Supreme Court Restores Mail-Order Abortion Pills
High Court blocks lower ruling on mifepristone access while legal fight over FDA mail-order policy continues
The U.S. Supreme Court on Thursday restored nationwide access to mail-order abortion pills, putting on hold a lower court ruling that would have required patients to obtain the medication in person.
In a 7-2 decision, the Court issued an unsigned order blocking a May 1 ruling from the U.S. Court of Appeals for the 5th Circuit. That appeals court decision had reinstated an in-person screening rule for the abortion drug mifepristone, reversing a 2023 policy change by the Food and Drug Administration that allowed the drug to be prescribed through telehealth and shipped by mail.
The Supreme Court’s order does not end the case. Instead, it freezes the lower court ruling while the broader legal fight continues through the federal courts. The majority did not explain its reasoning in the brief order. Justices Clarence Thomas and Samuel Alito dissented.
The lawsuit was brought by the State of Louisiana, which argued the FDA’s relaxed rules undermine State abortion bans and violate federal law. Anti-abortion groups also urged the justices to leave the appeals court ruling in place.
Mifepristone was first approved by the FDA in 2000 and is commonly used alongside misoprostol to end early pregnancies. Since the Supreme Court’s 2022 ruling in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, abortion pill access has become one of the nation’s most contested legal battles.
The FDA permanently removed the in-person dispensing rule in late 2021 and later expanded pharmacy access in 2023. Those changes allowed patients in many States to receive prescriptions through telehealth appointments and have the medication delivered by mail.
The recent 5th Circuit ruling would have blocked that process nationwide, even in States where abortion remains legal. Justice Samuel Alito had temporarily paused the appeals court order earlier this month while the full Supreme Court reviewed emergency appeals from drug manufacturers Danco Laboratories and GenBioPro.
According to the Associated Press, medication abortions accounted for nearly two-thirds of U.S. abortions in 2023.
The case now returns to lower courts for further review, though legal observers expect the dispute could ultimately return to the Supreme Court for a full hearing on the merits.
