Supreme Court Grants One-Week Stay on Fifth Circuit Order Limiting Telehealth Prescriptions of Mifepristone

The Supreme Court on May 5, 2026, issued a one-week administrative stay that temporarily prevents a Fifth Circuit order from taking effect while the justices consider emergency applications in the case. The stay allows providers to continue prescribing mifepristone via telemedicine and mailing the drug to patients through May 11, 2026. The parties were directed to file briefs by May 7, 2026.

Louisiana asked the Supreme Court to allow the Fifth Circuit’s order to take effect immediately. In its filing, the state argued that the FDA’s 2023 formalization of telehealth and mail-order access for mifepristone undermines Louisiana’s abortion laws and causes the state irreparable harm.

Louisiana sued the FDA last fall, contending that the agency exceeded its authority by removing long-standing in-person requirements that had been in place since the drug’s approval.

Judge Stuart Kyle Duncan wrote a 19-page opinion for the Fifth Circuit stating that telemedicine access to mifepristone injures Louisiana “by undermining its laws protecting unborn human life” and “by causing it to spend Medicaid funds on emergency care for women harmed by mifepristone.” Duncan wrote that both injuries “are irreparable.”

A district court had placed Louisiana’s challenge on hold in April 2026. Louisiana appealed that decision to the Fifth Circuit. The state became the first to schedule mifepristone and misoprostol as controlled dangerous substances in 2024. Its law requires prescribers to obtain special licensure, mandates that the drugs be stored under lock and key, and requires all prescriptions to be tracked through a state database.

Anyone possessing the pills without a valid prescription faces fines or jail time.

In December 2024, two months after the law took effect, a doctor performing an emergency C-section had to retrieve misoprostol from a locked pharmacy cabinet across the hospital; the drug had previously been kept within arm’s reach on delivery-room trays.

The FDA approved mifepristone in 2000 with a requirement that patients receive it in person at a clinic or doctor’s office. The agency long required physicians to prescribe the drug in person and supervise patients taking the first dose. During the coronavirus pandemic the FDA began allowing telehealth prescriptions and mail delivery.

It made that policy permanent in 2023. In September the FDA announced it would revisit the drug’s prescribing rules.

Louisiana is the first state to criminally indict an out-of-state physician for providing telemedicine abortion. Top Republicans urged the Supreme Court to reinstate abortion pill restrictions, according to court filings referenced in reporting on the case.

Medication abortion accounts for nearly two-thirds of all abortions in the United States. Telehealth now accounts for about one quarter of abortions nationwide. The Guttmacher Institute estimated there were 9,000 abortions in Louisiana in 2025. Nearly two dozen Democratic-led states filed an amicus brief. A group of former FDA leaders also submitted an amicus brief.