The Supreme Court on Monday temporarily preserved access to mifepristone, a widely used abortion medication, as the justices weighed whether restrictions ordered by a federal appeals court can take effect while a lawsuit brought by Louisiana continues. Justice Samuel Alito issued the order, which means women could keep obtaining the pill at pharmacies or through the mail without an in-person doctor visit while the court considered the dispute. MSI previously reported on the court’s recent intervention in similar access questions tied to the drug.
Alito’s order also prevented the appeals court’s restriction from going into effect for the time being, putting the litigation on hold at the Supreme Court stage rather than letting the lower-court pause proceed immediately. The appeals court had concluded that mail access and telehealth-style visits for mifepristone should be suspended while the case plays out, according to the AP report.
The case centers on Louisiana’s challenge to Food and Drug Administration rules governing how mifepristone may be prescribed. Louisiana argued that the FDA policy undermines the state’s abortion ban and questioned the drug’s safety. Mifepristone was first approved in 2000, and the report says abortion opponents have repeatedly challenged its safety for more than 25 years, generally alleging that federal authorities overlooked safety issues when approving and regulating the pill.
The AP report said the dispute has been closely tracked in federal courts since the Supreme Court’s conservative majority overturned Roe v. Wade in a 2022 decision and returned abortion regulation to the states. Four years after that shift, the current challenge before the justices reflects the continuing legal fight over medication abortions and the extent to which federal drug rules can be limited by state law.
The lower courts in Louisiana’s case had said the state was likely to prevail, and the 5th U.S. Circuit Court of Appeals issued a ruling directing that mail access and telehealth-style prescribing be suspended while the litigation continued. In the Supreme Court’s order Monday, Alito blocked that restriction from taking effect, according to the AP account.
Mifepristone is most often used with another drug, misoprostol, for medication abortions. The AP report said medication abortions accounted for nearly two-thirds of all abortions in the United States in 2023, the last year for which statistics were available when the story was filed.
The AP report also described a similar dispute that reached the Supreme Court three years earlier. In that earlier case, lower courts had sought to restrict access to mifepristone in a lawsuit brought by physicians who oppose abortion, but the Supreme Court blocked the 5th Circuit ruling from taking effect. In 2024, the high court unanimously dismissed the doctors’ suit, reasoning that they lacked legal standing to sue, the report said.
The report said mainstream medical groups, the pharmaceutical industry and Democratic members of Congress urged the Supreme Court not to limit access. It said pharmaceutical companies argued that a ruling for abortion opponents would upend the drug approval process, and that the FDA has eased multiple restrictions on mifepristone over time, including who can prescribe it, how it is dispensed and what safety complications must be reported.
The dispute also intersects with federal politics, with the AP report saying President Donald Trump’s administration has been unusually quiet at the Supreme Court. It said the government declined to file a written brief recommending what the court should do, despite federal regulations being at issue in the litigation.
Both sides viewed the administration’s silence as an implicit endorsement or approval of the appellate ruling, the report said. Alito, who handled the emergency appeal as the justice assigned to such matters, is also the author of the 2022 decision that declared abortion is not a constitutional right and returned the issue to the states.
In the current posture, the Supreme Court’s action ensures that the appeals court restriction does not begin immediately, leaving mifepristone access intact while the justices consider whether and how restrictions should take effect as the case proceeds.