The U.S. Supreme Court on Thursday ensured that the abortion pill can continue to be prescribed through telemedicine and dispensed by mail, as the justices restored for now a 2023 federal rule challenged by Republican-governed Louisiana.
The justices granted requests by two manufacturers of the abortion pill, called mifepristone, to lift a lower court's block on the rule issued by the FDA during the Biden administration, while Louisiana's legal challenge plays out.
The brief order was unsigned and offered no reasoning, as is common with emergency actions by the Supreme Court. Conservative Justices Samuel Alito and Clarence Thomas dissented.
The New Orleans-based 5th U.S. Circuit Court of Appeals on May 1 had ordered the imposition of a previous federal rule that required an in-person clinician visit to receive mifepristone.
Drugmakers Danco Laboratories and GenBioPro appealed the 5th Circuit action restricting access to mifepristone, a drug approved by the FDA in 2000. Both companies welcomed the court's action on Thursday.
The case put abortion back before the justices with November congressional elections looming and President Donald Trump's fellow Republicans fighting to retain control of Congress.
The Supreme Court has a 6-3 conservative majority. The ongoing battles over abortion rights follow its 2022 ruling that overturned Roe v. Wade, which had recognized a woman's constitutional right to terminate her pregnancy.
That ruling, in Dobbs v. Jackson Women's Health Organization, prompted 13 states to enact near-total bans on abortion. Those laws have driven a surge in medication abortion.
Since Dobbs, anti-abortion advocates have targeted mifepristone, claiming it is unsafe for women and that the FDA should not have approved it or relaxed limits on its use.
In his dissent on Thursday, Alito said that the delivery of abortion pills by mail from out-of-state providers has thwarted efforts by states like Louisiana that have sought to make abortion illegal.
In a separate dissent, Thomas said the federal Comstock Act prohibits the mailing of drugs intended for abortion.
President Trump's administration opposed Louisiana's legal challenge, citing an ongoing FDA review of safety regulations concerning mifepristone. The administration also argued that Louisiana lacks legal standing.
Abortion rights advocates have called the legal challenges to mifepristone the biggest threat to abortion access since Dobbs. They also called the Trump administration's review politically motivated.
The Supreme Court in 2024 unanimously rejected an initial bid by anti-abortion groups to roll back FDA regulations that eased access to the drug, ruling that the plaintiffs lacked legal standing.
Alexis McGill Johnson, president of the Planned Parenthood Federation of America, said, "The Supreme Court just did the bare minimum, but this ruling is a relief for patients. We know this is just one in a long line of attacks on our rights."
Lizzy Hinkley, legal director for the Abortion Coalition for Telemedicine, said, "Even this conservative Supreme Court is not willing to endorse anti-abortion extremists' latest attempt to deprive women of needed healthcare."
The brand-name version of mifepristone, Mifeprex, is Danco's only product, and GenBioPro derives most of its revenue from the generic version.
GenBioPro's CEO Evan Masingill said the company is committed to providing "evidence-based, essential medication to all who need it."
Danco spokesperson Abby Long said, "We are pleased that a safe and effective drug Americans depend on will continue to be available while this litigation proceeds."
Carol Tobias, president of the anti-abortion group National Right to Life, called Thursday's decision deeply troubling.
Medication abortion, typically a two-drug regimen of mifepristone followed by misoprostol, accounts for about two-thirds of U.S. abortions.
The FDA has said mifepristone was approved based on scientific evidence and continues to be safe and effective when used as directed.
Reproductive health experts note that hundreds of clinical trials and studies have shown mifepristone is safe and complications are rare.
Louisiana sued the FDA in 2025 claiming the 2023 rule that eliminated the in-person dispensing requirement was illegal and has allowed medication abortions to skyrocket despite the state's near-total ban.
Separate from Louisiana's case, two other pending lawsuits by five Republican-led states aim to curb access to the abortion pill even more drastically, including by cutting it off altogether.
