Supreme Court temporarily extends women’s access to a widely used abortion pill

WASHINGTON (AP) — The Supreme Court is leaving women’s access to a widely used abortion pill untouched until at least Thursday, while the justices consider whether to allow restrictions on the drug, mifepristone, to take effect.

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Justice Samuel Alito’s order Monday allows women seeking abortions to continue obtaining the pill at pharmacies or through the mail, without an in-person visit to a doctor. It prevents restrictions on mifepristone imposed by a federal appeals court from taking effect for the time being.

Advocates in Massachusetts welcomed the ruling, but with caveats.

While the drug remains available until Thursday, “patients and providers should never have to live in a constant state of legal limbo when it comes to accessing or providing essential health care,” Claire Teylouni and Taylor St. Germain, the interim co-executive directors of the Boston-based reproductive rights group, Reproductive Equity Now, said in a statement.

“This ongoing legal back-and-forth is dangerous by design — the uncertainty, confusion, and fear created by these court decisions are themselves barriers to care. The anti-abortion movement’s goal is to make people unsure of their rights, their legal risk, and whether care will still be available tomorrow,” they said.

Dominique Lee, President & CEO of Planned Parenthood League of Massachusetts, offered a similar sentiment.

“For thousands of our patients, access to telemedicine and receiving one’s medication by mail is not merely a convenience; it is a lifeline. They mean the difference between receiving timely medical care or going without it altogether,” Lee said. “Telehealth allows patients get time-sensitive health care while avoiding long travel distances, lost wages, the enormous cost of childcare, or unsafe situations.”  

“Access to healthcare should not depend on a patient’s zip code, income, or ability to take days off of work. Telehealth expands freedom, dignity, and self-determination. It gives people the ability to make deeply personal medical decisions with privacy, autonomy, and support.” Lee said.

The high court is dealing with its latest abortion controversy four years after its conservative majority overturned Roe v. Wade and allowed more than a dozen states to effectively ban abortion outright.

The case before the court stems from a lawsuit Louisiana filed to roll back the Food and Drug Administration’s rules on how mifepristone can be prescribed.

The state claims the policy undermines the ban there, and it questions the safety of the drug, which was first approved in 2000 and has repeatedly been deemed safe and effective by FDA scientists.

Lower courts concluded that Louisiana is likely to prevail, and a three-judge panel of the 5th U.S. Circuit Court of Appeals ruled that mail access and telehealth visits should be suspended while the case plays out.

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The drug is most often used for abortion in combination with another drug, misoprostol. Medication abortions accounted for nearly two-thirds of all abortions in the U.S. in 2023, the last year for which statistics are available.

The current dispute is similar to one that reached the court three years ago.

Lower courts then also sought to restrict access to mifepristone, in a case brought by physicians who oppose abortion. They filed suit in the months after the court overturned Roe.

The Supreme Court blocked the 5th Circuit ruling from taking effect over the dissenting votes of Alito and Justice Clarence Thomas. Then, in 2024, the high court unanimously dismissed the doctors’ suit, reasoning they did not have the legal right, or standing, to sue.

In the current dispute, mainstream medical groups, the pharmaceutical industry and Democratic members of Congress have weighed in cautioning the court against limiting access to the drug. Pharmaceutical companies said a ruling for abortion opponents would upend the drug approval process.

The FDA has eased a number of restrictions initially placed on the drug, including who can prescribe it, how it is dispensed and what kinds of safety complications must be reported.

Despite those determinations, abortion opponents have been challenging the safety of mifepristone for more than 25 years. They have filed a series of petitions and lawsuits against the agency, generally alleging that it violated federal law by overlooking safety issues with the pill.

President Donald Trump’s administration has been unusually quiet at the Supreme Court. It declined to file a written brief recommending what the court should do, even though federal regulations are at issue.

The case puts Trump’s Republican administration in a difficult place. Trump has relied on the political support of anti-abortion groups but has also seen ballot question and poll results that show Americans generally support abortion rights.

Both sides took the silence as an implicit endorsement of the appellate ruling. Alito is both the justice in charge of handling emergency appeals from Louisiana and the author of the 2022 decision that declared abortion is not a constitutional right and returned the issue to the states.

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