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Supreme Court restores access to mail-order abortion pill mifepristone, for now

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Justice Samuel Alito on Monday issued an administrative stay of a lower court order that had rolled back access to mifepristone nationwide.

The move restores expanded access to the abortion pill without the need for an in-person doctor’s visit, for now. The pill can once again be prescribed via telemedicine and obtained via mail or pharmacy, a practice approved by the Food and Drug administration in 2023. 

Justice Samuel Alito did not explain his decision.

The order from Alito is set to expire May 11, suggesting the full court will act by that time on whether to grant an extended stay of the lower court ruling as litigation over the safety of mifepristone guidelines continues.

The state of Louisiana, which bans abortion at all stages of pregnancy with limited exceptions, originally brought the case in a bid to block mail-order access to the abortion pill, alleging federal regulators did not properly consider safety risks when discontinuing an in-person doctor visit requirement. 

Drug makers, public health organizations and abortion rights advocates insist legally mandated reviews were conducted and that the drug has a lower adverse effects rate than penicillin and Viagra.

The 5th U.S. Circuit Court of Appeals, which Alito oversees, on Friday issued a nationwide order barring the commonly used abortion drug from being dispensed by telehealth providers or distributed by mail as litigation continues. The order was effective immediately.

In this April 13, 2023, file photo, packages of Mifepristone tablets are displayed at a family planning clinic, in Rockville, Md.

Anna Moneymaker/Getty Images, FILE

The two primary makers of mifepristone, Danco Laboratories and GenBioPrio, on Saturday asked the Supreme Court to lift a lower court’s ruling.

“The resulting chaos for patients, providers, pharmacies, and the drug-regulatory system is a quintessential irreparable harm that underscores the need for emergency relief from this Court,” lawyers for Danco Laboratories wrote in their filing.

In 2024, the Supreme Court unanimously rejected a similar legal challenge to mifepristone, concluding that the doctors and anti-abortion groups who sued over the drug did not have standing. 

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