The U.S. Supreme Court on Monday extended a temporary hold on a judicial decision that would have limited how the abortion pill mifepristone is prescribed and sent through the mail. Justice Samuel Alito kept the stay in place until May 14, enabling the drug to continue to be dispensed by mail while the justices determine their next steps.
All nine justices are now reviewing an application from two manufacturers of mifepristone seeking to overturn a ruling by the New Orleans-based 5th U.S. Circuit Court of Appeals. The 5th Circuit on May 1 reinstated an earlier requirement that patients obtain mifepristone only after an in-person visit with a clinician - a constraint that conflicts with a 2023 U.S. Food and Drug Administration rule issued during the administration of Democratic former President Joe Biden.
The manufacturers, Danco Laboratories and GenBioPro, have appealed the 5th Circuit decision that limited access to the medication. The Supreme Court previously issued an interim order on May 4 putting the appeals court action on hold in order to give the justices additional time to consider the matter.
Medication abortion typically involves a two-drug regimen with mifepristone followed by misoprostol, and it accounts for about two-thirds of abortions in the United States. Any court-imposed restriction on how mifepristone is prescribed or dispensed has the potential to substantially reduce access nationwide, according to the factual record in the case.
The dispute has returned the issue of abortion access to the high court's docket at a politically sensitive moment. The article's reporting notes that the November midterm congressional elections are approaching and that President Donald Trump’s fellow Republicans are contesting to keep control of Congress. The litigation follows a 2024, unanimous Supreme Court rejection of an earlier challenge by anti-abortion groups and some doctors seeking to undo FDA regulatory changes that eased access to mifepristone.
These legal battles occur in the wake of the Supreme Court's 2022 ruling that overturned the Roe v. Wade precedent. That decision led 13 states to enact near-total bans on abortion and prompted several other states to sharply restrict access to the procedure. In 2025, Louisiana filed suit against the FDA, asserting that the 2023 rule removing the in-person dispensing requirement was unlawful and arguing that the change had allowed medication abortions to increase dramatically despite the state’s near-total ban on abortion.
For now, the practical effect of the Supreme Court's latest order is to maintain the status quo for access to mifepristone by mail until the justices issue further direction or lift the temporary hold. The case remains active at the highest level of the federal judiciary and could lead to additional orders or a final ruling that would clarify whether the FDA's 2023 regulatory change will stand.
Context and process
- Justice Samuel Alito extended the stay on the 5th Circuit decision until May 14.
- The litigation challenges a 2023 FDA rule that eliminated an in-person dispensing requirement for mifepristone.
- Drugmakers Danco Laboratories and GenBioPro appealed the 5th Circuit action that reinstated the older in-person requirement.
Next steps
The Supreme Court will continue to consider the manufacturers’ request and may issue further orders after the temporary pause expires. Until the Court resolves the appeals or modifies the stay, mifepristone may continue to be prescribed via telemedicine and dispensed through the mail under the existing interim status.