The Fifth Circuit's unanimous ruling temporarily reinstated an in-person dispensing requirement, blocking a 2023 Food and Drug Administration (FDA) policy that allowed the drug to be prescribed via telehealth and delivered by mail.
"The regulation creates an effective way for an out-of-state prescriber to place the drug in the hands of Louisianans in defiance of Louisiana law," wrote Circuit Judge Kyle Duncan, of the New Orleans-based court.
In response, Danco Laboratories, a manufacturer of the pill, asked the Supreme Court on Saturday to reinstate mail access to the drug, marking the potential for one of the biggest Supreme Court decisions on abortion since Dobbs v. Jackson Women’s Health Organization, which reversed the constitutional right to abortion, returning authority on the issue to state governments.
“We are alarmed by this court’s decision to ignore the FDA’s rigorous science and decades of safe use of mifepristone in a case pursued by extremist abortion opponents,” said Evan Masingill, CEO of GenBioPro, one of the companies that manufactures mifepristone, in a statement.
The prevalence of this kind of medication abortion has made mifepristone a target for anti-abortion advocates in a post-Roe world. The drug—one part of a two-drug regimen that accounts for the most common medication abortion method—has been approved by the FDA since 2000. The Supreme Court already struck down a challenge against the drug in 2024.
A response to protections introduced by Democrats
When abortion access was repealed in many states in the wake of the Dobbs ruling, Democrat-led states passed shield laws to protect abortion providers who prescribe pills by telemedicine and send them to patients in states with abortion bans. Louisiana is just one of multiple GOP-led states whose state attorneys general are seeking to cut off access to this kind of care.
At the same time, the Trump Administration’s Department of Health and Human Services (HHS), led by Robert F. Kennedy Jr., is conducting a review of its regulations on mifepristone. The FDA had originally asked the courts to pause the case until it had completed its review. A district court granted that request, preventing any immediate changes to access to the abortion pill. Louisiana appealed the district court’s decision almost immediately, sending it to the Fifth Circuit Court of Appeals.
The American Civil Liberties Union, meanwhile, called the review a "thinly veiled attempt to lay the groundwork for additional medically unjustified restrictions” on the drug.
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