Supreme Court Extends Stay on Mifepristone Mail Access Through Thursday

The U.S. Supreme Court on Monday extended an administrative stay by Justice Samuel Alito, keeping abortion pill mifepristone available through the mail and pharmacies without an in-person visit to a doctor until at least Thursday at 5 p.m. EDT.

The order preserves access while the justices consider whether restrictions imposed by the 5th Circuit Court of Appeals can take effect, after the Fifth Circuit had temporarily banned mailing mifepristone and required in-person distribution.

ABC

Louisiana’s lawsuit against the Food and Drug Administration sought to restrict access to mifepristone, after the state objected to a 2023 FDA regulation that allowed mifepristone to be prescribed through telehealth, in pharmacies and through the mail.

Manufacturers Danco Laboratories and GenBioPro rushed to the high court after the 5th Circuit sided with the Republican-led state, arguing Louisiana has no right to sue because it hasn’t suffered actual harm and that removing the in-person requirement is safe.

The Trump administration did not take a position when the battle landed at the Supreme Court, leaving the dispute to be decided through the justices’ emergency review process.

The Supreme Court’s Monday order also kept telehealth access on hold, extending a short-term stay until Thursday at 5 p.m. ET as justices deliberated over an emergency appeal.

CNN reported that Alito’s order “included no rationale or explanation,” while medical providers described the hours after the May 1 5th Circuit decision as “craziest” and “most chaotic” they’ve experienced.

ABC News

In the underlying dispute, Louisiana argued that FDA’s telehealth and mail policy undermines the ban there and questioned the safety of the drug, which was first approved in 2000 and has repeatedly been deemed safe and effective by FDA scientists.

The 5th Circuit’s earlier ruling had required women to obtain mifepristone through in-person visits, and the court order said halting enforcement under Rule 705 would have, in practical terms, a national impact.

The stakes are framed differently by the ACLU and by Republican lawmakers, with the ACLU calling the Monday decision a “short-term positive development” and Senate Democratic Leader Chuck Schumer saying, “This fight has just begun.”

The Supreme Court’s extension gives the justices more time to decide whether restrictions on mifepristone can take effect, with the pause designed to “give the justices more time to mull it over” as the case proceeds.

If conservative activists succeed in banning mifepristone by mail, HuffPost said it would be a significant step toward a national abortion ban, noting that abortion pills by mail account for nearly two-thirds of all abortions in the U.S.

ABC7 New York reported that medication abortions accounted for nearly two-thirds of all abortions in the U.S. in 2023, and that the drug is most often used for abortion in combination with another drug, misoprostol.

The dispute also centers on how FDA rules interact with state bans, with the 5th Circuit writing that “every abortion made available under the FDA's process overrides the ban Louisiana has imposed.”

Beyond the immediate access question, the NPR report described how the telemedicine process allows a healthcare provider to prescribe mifepristone and misoprostol and how patients can pick up medicine at a local pharmacy or have providers mail the drugs to a patient’s home.