Supreme Court lifts ban on mail-order and online mifepristone
Justice Alito's action is effective until May 11, when further arguments are due
The U.S. Supreme Court on has temporarily lifted a ban on telehealth access to the abortion medication mifepristone, pausing a lower-court order that had blocked by-mail and remote prescriptions.
Justice Samuel A. Alito penned the brief order, which had been issued last weekend by the Fifth U.S. Circuit Court of Appeals in New Orleans. His one-sentence ordered pauses that action until at least May 11.
Attorneys for the parties are asked to file briefs by Thursday. The full court will then decide how to proceed.
The Fifth Circuit’s ruling came in response to a lawsuit filed by the state of Louisiana against the Food and Drug Administration, saying the availability of the medication by mail has allowed abortions to continue in the state despite its near-total ban.
Read the original story about the ban.
States had urged a stay of the Fifth Circuit’s order
New York Attorney General Letitia James today led a coalition of 21 other states and the District of Columbia in urging the U.S. Supreme Court to stay the mifepristone ruling.
In an amicus brief filed with the Supreme Court, Attorney General James and the coalition argue that the Fifth Circuit’s ruling is not supported by science, would create regulatory and administrative chaos nationwide, and would interfere with states’ ability to protect access to reproductive health care within their borders. They are calling on the Court to stay the lower court’s order and prevent these restrictions from taking effect.
“Forcing patients to obtain mifepristone in person will not make anyone safer, and it will not stop people from needing abortions,” said James, in a news release. “Every unnecessary restriction on abortion care has a human cost. It is paid by the patient who now must drive hundreds of miles, the mother who cannot find child care, the worker who cannot lose a day’s pay, and every person whose health is put at risk by delayed care. The Supreme Court must follow the science and stop this dangerous rollback of reproductive freedom.”
75 million people
Mifepristone, when used in combination with misoprostol, is the standard medication used to terminate a pregnancy through 10 weeks. Since the U.S. Food and Drug Administration (FDA) approved mifepristone in 2000, an estimated 7.5 million people in the United States have used the medication safely.
Medication abortion now accounts for 63 percent of all abortions in the formal U.S. health care system, with approximately one in four abortions provided via telehealth. Studies have consistently found mifepristone to be safe and effective.
In 2023, after extensive review, the FDA eliminated the in-person dispensing requirement for mifepristone as medically unnecessary. That decision followed years of evidence, including during the COVID-19 pandemic, showing that mifepristone could be safely provided without requiring patients to appear in person.
The FDA’s action allowed providers to offer mifepristone through telehealth and enabled patients to obtain the medication through certified mail-order pharmacies and other approved channels, expanding access for patients who face significant barriers to in-person care.
Rural, underserved communities hard hit
Attorney General James and the coalition argue that reinstating the in-person dispensing requirement would vastly curtail telehealth access to mifepristone, forcing patients to rely on more difficult alternatives or travel for in-person care.
Telehealth has become an increasingly important way for patients to access abortion care, with the share of abortions provided through telemedicine growing from five percent in 2022 to 27 percent in 2025. The coalition warns that the Fifth Circuit’s ruling would hit hardest in rural and underserved communities, and for patients who cannot afford to miss work, arrange child care, pay for travel, or navigate long distances to reach a clinic.
The brief also argues that the ruling would disrupt care in states like New York, where abortion remains legal and protected.
Since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, clinics in states that protect abortion access have faced increased demand from both in-state and out-of-state patients.
By forcing more patients to seek in-person care, the Fifth Circuit’s ruling would place new strain on clinics and health care systems that are already stretched, potentially delaying access not only to abortion care but also to other essential health services, including prenatal care, family planning, cancer screenings, and testing and treatment for sexually transmitted infections, James said.
The Fifth Circuit “has placed a federal thumb on the scale in favor of states that have made contrary policy choices, but that is the exact opposite of what [the Supreme] Court directed in Dobbs.”
Joining Attorney General James in filing today’s brief are the attorneys general of Arizona, California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Rhode Island, Vermont, Virginia, Washington, and the District of Columbia, as well as the Governor of Pennsylvania.