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Supreme Court Temporarily Blocks Appeals Court Ruling Restricting Nationwide Access to Abortion Pill Mifepristone

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Supreme Court Issues Temporary Stay on Mifepristone Ruling

Justice Samuel Alito issued an administrative stay on May 5, temporarily blocking an appeals court ruling that would have restricted nationwide access to the abortion medication mifepristone.

The stay allows existing telemedicine and mail-order prescriptions to continue while the court reviews emergency appeals, with the order effective until at least 5 p.m. ET on May 11.

Court Proceedings

Appeals Court Ruling

On May 1, a three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans ruled unanimously to reinstate a requirement that mifepristone be prescribed and dispensed only after an in-person visit to a clinic.

The panel consisted of Circuit Judge Kyle Duncan (appointed by President Donald Trump), Circuit Judge Leslie Southwick (appointed by President George W. Bush), and Circuit Judge Kurt Engelhardt (appointed by President Trump). Judge Duncan authored the opinion, stating that the FDA's allowance of mailed pills "cancels Louisiana's ban on medical abortions."

The ruling reversed FDA regulations that had permitted telehealth prescriptions and mail delivery of the drug. The court wrote that current federal regulations allow out-of-state prescribers to provide abortion pills to Louisiana residents in defiance of state law.

Supreme Court Intervention

The order responds to emergency requests from Danco Laboratories and GenBioPro, the two manufacturers of mifepristone.

Danco stated that the appellate ruling "injects immediate confusion and upheaval into highly time-sensitive medical decisions." GenBioPro argued the decision "unleashed regulatory chaos" and threatens to cut off access nationwide, including in states where abortion is legal.

Justice Alito requested that all parties file briefs by May 7.

Legal Background

The Lawsuit

The case was brought by Louisiana Attorney General Liz Murrill, who sued the U.S. Food and Drug Administration (FDA) in 2024. The lawsuit argues that FDA rules allowing mail-order mifepristone undermine the state's abortion ban, which took effect after the Supreme Court's 2022 decision overturning Roe v. Wade.

A federal district court partially sided with Louisiana in April, finding the FDA's policy "arbitrary and capricious," but stayed its own decision to allow the FDA time to complete a safety review. Louisiana then appealed to the 5th Circuit.

The appeals court panel found that Louisiana had standing because its Medicaid program paid for emergency care for two women who experienced complications after taking mifepristone from out-of-state providers. The panel stated the rule "injures Louisiana by undermining its laws protecting unborn human life and also by causing it to spend Medicaid funds on emergency care for women harmed by mifepristone."

Prior Supreme Court Case

This case marks the second time mifepristone access has reached the Supreme Court since the 2022 Dobbs v. Jackson Women's Health Organization decision. In 2024, the Court unanimously rejected a challenge from anti-abortion doctors, ruling they lacked legal standing. That case involved FDA actions from 2016 onward that eased access to the drug.

FDA Regulation History

  • 2000: The FDA approved mifepristone for early pregnancy termination, typically used in combination with misoprostol. The initial approval required in-person dispensing and prescription by certified physicians.
  • 2021: During the COVID-19 pandemic, the FDA lifted the in-person dispensing requirement after reviewing over 20 years of safety data.
  • 2023: The Biden administration finalized rules that permanently removed the in-person requirement, allowing telehealth prescriptions and mail delivery.

Impact and Statistics

Medication Abortion Trends

  • Medication abortion accounts for the majority of U.S. abortions. According to the Guttmacher Institute, medication abortions represented over 60% of U.S. abortions in 2023 and approximately two-thirds in 2025.
  • Telehealth abortions have increased significantly. According to #WeCount, more than 1 in 4 abortions nationwide were provided via telehealth in the first half of 2025, up from fewer than 1 in 10 in 2022.
  • The Guttmacher Institute estimates that in 2025, about 91,000 telehealth abortions were provided under shield laws to people in states with total abortion bans.

State Policies

  • Some Democratic-led states have enacted "shield laws" protecting providers who prescribe medication abortion via telehealth to patients in states with bans.
  • Since the 2022 Dobbs decision, voters in 14 of 17 states have supported abortion-rights ballot measures.

Statements from Involved Parties

Louisiana Attorney General Liz Murrill stated: "The administrative stay is temporary, and I am confident life and the law will win in the end."

Danco Laboratories stated that the 5th Circuit's order causes "immediate confusion and upheaval" for patients and providers.

GenBioPro CEO Evan Masingill stated that the company is "alarmed by this court's decision to ignore the FDA's rigorous science and decades of safe use of mifepristone."

National Right to Life Committee President Carol Tobias said the appeals court ruling "restores a critical layer of oversight."

Susan B. Anthony Pro-Life America President Marjorie Dannenfelser called the appeals court ruling "a huge victory for victims and survivors."

Kelsey Pritchard of Susan B. Anthony Pro-Life America stated: "What is shocking is that the Trump administration's inaction has stopped pro-life laws from taking effect, and that they forced several Republican attorneys general to take their battle to the federal courts."

ACLU lawyer Julia Kaye stated that the appeals court ruling "affects patients' access to abortion and miscarriage care in every state" and that restrictions harm rural communities, low-income individuals, people with disabilities, survivors of intimate partner violence, and communities of color.

Nancy Northup, president and CEO of the Center for Reproductive Rights, stated: "Telehealth has been the last bridge to care for many seeking abortion, which is precisely why Louisiana officials want it banned."

Mini Timmaraju, president and CEO of Reproductive Freedom for All, said the appeals court is "dictating medical practice and overriding state laws" and that the decision "moves us one step closer to a national abortion ban."

Kristan Hawkins, president of Students for Life, criticized the Supreme Court's stay, stating that "pill pushers receive every benefit of the doubt."

A White House spokesperson stated that the Trump administration is following the litigation closely and that the FDA continues its review of mifepristone's safety.

Next Steps

Louisiana must file briefs with the Supreme Court by May 7. The Justice Department may also file briefs. The Supreme Court could choose to extend the stay, vacate the 5th Circuit ruling, or take up the case on its merits.

If the stay expires without extension, the 5th Circuit restrictions would take effect nationwide, requiring in-person visits for mifepristone prescriptions and blocking telehealth and mail-order access during the legal process.