Court Allows Remote Abortion Pill Access for Now

The Supreme Court allowed women to continue accessing the abortion pill mifepristone through telehealth visits, maintaining the status quo while officials in Louisiana push to limit the drug’s availability in lower courts.

The conservative Supreme Court imposed a pause on a May 1 decision from the 5th US Circuit Court of Appeals that required women to obtain the drug through in-person visits.

Justices Clarence Thomas and Samuel Alito dissented from the decision, with Alito writing that the court’s order was “remarkable” and that what’s at stake is the “perpetration of a scheme to undermine our decision” overturning Roe v. Wade four years ago.

Thomas wrote in a brief solo dissent that he thought a 19th century law banning the mailing of drugs used for abortions, as well as the state’s strict abortion ban, barred manufacturers from getting courts to intervene on their behalf.

The companies, he wrote, “are not entitled to a stay of an adverse court order based on lost profits from their criminal enterprise.”

The court did not explain its reasoning or disclose the vote count, and it did not agree to hear arguments as both sides had asked it to do.

Instead, the decision means the merits of the case will now be hashed out in a federal appeals court, and the issue will likely reach the Supreme Court again in the future.

Louisiana Attorney General Liz Murrill, a Republican, called the court’s decision “shocking” and vowed to keep fighting.

Several anti-abortion groups, including Americans United for Life, decried the court’s order, with spokesperson Gavin Oxley saying it would “only further prolong the full effects of overturning Roe v. Wade by incompletely returning the issue to the American people.”

The case is the most significant involving abortion to reach the high court since the overturning of Roe, and both the case and mifepristone are heavily wrapped up in that decision.

After the fall of Roe in 2022, many conservative states banned in-clinic abortions, increasing demand for mifepristone, which can be obtained through telehealth appointments.

Women have been able to obtain mifepristone through telehealth appointments since the pandemic, and President Joe Biden’s Food and Drug Administration finalized that situation in 2023, ending the requirement that the medication be obtained through an in-person doctor’s visit.

According to the Guttmacher Institute, medication abortions account for more than 60% of abortions in the US.

The Society of Family Planning estimates that roughly 1 in 4 abortions nationwide were provided through telehealth in 2025, up from fewer than 1 in 10 in 2022.

Data analyzed show that mifepristone is safer than other common, low-risk prescription drugs, including penicillin and Viagra.

There were five deaths associated with mifepristone use for every 1 million people in the US who have used the drug since its approval in 2000, according to the FDA as of 2023.

“This isn’t a matter of convenience — for patients living hundreds of miles from the nearest clinic, it’s the difference between getting an abortion or not,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, emphasizing the importance of access to healthcare.

The order, she said, “buys time, but no peace of mind.”

Louisiana sued the FDA over its policy last year, asserting that the Biden-era regulation undermined its own strict abortion ban.

A federal district court in April partly sided with the state, finding that the FDA’s new policy was arbitrary because the agency did not have adequate data to gauge the drug’s safety.

But the district court blocked its decision from taking effect to give the FDA time to complete an ongoing review of the drug.

A 5th Circuit panel of three judges put the FDA’s rule about mifepristone on hold immediately earlier this month, requiring women seeking to access the drug to do so with in-person visits.

Medical providers described the hours following that order as some of the “craziest” and most “chaotic” they’ve experienced, highlighting the need for clear healthcare options.

Danco Laboratories, the maker of mifepristone, and GenBioPro, which makes a generic version of the drug, filed emergency appeals with the Supreme Court.

The appeal is largely a repeat of an issue the justices just took up two years ago, when a unanimous court rejected a lawsuit challenging the same FDA regulation dealing with the same drug.

Similar issues are already being raised about whether Louisiana has standing to sue over a decision by the FDA to regulate a drug on a nationwide basis, which may impact awareness of healthcare issues.

The state has made two claims to argue it can bring its suit, including that it has suffered “sovereign harm” because the drug use allows women to effectively bypass the state’s ban on abortion.

The Supreme Court rejected the idea that parties could claim “downstream” economic injuries from an FDA-approved drug just two years ago in the earlier mifepristone case.