U.S. Senator John Hickenlooper is renewing a call to repeal part of a 19th-century law that conservative activists have used to restrict medication abortion access in cities across the country.

“These extreme Republicans and dust-covered laws from 1873 should not be directing a women’s right to make her own health care decisions,” the Colorado Democrat said during a Wednesday virtual panel with Colorado OB-GYNs and reproductive health leaders.

Hickenlooper is a sponsor of the Stop Comstock Act, which would repeal the Comstock Act of 1873, a measure that outlaws the mailing of “lewd” and “indecent” material. Anti-abortion activists have sought enforcement of the dormant law to essentially enact bans on many abortions, including medication abortions where patients receive mifepristone and other drugs in the mail after consulting with a doctor. Mifepristone is also used in many miscarriage treatments.

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The federal tax break and spending cut bill signed into law by President Donald Trump last week cuts Medicaid reimbursements for Planned Parenthood — though that provision was temporarily blocked by a judge — and advocates worry that it could add strain to an already under-attack reproductive health system.

“We know that many of those people (on Medicaid) will not be able to seek care and other institutions or other avenues, and we know that places that are able to continue providing sexual health care are going to face increased demand and increased weight,” said Dr. Rebecca Cohen, a Colorado OB-GYN.

Pueblo City Council has voted twice since 2022 to oppose a proposed city ordinance that would have used the Comstock Act to restrict abortion access in the city. In October 2024, the council voted 4-3 to kill the ordinance before it moved to a final vote. If it had passed in Pueblo, it almost certainly would have been struck down due to Colorado’s Reproductive Health Equity Act.

“Abortion opponents have seized on the idea that the Comstock Act could be misused to ban the mailing of mifepristone and other drugs used in medication abortions,” Cobalt President Karen Middleton said.

Backers of the so-called “Sanctuary Cities for the Unborn” project have helped over 20 local governments, mostly in Texas, pass ordinances to ban abortion by enforcing the federal law, most recently Big Sandy in Texas with a population of about 1,300.

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Hickenlooper called the legislative effort a “marathon.” Republicans hold a 53-47 majority in the U.S. Senate and a 220-212 majority in the U.S. House of Representatives.

“The issue with this circumstance, like every circumstance, is there are a number of reasonable, moderate Republicans that have been pushed to the corner, and they are threatened with primaries with tens of billions of dollars against them if they violate anything that the White House is trying to push,” he said. “At some point, when we have a breakthrough election, this will be the kind of thing — all the debris that is accumulated from the Trump years — we’ll be able to clean it out.”

Melisa Hidalgo-Cuellar, the chair of the Cobalt Abortion Fund, said the organization has seen a nearly 1,200 percent increase in funding for people accessing care at telehealth-only clinics that mail abortion medication to patients. It can be difficult to travel to a brick-and-mortar clinic for people without reliable transportation, who don’t have child care or who live far from a physical clinic.

“You really see that people are opting for this because it’s a more convenient and affordable option for a lot of abortion seekers,” Hidalgo-Cuellar said.

Hickenlooper’s bill was assigned to the Senate Judiciary Committee when it was introduced.