WASHINGTON — The Supreme Court decided on Thursday to maintain access to a widely used abortion drug, overruling lower-court limitations while litigation continues.
The court’s directive ensures that women can continue to obtain the drug, mifepristone, from pharmacies or through the mail without needing an in-person consultation with a doctor. This access is expected to remain until at least next year as the case progresses, possibly reaching the Supreme Court again.
The justices accepted emergency appeals from mifepristone manufacturers who are contesting a federal appeals court decision that would mandate in-person doctor visits and halt mail delivery of the drug. The Food and Drug Administration (FDA), which initially approved mifepristone for abortion in 2000, lifted the requirement for in-person visits five years ago.
Anti-abortion advocates, dissatisfied with President Donald Trump’s administration, are urging the FDA to expedite a review they hope will lead to restrictions on mifepristone, including preventing its prescription via telehealth. The administration argues that the review process requires time.
Earlier this week, FDA Commissioner Marty Makary resigned following prolonged criticism from Trump’s political supporters, including those opposed to abortion.
Susan B. Anthony Pro-Life America and similar organizations had urged Trump to dismiss Makary due to the slow progress of the mifepristone review.
The court faces this abortion case four years after its conservative majority overturned Roe v. Wade, leading to abortion bans in over a dozen states.
The case at hand arises from a lawsuit filed by Louisiana challenging the FDA’s regulations on mifepristone prescriptions. The state argues that the regulations undermine its abortion ban and raises safety concerns about the drug, which FDA scientists have repeatedly deemed safe and effective.
Lower courts determined that Louisiana is likely to succeed, with a three-judge panel from the 5th U.S. Circuit Court of Appeals ruling to suspend mail access and telehealth consultations during the case.
Mifepristone is typically used in conjunction with misoprostol for abortions. Medication abortions accounted for nearly two-thirds of all U.S. abortions in 2023, according to the most recent statistics.
This case resembles a similar dispute that reached the court three years ago.
At that time, lower courts also sought to limit mifepristone access in a lawsuit filed by anti-abortion physicians shortly after Roe was overturned.
The Supreme Court prevented the 5th Circuit’s decision from taking effect, despite dissenting votes from Justices Samuel Alito and Clarence Thomas. In 2024, the high court unanimously dismissed the doctors’ lawsuit, stating they lacked the legal standing to sue.
In the ongoing case, mainstream medical organizations, the pharmaceutical industry, and Democratic lawmakers have cautioned the court against restricting the drug. Pharmaceutical companies warn that a decision favoring abortion opponents could disrupt the drug approval process.
The debate over mifepristone’s safety has persisted for over 25 years. The FDA has eased several initial restrictions on the drug, including prescribing guidelines and reporting of safety issues.
Despite these conclusions, anti-abortion groups have repeatedly challenged the FDA, alleging it overlooked safety concerns with the drug.
Trump’s administration has remained notably silent at the Supreme Court, refraining from filing a brief on the matter, even though federal regulations are at stake.
This situation places the administration in a difficult position. Trump has relied on the political backing of anti-abortion groups but is also aware of ballot measures and polls indicating that many Americans support abortion rights.
Both sides interpret the administration’s silence as a tacit endorsement of the appellate ruling.
— Mark Sherman, Geoff Mulvihill, and Matthew Perrone
Mulvihill reported from Haddonfield, N.J.
