Supreme Court Extends Administrative Stay on 5th Circuit Mifepristone Ruling Through Thursday

m. Thursday. The order delays implementation of a 5th U.S. Circuit Court of Appeals ruling that had reinstated a pre-pandemic requirement for in-person doctor or clinic visits before patients can receive the drug. Louisiana and other states had challenged the FDA's 2021 decision to eliminate the in-person dispensing requirement, arguing the change undermined their abortion laws.

Mifepristone was first approved by the FDA in 2000. The agency has gradually eased restrictions on who may prescribe it, how it is dispensed and what safety data must be collected. Abortion opponents have challenged the drug's approval and modifications for more than 25 years, filing multiple petitions and lawsuits alleging overlooked safety concerns.

Louisiana sued the FDA last fall. The state maintains that telemedicine prescriptions effectively nullify its near-total abortion ban by allowing residents to receive pills from out-of-state providers. Louisiana officials argue the eased rules pose safety risks and that the state is likely to prevail on the merits, a position the lower courts accepted before the Supreme Court intervened.

The 5th Circuit had reinstated the in-person visit requirement. Medication abortions using mifepristone in combination with misoprostol accounted for nearly two-thirds of all abortions performed in the U.S. in 2023. One quarter of abortions now occur via telemedicine.

The Trump administration has remained silent on the latest case, declining to file a brief despite the federal regulations at stake. Both sides in the litigation interpreted the administration's decision not to weigh in as tacit acceptance of the 5th Circuit's position.

The current dispute echoes a 2023 case in which the Supreme Court blocked an earlier 5th Circuit ruling that sought to restrict mifepristone access. In that matter, brought by physicians opposed to abortion, the court later ruled unanimously in 2024 that the doctors lacked standing to sue.

The justices are expected to rule on the emergency application soon after the extended Thursday deadline. Their ultimate decision could determine whether the in-person visit requirement returns while the full case proceeds or whether current access rules remain in force during litigation.