Just the Pill was supposed to revolutionize abortion care delivery. What happened?
I first interviewed Julie Amaon, a family medicine physician and then the medical director of Just the Pill, for a Rewire News Group story in summer 2022, only weeks after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.
In that interview, and in subsequent ones in July 2022, Amaon and Just the Pill’s founding executive director, Brooke Bailey, painted an exciting picture of an organization that was pioneering not only telemedicine abortion care, but mobile procedural abortion clinics–the first of their kind.
But on January 17, nearly three-quarters of Just the Pill’s staff were abruptly laid off. Four former employees, who asked to remain anonymous because they were concerned about their job prospects in the future, told me that although the organization had financial problems, the mass layoff was a shock. Amaon, the interim executive director of Just the Pill, informed me this week that Just the Pill is taking a “pause” for two weeks to revamp and restructure. The pause will last until the 17th of February. Amaon responded that the process was flawed but said all patients eventually received a response or, if necessary, a referral. She said that the crisis was more complex than financial difficulties and a challenging philanthropic environment. Former employees confirmed the same facts. Just the Pill’s operations never lined up with the image its leaders presented to the public, these employees said, alleging widespread internal issues that stemmed from severe mismanagement and the placement of unqualified nepotism hires in key positions.
“Just the Pill has purposely misrepresented what we’ve done to the media,” said one former employee RNG is identifying as Jamie. All former employee names are pseudonyms. “They strung me up,” said Sam, a former employee. “Now, after the fact, I’m like, ‘How did I fall for their bullshit?'”
An optimistic plan–with underutilized staff
Just the Pill was founded in Minnesota in 2020, when Food and Drug Administration (FDA) regulations still required mifepristone, one of the two drugs commonly used for medication abortion, to be dispensed in person. Amaon told me at the time that they were already building mobile abortion clinics, with one equipped to provide medication abortions and another for first trimester procedural abortions. They were already building out mobile abortion clinics, Amaon told me at the time, beginning with one equipped to provide medication abortions and another equipped for first trimester procedural abortions.
These discreet mobile clinics would be able to drive right up to ban state borders, reducing the distance patients from states like Texas–where a near-total abortion ban had already been in effect since late 2021–had to travel to access care.
“We hope to be able to go to all the safe states and drive around to offer access,” Amaon told me in early July 2022.
Later that month, I interviewed both Amaon and Bailey for a profile of the Just the Pill that was published in an October 2022 issue of Cosmopolitan. Amaon, the sole member of the Just the Pill organization who was acting as the public spokesperson at the time, identified Bailey under the pseudonym Amanda in the story. RNG identifies Bailey by name because she is named on public documents, including Just the Pill’s IRS filings. Amaon Bailey informed me in 2022 that a mobile clinic had already been established to provide medication abortions. Colorado was the state chosen by Just the Pill as the pilot for its mobile clinic fleet. Sam, a former employee of Just the Pill, said that they had never seen concrete steps being taken to turn the mobile clinics into reality. The only clinic any of them had ever seen, they said, was the one used for medication abortion, which was more of a mobile pharmacy.
“As an optimistic abortion worker trying to do something a little innovative, I was hoping we would eventually get to the point” of using the mobile clinics, Sam said.
They added that the highly experienced staff was “very underutilized.”
“They would ask for our input, but they never did anything with it,” Sam said.
Untapped horsepower
I spoke with Amaon again in September 2024, for a story following up on the innovative–and outlandish–ideas for post-Dobbs abortion care provision. She confirmed the mobile clinics were not in use at that time, and said that Just the Pill had found that pop-up clinics hosted by local partners worked better for its patients.
Just the Pill had run into a number of challenges in attempting to use its mobile clinics for procedures, she said, including issues with security, parking, medical waste disposal, and community partners being generally less willing to host procedural abortion care compared to medication abortion care.
Former employees echoed this. They found that contrary to the notion that driving to state borders to provide abortion pills or procedures would be most helpful, most patients wanted to travel by plane to receive in-person treatment. It made sense to offer care near an airport in Denver. Having to help some patients who ran into issues on the road, such as flat tires or being pulled over by police, further convinced employees that the mobile clinics weren’t viable.
