Supreme Court Temporarily Blocks Ruling Restricting Abortion Pill Access

Justice Samuel Alito issued an administrative stay on May 5, 2025, halting a federal appeals court decision that would have restricted nationwide access to the abortion medication mifepristone.

The order places a hold on a May 1 ruling by the U.S. 5th Circuit Court of Appeals until at least May 11, 2025. The underlying case, Louisiana v. FDA, challenges the legality of current FDA regulations that allow the drug to be prescribed via telehealth and dispensed through the mail.

"The stay maintains the status quo," allowing current FDA regulations permitting mail-order and telehealth access to mifepristone to remain in effect while the Supreme Court considers next steps.

Ongoing Legal Dispute

The Supreme Court's order requires all parties to file briefs by May 7, 2025. The hold prevents the 5th Circuit's ruling from taking effect, which had reinstated a nationwide requirement for the drug to be prescribed and obtained only during an in-person visit to a clinic. The associated lawsuit is expected to proceed in the lower courts.

The dispute originated when the state of Louisiana sued the U.S. Food and Drug Administration (FDA) in 2024. The state argued that the FDA's 2023 rule change, which removed the in-person dispensing requirement, violates state law and undermines Louisiana's near-total ban on abortion.

The Appeals Court Ruling

On May 1, 2025, a three-judge panel of the 5th U.S. Circuit Court of Appeals, based in New Orleans, issued a ruling siding with Louisiana. The panel—consisting of judges appointed by Republican presidents—found that Louisiana had legal standing to sue.

The court argued that the state was harmed because its Medicaid program paid for emergency care for two women who experienced complications after taking mifepristone obtained from out-of-state providers. The judges also wrote that the FDA's rule undermines Louisiana's laws protecting unborn life.

This ruling effectively reversed FDA regulations that had been in place since 2021, which allowed the drug to be prescribed remotely and delivered by mail or at pharmacies.

Supreme Court Intervention

Following the appeals court decision, the two manufacturers of mifepristone—Danco Laboratories and GenBioPro—filed an emergency appeal with the U.S. Supreme Court. They requested a stay of the appeals court ruling, warning of "immediate confusion and upheaval" for patients and providers. They argued the lower court's decision "unleashed regulatory chaos" and threatened to cut off access nationwide, including in states where abortion is legal.

In response, Justice Samuel Alito issued an administrative stay, temporarily blocking the appeals court decision.

Statements from Parties

Louisiana Attorney General Liz Murrill stated that the administrative stay is temporary and expressed confidence that "life and the law will win in the end."

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

Context and Background

Mifepristone, in combination with misoprostol, is used for medication abortion. The FDA first approved the drug in 2000, initially requiring in-person dispensing. The FDA permanently lifted the in-person requirement in 2021 after a safety review, and the Biden administration finalized these rules in 2023.

The Supreme Court's 2022 decision in Dobbs v. Jackson Women's Health Organization overturned Roe v. Wade, allowing states to enact their own abortion laws. Following that decision, access to telehealth and mail-order abortion pills became a significant method of abortion, particularly for patients in states with restrictive laws. Data indicates that more than one in four abortions nationwide were provided via telehealth in the first half of 2025.

This is the second time the Supreme Court has considered a case involving mifepristone access. In 2024, the Court unanimously ruled that a group of anti-abortion doctors and organizations lacked standing to challenge the FDA's regulations, preserving access at that time.

Next Steps

The temporary hold is set to expire on May 11, 2025. The Supreme Court may extend the stay, issue a longer ruling, or allow the appeals court decision to take effect. Alternatively, the court could choose to hear the case on its full merits. The case is expected to return to the 5th Circuit for further proceedings if the Supreme Court does not take further action.

Jurisdictions with Relevant Legislation

• Missouri: On May 8, 2025, a state judge struck down several abortion restrictions, including a 72-hour waiting period and a requirement that the first dose of abortion pills be taken in the presence of a doctor. The judge ruled that these laws conflicted with a 2024 state constitutional amendment that allows abortion until fetal viability. The state has said it will appeal the ruling.