Supreme Court Pauses Appeals Court Decision Reinstating In-Person Requirement for Mifepristone

U.S. Circuit Court of Appeals ruling on hold for one week, preserving telemedicine access to mifepristone through May 11, 2026 at least. Two drugmakers had appealed the May 1 decision immediately after it rolled back nationwide the ability to prescribe the drug via telemedicine and send it through the mail.

U.S. Circuit Court of Appeals is based in New Orleans. On May 1 a panel of its judges agreed with Louisiana and brought the in-person requirement back nationwide effective immediately. Judge Stuart Kyle Duncan, a Trump-appointee, wrote the 19-page opinion.

Judge Stuart Kyle Duncan wrote 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, and that both injuries are irreparable.

The ruling marked the latest turn in a legal battle that began last fall when Louisiana sued the FDA. The state argued that telemedicine access undermines its strict abortion ban.

A district court judge put the Louisiana case on hold in April 2026, prompting the state to appeal to the 5th Circuit. Louisiana is the first state to schedule mifepristone as a controlled substance. It is also the first state to criminally indict an out-of-state physician providing telemedicine abortion, according to Mary Ziegler, a law professor and abortion historian at the University of California Davis.

The FDA approved mifepristone in 2000 with a requirement that patients go in person to a clinic or doctor's office. During the COVID-19 pandemic the FDA began to allow the drug to be dispensed at a local pharmacy or through the mail. The agency made the telemedicine policy official in 2023.

The Supreme Court overturned the constitutional right to abortion in the Dobbs decision. Telemedicine abortion now accounts for one quarter of abortions across the country. The number of abortions has increased since Roe v.

Wade was overturned nearly four years ago. U.S. in 2025. In Louisiana, the same organization counted 9,000 abortions last year.

Nearly two dozen Democratic-led states submitted an amicus brief in the case. A group of former leaders of the FDA also wrote an amicus brief defending the agency's process. In 2023 a federal judge in Texas named Matthew Kacsmaryk ruled that mifepristone should be pulled from the market altogether.

The Supreme Court unanimously dismissed that case in 2024 because the justices determined the group of pro-life doctors did not have standing. The Supreme Court's one-week stay expires on Monday, May 11, 2026. NPR reported that at that point the court could extend the stay, grant a longer one, or allow the appeals court decision to take effect while litigation continues.