Speaking to RNG this week, Amaon again confirmed that Just the Pill did build out two mobile clinics for procedural care, one in a van and one larger one with multiple rooms. They are still in storage, and they have not yet been used to provide procedural abortion services. Just the Pill also provides telemedicine abortion care to patients in Colorado, Minnesota, Montana, and Wyoming.
According to Just the Pill’s website, it has served more than 8,000 patients. Former staff stated that telemedicine was responsible for the majority of these patients. They said that in 2022 the number of patients traveling to Colorado for an abortion pill and to consult a doctor was around 30 per month. By 2024, it was less than 10 per month. Amaon stated that the leaders of Just the Pill did all they could to make the clinics mobile. We looked into buying land for the mobile clinics. And really nothing felt like we had the safety and security of our patients locked down, and so that was the reason we kept pushing off the launch of the mobile clinics.”
But former employees said the organization didn’t communicate transparently with staff about these efforts, and failed to take decisive action when it became clear that the mobile clinics were not going to work as planned.
“There were a lot of programmatic choices and ways that we should have been pivoting that we didn’t pivot, and things that we should have changed,” Jamie said. “And we were doing things the way that we were doing them for a while because of funders wanting this idea … the money was really specific to this very transportation-oriented, sensationalized abortion care that people were interested in funding.”
Alleged public misrepresentation
In any new venture, especially one that’s the first of its kind, there are bound to be bumps in the road (no pun intended). Staff members claim that Just the Pill misrepresented its care to the public. Press coverage continued to depict Just the Pill, despite the fact that fully equipped mobile clinics sat unoccupied and pop-ups clinics were centrally located in the Denver area. Just the Pill’s own website continued to refer to a “fleet” of clinics, and the organization’s public financial filings suggested it was providing abortion procedures.
Amaon took over as Just the Pill’s interim executive director in June 2024, following Bailey’s departure. Amaon, a former employee of Just the Pill, said that Bailey had been fired. She could not comment on personnel issues. All four former employees claimed that they were informed at one time that Just the Pill returned money to a grant funder after the funder was wrongly told that Just the Pill served patients near the border of ban states. Amaon, the company’s spokesperson, said that she could not confirm what Brooke told staff. Just the Pill’s 990 for fiscal year 2024 has not yet been filed.
Digital clues suggest that, at the very least, Just the Pill failed to correct the record when its use of mobile clinics was portrayed inaccurately.
“First providing medication abortion by mobile clinic in Minnesota, Just the Pill has expanded service by mail and by mobile and pop-up clinics in states including Colorado, Montana, and Wyoming, and is now piloting a mobile clinic for surgical abortions, the first of its kind in the U.S.,” read a now-removed page on the Overbrook Foundation’s website, which was live from at least December 2023 to December 2024, website captures from the Internet Archive show. IRS records show that the Overbrook Foundation donated $75,000 to Just the Pill in 2023. We are laying the foundation for others to follow.”
The Overbrook Foundation didn’t respond to a comment request. RNG contacted the funders of Just the Pill identified in publicly available documents and asked about the returned grant money. Abortion Care network, the only funder who responded, confirmed that it had given Just the Pill general operating funding in 2022, and never asked for a return of funds. We are now operating the first fleet mobile clinics to provide abortion care. Our mobile clinics are in Colorado with plans to expand to the Midwest later this year.”
By October 2023, the reference to a Midwest expansion was removed, but the claim about mobile clinics remained.
Media coverage continued to tout Just the Pill’s focus on mobile clinics. A CBS Minnesota segment, dated December 2023, prominently displayed the logo of Just the Pill’s Abortion Delivered initiative. The image featured a van. Amaon stated that “Just the Pill was made aware of inconsistencies with our data” and they have now resolved the issue. “The board and I are committed to strengthening Just the Pill and holding ourselves to the highest standard as a medical provider, as a nonprofit and as an employer.”
Amaon said that prior to stepping in as interim executive director, she didn’t see all of the organization’s grant proposals, reports, or communications with funders, but all of those that she did see were accurate.
‘Nepotism hires’
Amaon also told RNG that she wasn’t aware of the organization’s financial difficulties until she stepped in as interim executive director.
