Supreme Court Preserves Nationwide Mail Access to Mifepristone, Pausing Fifth Circuit In-Person Requirement

WASHINGTON (LN) — The Supreme Court on Monday extended a temporary administrative stay that keeps mifepristone widely available by mail across the United States, pausing a Fifth Circuit ruling that would have forced in-person dispensing at least until May 14.

The order maintains the status quo litigation over the FDA’s approval of the drug, which is used common form of abortions. The stay, initially scheduled to expire at 5 p.m. EDT on Monday, now lasts until 5 p.m. EDT on Thursday, May 14.

The Fifth Circuit had agreed with the state of Louisiana that it had standing to challenge the FDA’s rollback of restrictions on mifepristone, which included allowing the drug to be prescribed through telehealth and dispensed through the mail. The appeals court granted Louisiana’s request to reinstate the in-person dispensing requirement while the case proceeds.

Two manufacturers of mifepristone, Danco Laboratories and GenBioPro, petitioned the Supreme Court on May 2 to pause the Fifth Circuit’s order.

GenBioPro argued that freezing the appeals court’s decision would simply allow the "years-long status quo to remain in force while the Food and Drug Administration ('FDA') completes its ongoing review" of the drug’s safety.

The company warned that if the Fifth Circuit’s order remained in place, it would "eliminate access to mifepristone through certified pharmacies and by mail, abruptly cutting off access for patients nationwide—including in the States that do not ban abortion."

Louisiana countered that it had suffered specific injuries giving it the right to sue. The state contended that its sovereignty was injured by the violation of its laws and its inability to enforce them. Louisiana also argued it incurred financial costs to investigate cases where mifepristone was sent from out of state and to cover large Medicaid bills for women who had to go to the emergency room after taking the drug.

This marks the second time the Supreme Court has intervened battle over mifepristone. In 2024, in FDA v. Alliance for Hippocratic Medicine, the justices ruled unanimously that doctors and medical groups opposed to abortion did not have standing to challenge the FDA’s decision to allow the drug to be used through the 10th week of pregnancy rather than the seventh.

Alito issued the initial administrative stays on May 4, which were set to expire on May 11. The extension ensures that mail-order access to the abortion pill remains uninterrupted while the justices consider the manufacturers’ request for a longer-term pause.