Mail-order access to abortion drug reinstated by Supreme Court
Maureen GroppeWASHINGTON – The Supreme Court on May 4 reinstated mail-order access to the widely used abortion drug mifepristone, a temporary decision that gives the justices more time to consider the issue.
The court intervened after the Food and Drug Administration was ordered on May 1 to revive a requirement that doctors prescribe the drug only after an in-person exam. It was the first time access to mifepristone had been significantly curtailed during years of litigation over the drug, which was first approved in 2000.
At the request of drugmakers, Justice Samuel Alito paused until May 11 the restrictive ruling by a lower court while the full court decides what the rules for mifepristone should be as Louisiana challenges expanded access.
“This ruling is not final − keep watching,” Nancy Northup, head of the Center for Reproductive Rights, said in a statement. “Getting abortion pills through telehealth has been a lifeline for women since Roe v. Wade was overturned. There is no reason people shouldn’t be able to get mifepristone at a pharmacy or through the mail.”
State officials argue that allowing the drug to be dispensed through the mail or a pharmacy ignores the threat of complications from mifepristone, such as sepsis and hemorrhaging. Louisiana Attorney General Liz Murrill also says mailed delivery of the drug allows women to get around abortion bans.
In its ruling May 1, the conservative 5th U.S. Circuit Court of Appeals said Louisiana is likely to win its challenge and blocked mail-order access for now.
Danco Laboratories, which makes Mifeprex, the brand-name version of mifepristone, said that decision injected “immediate confusion and upheaval into highly time-sensitive medical decisions.”
Danco also told the Supreme Court that Louisiana’s challenge should be rejected for the same reasons the justices in 2024 tossed out a similar lawsuit brought by anti-abortion doctors.
In that case, the court said the doctors couldn’t sue because they hadn’t shown they were sufficiently harmed by the FDA’s loosening of the regulations for mifepristone in 2023.
Louisiana argues the state's ability to enforce its anti-abortion laws is harmed by the ability of women in the state to more easily access mifepristone. State officials also say Louisiana's Medicaid program had to pay $92,000 for the emergency care of two women who had complications after taking mifepristone.
Danco said the Supreme Court rejected a similar argument about downstream economic injuries when dismissing the anti-abortion doctor's lawsuit.
Multiple Republican-led states are trying to make it harder for women to access mifepristone, a pill used in nearly two-thirds of abortions across the United States – including in states that have largely banned abortion.
But Louisiana "is alone in seeking such sweeping preliminary relief," GenBioPro, which makes a generic version of Mifeprex, told the Supreme Court in its appeal.
The Trump administration's FDA is now reviewing the safety of the drug. Abortion rights advocates have called the review a sham, saying the science behind the agency’s previous decision is solid.
In January, the administration asked a judge to pause Louisiana’s challenge until the FDA’s review is done.
A federal judge agreed. But the appeals court blocked that ruling and said the in-person dispensing requirement should return while Louisiana appeals the judge’s decision.