April 2025, the day after the San Antonio City Council put $100,000 into a Reproductive Justice Fund to help residents travel out of state for abortions, Ken Paxton sued the city. A state appeals court blocked the payments in June 2025, and on January 9, 2026 Paxton announced a settlement that ends the fund. The fund covered travel for out-of-state abortions for San Antonio residents, and the Legislature then followed Paxton's suits against Texas cities with a law banning such funding, ProPublica reports.
- Paxton Sued Doctors in New York, Delaware and California Over Abortion Pills Mailed to Texans. In December 2024, Ken Paxton sued Dr. Margaret Carpenter, a New York physician he accused of mailing abortion pills to a 20-year-old woman in Collin County, and won by default when she did not respond. In 2026 he filed two more civil suits, against Debra Lynch, a Delaware-based nurse practitioner, on January 27, and against a network that ships abortion drugs into Houston, San Antonio and Dallas, on February 24. Texas was unable to collect on more than $100,000 in civil fines and court fees from Carpenter because a New York clerk invoked that state's shield law,. Dr. Jennifer Villavicencio, an abortion provider, told ProPublica she has felt compelled to move her family twice to states with strong shield laws, partly out of concern that Paxton is creating a blueprint for targeting providers like her.
- Paxton Challenged the VA Rule That Allowed Abortion Care for Veterans. On December 22, 2022, Ken Paxton sent a letter challenging the Department of Veterans Affairs rule that made abortions and abortion counseling available for certain veterans, and on February 7, 2023 he joined a Mississippi-led amicus brief supporting an injunction against it. Under Secretary Doug Collins, the VA later issued a final rule, effective January 30, 2026, to reinstate the exclusions on abortions and abortion counseling from the medical benefits package. It ended a policy that allowed VA medical personnel to conduct abortions in cases of rape or incest and now prohibits the procedure at VA medical facilities unless the life of the mother is endangered.
- Paxton Brought the First Criminal Abortion Case by a State Attorney General. On March 17, 2025, Ken Paxton announced the arrest of Maria Margarita Rojas, who ran clinics in Waller and the Houston area, and he is the first and so far the only attorney general to criminally prosecute a provider in his state for violating an abortion ban. She is charged with practicing medicine without a license and violating the ban, and she has pleaded not guilty. Paxton moved to shut down her clinics, which catered to low-income, Spanish-speaking patients, while the case proceeds. An appeals court in summer 2026 overturned the order shuttering the clinics, and Paxton said he is appealing; no trial has been scheduled.
- As a State Senator, Paxton Co-Sponsored a 20-Week Abortion Ban. Ken Paxton served in the Texas Senate from 2013 to 2015, and a law he co-sponsored there banned almost all abortions after 20 weeks. ProPublica notes that similar 20-week bans had spread across the country as court rulings chipped away at Roe.
- Paxton Did Not Respond to Questions About Texas Women Who Died Without Emergency Care. Ken Paxton has not publicly commented on any of the deaths of pregnant Texas women who died without what experts said was appropriate emergency care and did not respond to ProPublica's questions about them, ProPublica reported on October 19, 2026. Tierra Walker's family sued Paxton in September 2026, alleging that Texas's abortion restrictions and her care led to her death, and he has not responded to the suit. Walker developed preeclampsia in San Antonio and died from it, and none of the 90 physicians involved in her care offered her the option of ending her pregnancy, even after she asked whether doing so might keep her safe.
What Ken Paxton's Abortion Record Means for Pregnant Texans
- Sepsis. After Texas's ban, the rate of sepsis shot up more than 50% for women hospitalized after losing a pregnancy in the second trimester, a 2025 ProPublica analysis found.
- Miscarriage care. Blood transfusions during emergency room visits for first-trimester miscarriage shot up by 54% in Texas after the ban, according to a separate ProPublica analysis in 2025.
- Deaths. Josseli Barnica arrived at a Houston hospital days after the six-week ban took effect, waited 40 hours for care while losing her pregnancy, and died days later of sepsis, ProPublica reported.
- Public opinion. In a January 2025 University of Houston poll of 1,200 Texans, 49% wanted state lawmakers to make it easier to get an abortion in Texas and 13% wanted to make it harder.
Frequently Asked Questions About Ken Paxton on Abortion and reproductive health
What is Ken Paxton's record on abortion and reproductive health under Trump?
Ken Paxton won a lawsuit that blocked federal emergency-abortion guidance in Texas, a ruling the Fifth Circuit affirmed in January 2024 before the Trump administration rescinded the guidance nationwide. He defended Texas's six-week ban, asked the Supreme Court to overrule Roe, tried to stop Kate Cox's abortion, and brought the first criminal abortion case by a state attorney general. He has also sued out-of-state doctors who mail pills to Texans and ended San Antonio's abortion travel fund, and he did not answer ProPublica's questions about Texas women who died without emergency care.
Did Ken Paxton try to stop Kate Cox from getting an abortion?
Yes. Ken Paxton asked the Texas Supreme Court to halt the December 7, 2023 ruling that let Kate Cox end her pregnancy, and the same day he warned three hospitals that the order did not protect them or her doctor from civil and criminal liability. Legal experts told ProPublica they had not seen another state attorney general take that step. Cox sought an abortion out of state.
What happened in Ken Paxton's lawsuit over emergency abortion care?
Ken Paxton's 2022 lawsuit against the federal emergency-abortion guidance succeeded, and the ruling also barred the federal government from pursuing cases against members of two anti-abortion medical groups that joined his suit. ProPublica reports that the Supreme Court has still not resolved whether the federal emergency-care law overrides state abortion bans, a question his litigation raised.
Is Ken Paxton prosecuting abortion providers in Texas?
Yes. Ken Paxton's office is prosecuting Maria Margarita Rojas, the first criminal case by a state attorney general under an abortion ban, and months after her arrest he announced the arrest and indictment of eight other clinic staff members. Rojas has pleaded not guilty, and the appeals court that overturned the order closing her clinics did not rule on whether she had performed illegal abortions.
Has Ken Paxton sued doctors in other states over abortion pills?
Yes. Ken Paxton sued New York physician Margaret Carpenter in December 2024 and, in 2026, providers in Delaware and California who mail abortion medication to Texas. A New York judge dismissed his case seeking to enforce the Carpenter judgment, and the attorneys general of Louisiana, Arkansas and Alabama have since copied his approach in a federal suit against out-of-state pill providers.
Last updated: 2026-10-25