Supreme Court Preserves Access to Abortion Pill Mifepristone via Mail and Telehealth
The Supreme Court blocked a lower court ruling that would have restricted access to the abortion pill mifepristone, allowing doctors to continue prescribing it via telehealth and shipping it by mail. The decision came as conservative Justices Thomas and Alito dissented.
Supreme Court Emergency Decision
Preserving Medication Access: The U.S. Supreme Court on Thursday indefinitely extended protection for mifepristone access, blocking an appeals court ruling that would have required in-person doctor visits for the drug.
What the Ruling Does
Current Policy Maintained
Telehealth and Mail Access Continues: Women can now continue to:
- Obtain mifepristone through telehealth appointments
- Receive the drug by mail without an in-person clinic visit
- Access the medication through pharmacies and providers nationwide
Impact on Medication Abortion
Mifepristone is used in approximately 60-65% of all U.S. abortions. It is taken in combination with misoprostol to induce medication abortion.
The Legal Battle
Lower Court Ruling
The New Orleans-based 5th U.S. Circuit Court of Appeals had ruled on May 1 that mifepristone could only be dispensed in person, reverting to pre-pandemic FDA rules.
Louisiana's Challenge
The state of Louisiana sued the FDA last fall, arguing that telemedicine access to mifepristone undermines Louisiana's near-total abortion ban and causes the state to spend Medicaid funds on emergency care.
Dissents and Opposition
Conservative Justices Object: Justices Samuel Alito and Clarence Thomas dissented from the unsigned decision.
Thomas: Argued the drug manufacturers are not entitled to block the lower court order "based on lost profits from their criminal enterprise," citing the Comstock Act, an 1873 law banning mailing of abortion-related materials.
Alito: Said the expanded access to mifepristone "undermines" the Supreme Court's 2022 decision overturning Roe v. Wade, calling it a "scheme to undermine" states' rights to regulate abortion.
FDA Commissioner Resignation
Leadership Change: FDA Commissioner Dr. Marty Makary resigned earlier this week under pressure from the White House and anti-abortion groups frustrated with the slow pace of a safety review of mifepristone. His replacement has been more vocally anti-abortion.
Ongoing Litigation
What's Next: The Supreme Court did not agree to hear the full legal arguments in Louisiana's case. The decision sends the underlying case back to the 5th Circuit, where it will likely be appealed again to the Supreme Court.
Timeline: Access is expected to remain uninterrupted at least through 2026 and into 2027 as litigation continues.
Broader Context
This marks the second major Supreme Court intervention on mifepristone access in recent years. Three years ago, the justices also blocked a 5th Circuit ruling and kept mifepristone widely available, again with dissents from Alito and Thomas. Two other pending lawsuits by Republican-led states could pose even greater threats to mifepristone access.