Court extends temporary order allowing access to abortion pill by mail

Mifepristone, one of the two drugs used in medication abortions, which are the most common form of abortions in the United States, will remain widely available throughout the United States, at least for now. In a pair of brief orders, Justice Samuel Alito extended the temporary pause – known as an administrative stay – that he had placed on a ruling by a federal appeals court in Louisiana, which would require mifepristone to be dispensed in person. That pause, which had been scheduled to expire at 5 p.m. EDT on Monday, will now last at least until 5 p.m. EDT on Thursday, May 14.

This is the second time that the Supreme Court has been asked to intervene in the battle over mifepristone. In 2024, in FDA v. Alliance for Hippocratic Medicine, the justices ruled unanimously that doctors and medical groups opposed to abortion did not have a legal right to sue, known as standing, to challenge the FDA’s roll-back of restrictions on access to mifepristone – for example, allowing the drug to be used through the 10th week of pregnancy rather than the seventh, and allowing it to be prescribed through telehealth appointments and dispensed through the mail.

Louisiana went to federal court last year, seeking to reinstate the in-person dispensing requirement. It contended that allowing mifepristone to be sent through the mail to women in Louisiana effectively circumvented the state’s strict abortion laws.

The U.S. Court of Appeals for the 5th Circuit agreed that the state has a legal right to sue, and it granted the state’s request to restore the in-person requirement while litigation continues.

That prompted two manufacturers of mifepristone, Danco Laboratories and GenBioPro, to come to the Supreme Court on May 2, seeking to pause the 5th Circuit’s order and allow mifepristone to be distributed by mail. GenBioPro told the justices that freezing the 5th Circuit’s order would simply “allow the years-long status quo to remain in force while the Food and Drug Administration (‘FDA’) completes its ongoing review” of mifepristone’s safety. If that order remains in place, it argues, “it would eliminate access to mifepristone through certified pharmacies and by mail, abruptly cutting off access for patients nationwide—including in the States that do not ban abortion.”

Louisiana countered that it had suffered the kind of injuries that give it a legal right to sue. Not only had its sovereignty been injured by the violation of its laws and its inability to enforce those laws, it contended, but it has incurred financial costs to investigate cases in which mifepristone has been sent from out of state and cases in which women who take mifepristone have had to go to the emergency room, leading to large Medicaid bills that the state must shoulder.

Alito on May 4 issued administrative stays – which put the 5th Circuit’s order on hold to give the justices time to consider the drug companies’ request – that were initially scheduled to last until Monday, May 11, at 5 p.m. EDT. But shortly before those stays were scheduled to expire, Alito extended them until Thursday, May 14, at 5 p.m. EDT.