The Supreme Court on Monday temporarily extended access to the widely used abortion pill mifepristone, blocking for now a lower-court ruling that would have required in‑person doctor visits and suspended mail‑order prescriptions. Justice Samuel Alito’s administrative order keeps current FDA rules in place until at least Thursday, while the full court considers whether to let the 5th U.S. Circuit Court of Appeals’ restrictions take effect.
The case began when Louisiana sued to roll back the FDA’s prescribing rules for mifepristone. The state contends the policy undermines its abortion ban and questions the safety of the drug, which was first approved in 2000. A three-judge panel of the 5th Circuit agreed that Louisiana is likely to prevail, ruling that mail access and telehealth visits should be suspended while the litigation proceeds. Alito’s order puts that ruling on hold.
Mifepristone, most often used in combination with misoprostol, accounted for nearly two‑thirds of all U.S. abortions in 2023, the most recent year for which statistics are available. The FDA has progressively eased restrictions on the drug over two decades, and the agency’s scientists have repeatedly determined that it is safe and effective under the current prescribing framework.
The present dispute echoes a similar challenge that reached the court three years ago. In that case, anti‑abortion physicians sought to restrict mifepristone access, and the Supreme Court blocked the 5th Circuit’s ruling from taking effect. In 2024, the justices unanimously dismissed the physicians’ suit, holding that they lacked standing to sue.
Mainstream medical organizations, pharmaceutical companies, and Democratic members of Congress have all weighed in, warning the court that limiting access to mifepristone would disrupt medical practice and, in the pharmaceutical industry’s view, upend the drug‑approval process.
The Trump administration has been notably quiet. It declined to file a written brief recommending what the court should do, even though federal regulations are at issue. Both supporters and opponents of the appellate ruling have read the administration’s silence as an implicit endorsement of the 5th Circuit’s position.
Alito, the justice responsible for emergency appeals from Louisiana, was the author of the 2022 decision that overturned Roe v. Wade and returned abortion regulation to the states. His order Monday keeps the status quo in place while the full court weighs the next move in the post‑Roe legal landscape.