Supreme Court Temporarily Restores Access to Abortion Pill Mifepristone
The Supreme Court has temporarily restored nationwide access to the abortion pill Mifepristone, pausing a lower court ruling that had restricted how patients could obtain the medication.
In an order issued May 4, Justice Samuel Alito halted a decision from the U.S. Court of Appeals for the Fifth Circuit that limited access to the drug. The administrative stay allows patients to continue receiving mifepristone through pharmacies or by mail, including through telehealth prescriptions across state lines.
The order remains in effect until May 11 while the full court considers emergency requests from the drug’s manufacturers, including Danco Laboratories and GenBioPro, which argue the appeals court ruling conflicts with federal authority over drug approvals. Justice Alito directed Louisiana to respond by May 7 as the justices consider whether to extend the stay.
The case follows a Fifth Circuit ruling that imposed new limits on how the medication can be prescribed and distributed. Louisiana and other states argue that wider access to the drug undermines state abortion bans and raises safety concerns. The states claim that allowing providers to prescribe the medication remotely and ship it across state lines interferes with their ability to enforce local laws.
Mifepristone is used with a second drug, misoprostol, in a two-step regimen that accounts for a majority of abortions in the United States. Access to the medication has become a central issue since the Supreme Court’s 2022 decision overturning Roe v. Wade, as providers have increasingly relied on telehealth and mail distribution.
In their emergency appeal, the drug manufacturers argue courts should defer to the authority of the Food and Drug Administration, which approved mifepristone and later expanded access to allow telehealth prescribing and mail delivery. The companies warn that court-imposed limits could interfere with the federal system for regulating prescription drugs.
Under federal law, the FDA is responsible for determining whether prescription drugs are safe and effective and for setting the conditions under which they can be used. Courts generally defer to the agency on those decisions, especially when they are based on scientific review. States regulate medical practice within their borders, including abortion, which can conflict with federal rules.
A key dispute is how far state laws can limit access to medications approved at the federal level. Louisiana argues that allowing abortion pills to be prescribed remotely and mailed into the state undermines its laws and its ability to regulate healthcare. The manufacturers point to a legal principle known as federal preemption, which holds that federal law can override conflicting state laws.
The Supreme Court’s order restores access to Mifepristone under the rules in place before the Fifth Circuit's decision. Providers in states where abortion remains legal can prescribe the medication through telehealth and send it by mail. Some shifted to misoprostol-only regimens or paused services after the lower court ruling.
The administrative stay is set to expire on May 11.
