The U.S. Supreme Court has temporarily restored nationwide access to the abortion pill mifepristone by mail, halting a lower court ruling that would have required in-person prescriptions. Justice Samuel Alito issued an administrative stay on Monday, delaying the appeals court decision until May 11 at 5 p.m. The move allows the drug to continue being prescribed via telehealth and dispensed through pharmacies or mail, as permitted by the Food and Drug Administration (FDA) since 2023.
The 5th U.S. Circuit Court of Appeals had ruled on Friday that the FDA failed to adequately study the safety of remotely prescribing mifepristone, ordering a nationwide halt to mail-order and telehealth prescriptions. The appeals court, led by Judge Kyle Duncan, a Trump appointee, argued that women could suffer "irreparable harm" if the current regulations remained in place. The ruling would have blocked access to mifepristone in states like California, where abortion remains legal, if patients did not see a doctor in person.
Louisiana, which has a near-total abortion ban, sued the FDA, arguing that the availability of mifepristone by mail undermines its state law. The state contends that the FDA did not properly assess the safety of remote prescriptions when it lifted the in-person requirement during the COVID-19 pandemic. Drugmakers Danco Laboratories and GenBioPro, which produce mifepristone, appealed to the Supreme Court, calling the lower court's decision "chaotic" and urging the justices to intervene.
The Supreme Court has not yet decided whether to take up the case on its merits. In 2024, the court unanimously rejected a similar challenge to mifepristone, ruling that anti-abortion doctors lacked standing to sue over a drug they did not prescribe. The current case, however, involves a state-led challenge, raising new legal questions about federal and state authority over medication abortion.
Abortion rights advocates have warned that restricting mifepristone access could force patients to rely solely on misoprostol, the second drug in the two-pill regimen, which is less effective when used alone. Public health organizations and drugmakers argue that mifepristone has a strong safety record, with lower adverse effects than common medications like penicillin and Viagra.
The Supreme Court's temporary stay provides a brief reprieve, but the legal battle over mifepristone access is expected to continue, with potential implications for abortion rights nationwide.