WASHINGTON — The U.S. Supreme Court is maintaining the current accessibility of a commonly used abortion medication, mifepristone, at least through Thursday. The justices are deliberating on whether to implement new restrictions on the drug.
Justice Samuel Alito issued an order on Monday permitting women to continue obtaining mifepristone from pharmacies or by mail without needing a doctor’s in-person consultation. This decision temporarily blocks restrictions imposed by a federal appeals court.
This case brings the Supreme Court back into the abortion debate, four years after its conservative wing overturned Roe v. Wade, leading to abortion bans in more than a dozen states.
The current legal battle originates from a lawsuit filed by Louisiana, challenging the Food and Drug Administration’s regulations on mifepristone prescriptions. Louisiana argues that these rules conflict with the state’s abortion ban and raises concerns about the drug’s safety, despite the FDA’s longstanding approval and repeated endorsements of its safety and efficacy.
Lower courts have favored Louisiana’s position, with a panel from the 5th U.S. Circuit Court of Appeals deciding to suspend mail access and telehealth consultations for mifepristone while the case is under review.
Mifepristone is typically used alongside another medication, misoprostol, for abortions. In 2023, medication abortions comprised nearly two-thirds of all abortion procedures in the United States, according to available data.
The current dispute is similar to one that reached the court three years ago.
Lower courts then also sought to restrict access to mifepristone, in a case brought by physicians who oppose abortion. They filed suit in the months after the court overturned Roe.
The Supreme Court blocked the 5th Circuit ruling from taking effect over the dissenting votes of Alito and Justice Clarence Thomas. Then, in 2024, the high court unanimously dismissed the doctors’ suit, reasoning they did not have the legal right, or standing, to sue.
In the current dispute, mainstream medical groups, the pharmaceutical industry and Democratic members of Congress have weighed in cautioning the court against limiting access to the drug. Pharmaceutical companies said a ruling for abortion opponents would upend the drug approval process.
The FDA has eased a number of restrictions initially placed on the drug, including who can prescribe it, how it is dispensed and what kinds of safety complications must be reported.
Despite those determinations, abortion opponents have been challenging the safety of mifepristone for more than 25 years. They have filed a series of petitions and lawsuits against the agency, generally alleging that it violated federal law by overlooking safety issues with the pill.
President Donald Trump’s administration has been unusually quiet at the Supreme Court. It declined to file a written brief recommending what the court should do, even though federal regulations are at issue.
The case puts Trump’s Republican administration in a difficult place. Trump has relied on the political support of anti-abortion groups but has also seen ballot question and poll results that show Americans generally support abortion rights.
Both sides took the silence as an implicit endorsement of the appellate ruling. Alito is both the justice in charge of handling emergency appeals from Louisiana and the author of the 2022 decision that declared abortion is not a constitutional right and returned the issue to the states.
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Mulvihill reported from Haddonfield, N.J.
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