But former staff said they were aware that something was wrong long before. There was also a pattern in the organization of nepotism. Bailey hired three of her family members–her husband, her sister, and her niece–and former clinic manager Frances Morales hired her sister and sister-in-law.
Laid off employees said it took some time for them to recognize that all of these staff members were related, because only first names appeared in the organization’s slack and email addresses. “All the experienced people were on the fringe.” “All the experienced people were on the fringe.”
Another laid off employee said the financial assistance department was “entirely nepotism hires.”
“The people who handled money in our organization, that saw budgets, that talked to the accountants, were all nepotism hires,” Jamie said.
It often took days for patients’ financial assistance requests to be processed, the former employees said, which was unusual based on their experience from other clinic settings.
“No one else knew how they were doing it, or what the criteria for assistance were,” said Drew, another former staffer.
The organization never had a formal or transparent revenue recognition system, the former staffers said. In other words, patients were paying and pledges were coming in from other abortion funds in addition to Just the Pill’s own internal fund, but none of this was being appropriately tracked, all four former employees said.
Though Amaon declined to comment on staffing or allegations of nepotism, she said that “one of the projects that is in our two-week revamp and reset is our revenue recognition process.”
Former staff also said that Bailey’s husband was in charge of state abortion reporting requirements–a critical responsibility, because reporting mistakes can jeopardize a physician’s license. Wyoming has an extremely specific and strict reporting requirement. Amaon stated that there were inconsistencies with our data. We have corrected them. We focused on flying in patients when we faced delays in the project launch at borders. “He was not in charge of state reporting, that is the responsibility of the medical director.”
Bailey confirmed that the operations director in question was her husband.
“We started as a small group of family and friends giving our time to create an organization,” she said.
Eventually, Just the Pill’s human resources head came to refer to these staff members as the “familial cluster,” former employees said. Just the Pill Workers United sent a letter to the board of directors of the organization on January 22, 2024, after repeatedly voicing concerns over the behavior of certain members of the “cluster”, both towards fellow employees and patients. “It is clear to staff that the family employees are not held to the same rules as general staff and that they are not being held accountable for their mistakes.”
According to the former employees, Bailey’s sister was let go a few months after Bailey and her husband, employees said. Morales, who was also fired around the same period, is believed to have been dismissed at the same time. Amaon declined to comment on any personnel matters. Amaon refused to comment on personnel issues. Amaon said this week that they did all they could to change the organization before they had to lay off employees. Sam said, “We asked for that as staff.” Drew added that many on staff had advocated to use the mobile clinics to provide ultrasounds in abortion ban states, where ultrasounds are hard to come by in clinics that aren’t “crisis pregnancy centers.”
Most of all, staff said they tried to help, offering their expertise to help get critical systems back on track.
“I’m like, ‘Okay. Sam stated that “all hands were on deck” at last. The layoffs “felt like union busting, because they came after our demands to be allowed back into the budget, as the board had promised us we would be,” said Adrian, another former employee.
“This firing was just a tool to keep us in our place and rehire us at lower rates,” they continued. The layoffs “really felt like union busting, because they came after our demands to be allowed back into the budget, as the board had promised us we would be,” said Adrian, another former employee.
“This firing was just a tool to keep us in our place and rehire us at lower rates,” they continued.
In response, Amaon said, “as its members agreed, there is no formally recognized union that represents the workforce as a whole at Just the Pill.”
“We also value our employees and strive to support them,” she continued, listing benefits including employer-paid health insurance, remote work stipends, and unlimited paid time off.
According to Just the Pill Workers United, management formally recognized their union on June 9, 2023. Union members said most of the non-management staff who weren’t included in the union were part of the “familial cluster.”
Amaon declined to say what Just the Pill’s future would be until after its organizational “pause.” Several of the former employees said they suspect it may relaunch with a focus on telemedicine only.
Another person who had direct knowledge of Just the Pill’s operations in 2022–but is not one of the recently laid off employees–said they were “heartbroken,” but unsurprised to hear of Just the Pill’s struggles.
“They had the idea, they just didn’t know how to build the scaffolding to support the idea, or how to be leaders,” they said. They didn’t understand how to be leaders or build the scaffolding that would support their idea.
