Louisiana requested on Thursday that the U.S. Supreme Court refuse emergency relief that would restore broader access to the abortion pill mifepristone via telemedicine and mail delivery, asking the justices to allow a lower court order restricting the drugs distribution to remain while the state's legal challenge proceeds.
In a filing, the office of Republican Attorney General Liz Murrill urged the high court to reject motions by two mifepristone manufacturers, Danco Laboratories and GenBioPro, which have asked justices to lift a decision from the 5th U.S. Circuit Court of Appeals that narrowed access to the medication. Murrills filing framed the FDA regulation at issue as the catalyst for a surge in medication abortions in Louisiana despite a near-total state ban.
The contested Food and Drug Administration regulation, issued during the administration of President Joe Biden, removed a prior in-person dispensing requirement for mifepristone and permitted prescribing by telemedicine and distribution by mail. Murrills office said the change has led to a significant increase in medication abortions in Louisiana, writing in the court filing: "Notwithstanding Louisianas policy and laws, hundreds of abortions are occurring every month in Louisiana. That is the predictable consequence of a drug war enabled by President Bidens FDA."
The regulation remains effective for now after the Supreme Court on Monday issued an interim order that temporarily paused the 5th Circuits recent ruling in favor of Louisiana. The temporary stay was taken to give the justices time to consider the emergency petitions filed by Danco and GenBioPro, which intervened in the litigation to defend the FDA rule.
The dispute has again placed the question of access to mifepristone before the court as groups opposed to abortion seek to curtail the pills availability, with the legal fight unfolding against the backdrop of the upcoming U.S. congressional elections in November.
The Supreme Court previously addressed a related challenge in 2024 when it unanimously rejected an earlier attempt by anti-abortion groups and several doctors to rescind FDA measures that had eased access to mifepristone. In that decision, the justices found the plaintiffs lacked the legal standing required to pursue their claims.
The current litigation follows earlier, consequential judicial developments. After the court's 2022 ruling that struck down the federal precedent that had guaranteed a nationwide right to an abortion, a number of states moved to tightly restrict or ban abortion. That environment has prompted opponents of abortion to target the regulatory framework governing mifepristone, arguing the drug is unsafe and that the FDAs approval and subsequent relaxation of dispensing rules were improper.
The FDA has defended its actions, saying the approval of mifepristone was grounded in scientific evidence and that the medication remains safe and effective when used according to guidance. Reproductive health specialists note a large body of clinical work supporting the safety profile of mifepristone, including hundreds of trials, studies and reviews, and they say serious complications and adverse events associated with telehealth and mail provision of the pill are rare.
Mifepristone, which received FDA regulatory approval in 2000, is taken in combination with misoprostol to effect a medication abortion. Medication abortions now make up more than 60% of all abortions in the United States, according to figures cited in the litigation record.
In 2025, Louisiana filed suit against the FDA, contending that the agencys conclusion that available data supported removing the long-standing in-person dispensing requirement was unlawful and undermined the effectiveness of the states near-total abortion ban. Danco Laboratories and GenBioPro intervened to defend the FDA regulation in that case.
The Republican administration of President Donald Trump filed a brief opposing Louisianas challenge, citing an ongoing federal review of mifepristones safety and arguing that Louisiana lacked standing to bring the suit. In April, U.S. District Judge David Joseph in Lafayette declined to enjoin the FDA regulation but agreed with the executive branch that the case should be held in abeyance while the review proceeded. The 5th Circuit then issued an order blocking the rule on May 1.
Advocates for abortion rights have criticized the Trump administrations safety review as politically motivated and unnecessary, noting what they describe as decades of research supporting mifepristones safety. These advocates warn that the review could produce recommendations or actions that further limit access to the medication.
Context and next steps
The Supreme Courts interim decision preserves the challenged FDA rule for the moment while the court considers the manufacturers emergency petitions and the broader legal questions returned to it by the lower courts. The high court must decide whether to allow the 5th Circuits block of the rule to remain in place nationwide or to deny the manufacturers requests and keep the regulation operative during continued litigation.
At the center of the dispute are competing legal positions on standing, the scope of federal regulatory authority, and the implications of the removal of the in-person dispensing requirement for state-level abortion restrictions. Those legal issues will determine whether telemedicine prescribing and mail distribution of mifepristone remain broadly available while litigation and the federal safety review continue.
Because the litigation intersects with ongoing federal reviews and prior Supreme Court rulings, its outcome may further influence state-level enforcement of abortion bans and the regulatory environment for medication abortion providers and manufacturers.