The Supreme Court has temporarily preserved access to a widely used abortion pill, mifepristone, by delaying a decision on potential restrictions until at least Thursday.
This order, issued by Justice Samuel Alito on Monday, means women can continue to obtain the medication through pharmacies or by mail, bypassing requirements for an in-person doctor’s visit. It effectively blocks a federal appeals court’s imposed restrictions from taking immediate effect.
The high court is now grappling with its latest abortion-related dispute, coming four years after its conservative majority overturned Roe v. Wade, which led to outright abortion bans in over a dozen states.
The current legal challenge originates from a lawsuit filed by Louisiana, seeking to roll back the Food and Drug Administration’s established rules for prescribing mifepristone.
Louisiana claims the policy undermines the ban there, and it questions the safety of the drug, which was first approved in 2000 and has repeatedly been deemed safe and effective by FDA scientists.
Lower courts concluded that Louisiana is likely to prevail, and a three-judge panel of the 5th U.S. Circuit Court of Appeals ruled that mail access and telehealth visits should be suspended while the case plays out.
The drug is most often used for abortion in combination with another drug, misoprostol. Medication abortions accounted for nearly two-thirds of all abortions in the U.S. in 2023, the last year for which statistics are available.
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.
