The Supreme Court has temporarily restored the ability for patients to receive the abortion drug mifepristone by mail, pausing a recent lower court ruling that would have required in-person doctor visits to obtain the medication. The decision, announced on Monday (May 4), means telehealth and mail access to the abortion pill will continue while the justices review emergency appeals from the drug’s manufacturers.
The temporary hold, known as an “administrative stay,” was requested after the 5th Circuit Court of Appeals ruled on Friday (May 1) in favor of Louisiana, which argued that Biden-era rules allowing for telehealth prescribing and mail delivery of mifepristone threatened both patient safety and the state’s abortion ban. The appeals court’s ruling would have required patients nationwide to get the drug in person from a physician, even in states where abortion is legal.This would have left patients scheduled for appointments in limbo and created “immediate chaos” for those seeking timely care.
Danco Laboratories and GenBioPro, the two pharmaceutical companies that manufacture mifepristone, urgently appealed to the Supreme Court on Saturday (May 2), warning of confusion and potential harm to patients and their business. Danco’s lawyers argued that the lower court’s decision would cause “irreparable” harm, as mifepristone is its only product and a nationwide ban on telehealth and mail distribution would eliminate its sole revenue source. The company also asked the justices to take up the case before their summer recess, saying the legal uncertainty “injects immediate confusion and upheaval into highly time-sensitive medical decisions.”
Medication abortions, which use mifepristone, account for more than half of all U.S. abortions. The Guttmacher Institute reports that over sixty percent of abortions in 2023 were medication abortions, and about one quarter of patients depend on telehealth to access the drug. The lower court ruling would have also affected non-abortion uses of mifepristone, such as treating miscarriages.
The case originated after the Food and Drug Administration (FDA) made permanent a regulation in 2023 that allowed mifepristone to be prescribed online and mailed to patients. Louisiana sued, arguing this undermined its state abortion ban. The Supreme Court’s action on Monday (May 4) does not decide the merits of the case but keeps the current FDA policy in place for now.
Industry leaders and advocacy groups have warned that if the appeals court ruling stands, it could set a precedent for challenges to other FDA-approved medications, affecting treatments beyond abortion. Shehnaaz Suliman, CEO of ReCode Therapeutics, said such a move “threatens the evidence-based framework that has enabled generations of Americans to access safe, innovative medicines.”
The Supreme Court is expected to decide soon whether to take up the case and issue a long-term ruling on mail and telehealth access to mifepristone. For now, patients can continue to receive the drug by mail as the legal process continues. This is not a final decision, but it maintains the status quo while the court reviews the emergency appeals.
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