The Supreme Court has decided to continue blocking nationwide restrictions on mifepristone, following a conservative appeals court ruling that sought to cut off mail-order and telehealth access to the widely used abortion drug. If the lower court's decision had been allowed to take effect, millions of patients across the country could have been forced to travel to a health center to take the mifepristone pill in person — a journey that might span hundreds of miles for individuals living in states where abortion is entirely prohibited.
The Supreme Court had paused the appeals court ruling twice over the past week. The most recent pause expired at 5 p.m. on May 14, but the justices have now frozen the lower-court ruling indefinitely while the legal challenge continues. Conservative Justices Clarence Thomas and Samuel Alito dissented from the decision.
Advocates have warned that imposing in-person requirements for mifepristone in a country with fragmented access to legal abortion could pose the most significant threat to abortion access since the overturning of Roe v. Wade. This latest fight over access to the commonly used drug is likely to trigger another high-profile battle for abortion rights at the nation's highest court.
Medication abortion now accounts for the vast majority of abortions. Roughly 63 percent of all abortions are medication abortions, according to the Guttmacher Institute, a reproductive health advocacy group. Mifepristone, one of two prescription drugs used in medication abortions, is approved for use by the Food and Drug Administration up to 10 weeks of pregnancy. Nearly 93 percent of all abortions are performed before the 13th week, according to the CDC.
In 2021, the FDA under then-President Joe Biden permanently lifted the in-person requirement for mifepristone prescriptions, allowing patients to access the drugs via telehealth appointments and online pharmacies. More than one in four people who have an abortion now obtain their medication through telemedicine, according to Guttmacher.
Anti-abortion activists have urged Donald Trump's administration and the courts to revoke telehealth access while demanding that the FDA strip mifepristone's approval altogether — a campaign that critics have characterized as a backdoor effort to ban abortion nationally. The FDA first approved mifepristone more than 20 years ago, but the Trump administration has pledged to revisit the drug's approval process.
On May 1, the Fifth Circuit Court of Appeals in Louisiana reinstated a nationwide requirement that patients obtain the drug in person, briefly upending abortion access for millions of people across the country. Drug manufacturers subsequently turned to the Supreme Court to block that ruling.
