Supreme Court Keeps Abortion Pill Available by Mail

The Supreme Court ensured on May 14, 2026, that the abortion pill mifepristone can continue to be available by mail without an in-person appointment with a clinician. A ruling by the New Orleans-based 5th U.S. Circuit Court of Appeals on May 1 had imperiled widespread access to the pill.

The Supreme Court granted emergency requests brought by drugmakers Danco Laboratories and GenBioPro seeking to block that ruling. The decision, a loss for the state of Louisiana, ensures there will not be any disruption to the availability of the drug as litigation continues.

On May 4, in an order issued by conservative Justice Samuel Alito, the court had provisionally put the appeals court ruling on hold while the justices considered their next steps. Two conservative justices, Clarence Thomas and Samuel Alito, dissented from the latest order.

” In a separate opinion, Alito said the former Biden administration’s decision to make mifepristone available by mail in 2023 was an attempt to “undermine” the court’s 2022 ruling that overturned abortion rights landmark Roe v. Wade. >"The Supreme Court just did the bare minimum, but this ruling is a relief for patients who can continue to get the care they need.

" — Alexis McGill Johnson, president of the Planned Parenthood Action Fund (@NBCNews) The underlying case involves Louisiana’s challenge to the Food and Drug Administration’s decision during the former Biden administration to allow mifepristone to be administered without in-person appointments.

This allows access to the drug even in states where abortion is banned. Anti-abortion groups have been pushing to reinstate the in-person dispensing requirement, alleging that taking mifepristone at home can be dangerous, although studies have found it to be safe and effective.

In asking the Supreme Court not to intervene, Louisiana Attorney General Liz Murrill, a Republican, wrote in court papers that even though abortion is almost totally banned in the state, up to 1,000 abortions a month are taking place because of mifepristone pills being mailed to women there.

Murrill said it is shocking that the Supreme Court would block this common-sense return to medically ethical practices and oversight. She added that the state will keep fighting. Erin Hawley, an attorney for the Alliance Defending Freedom, which is litigating the case alongside the state of Louisiana, said it is high time the former Biden FDA be held accountable for the destruction it has caused with this high-risk drug.

The attorney added that the groups look forward to litigating their appeal at the 5th Circuit to protect mothers and their children.

Mifepristone is used as part of a two-drug FDA-approved regimen that is now the most common form of abortion in the U.S. It is also used in miscarriage care. The companies argued that Louisiana did not have standing, citing the Supreme Court’s 2024 decision that rejected a similar challenge to the FDA’s approvals of mifepristone on the grounds that the plaintiffs could not show they had suffered any injury.

Danco, which makes Mifeprex, the brand-name version of mifepristone, said in a statement that it is pleased that a safe and effective drug Americans depend on will continue to be available while this litigation proceeds. Evan Masingil, CEO of GenBioPro, which markets the generic version of the pill, said the company is committed to providing the evidence-based, essential medication to all who need it.

In an unusual move, the Trump administration did not file a brief at the Supreme Court even though the FDA is technically a defendant in the case. The government did file in the appeals court case, urging the court to rule in favor of the drug companies on the basis that Louisiana did not have legal standing to bring its claims.

The FDA is reviewing the safety protocols for mifepristone, meaning availability by mail could still be overturned. Louisiana’s lawsuit not only would disrupt FDA’s ongoing review, and usurp FDA’s scientific role, but would also threaten chaos, the Justice Department told the appeals court.

Following the Supreme Court decision, the FDA said on X that it will press forward to complete its science-based safety review of the pill. Abortion is effectively banned altogether in 13 states, while several others have tight restrictions, according to the Guttmacher Institute, a research group that backs abortion rights.