The Supreme Court on Friday blocked restrictions on mifepristone while a lawsuit by anti-abortion groups targeting the pill’s proceeds is brought.
In an unsigned order, the judges granted an emergency request by the Biden administration to block a lower court ruling targeting the Food and Drug Administration’s regulation of the pill. As a result of the Supreme Court order, access to the drug will remain unchanged for now.
Reproductive rights groups were anxiously awaiting the High Court’s decision, as its refusal to block the lower court’s ruling would mean a substantial reduction in access to the most common method of abortion in the US, as well as the consequences of abortion care.
It is the most important abortion rights case to make its way through the courts since Roe v. Wade was overturned in 2022. Thirteen states have banned abortions in the past nine months, but the new restrictions on the pill will apply even in states where the procedure is still allowed.
What happened?
A lawsuit was filed in November by the Christian legal group Alliance Defending Freedom (ADF), arguing The FDA exceeded its regulatory authority and ignored safety concerns when it approved mifepristone — a drug that blocks progesterone, a hormone necessary for pregnancy to develop — more than two decades ago. The FDA vehemently rejected those arguments, pointing to repeated and rigorous reviews of the highly regulated drug.
A Trump-appointed federal judge in Texas, Matthew Kaczmarik, suspended a 23-year-old approval of mifepristone by the FDA, issuing a preliminary injunction on April 7 in favor of the plaintiffs. He also supported the plaintiffs’ views that a previously defunct, 150-year-old anti-vice law called the Comstock Act “clearly forbids mail-order abortion”.
ADF is believed to have chosen to file the lawsuit in Amarillo, Texas, specifically because it will appear before Kacsmaryk, who is known for his anti-abortion views, and has used anti-abortion rhetoric throughout his decision. In which mifepristone is referred to as a drug. Used to “kill the unborn human”.
The Biden administration took the decision to the Fifth Circuit Court of Appeals, where two judges — who were also appointed by Donald Trump — blocked the portion of the decision that overturned the FDA’s initial 2000 approval of mifepristone, but which was approved earlier by the FDA. Bans on the removed drug were reimposed. , They include limiting the use of mifepristone after seven weeks of pregnancy – it is currently approved after 10 weeks – and banning delivery by mail. The FDA had decided in 2021 to remove the requirement for in-person delivery of the drug during the pandemic, broadening access by allowing the drug to be prescribed via telehealth and sent in the mail.
Where does the matter stand?
The Supreme Court has completely stayed the order of Kansmarik. The case is now back in the Fifth Circuit, which has set oral arguments for May 17, and is likely to go back to the Supreme Court.
What is the status of the abortion pill?
For the time being, mifepristone is not banned and access remains unaffected as the case progresses. Misoprostol, another drug commonly given with mifepristone to induce a medical abortion, is not at issue in the lawsuit.
Even the Supreme Court ruling should have little effect in states where abortion is already prohibited: neither misoprostol nor mifepristone are legally available for abortion in these states since the fall of Roe. After that the restrictions came into force.
While misoprostol – which helps empty the uterus by softening and dilating the cervix, and causing the uterus to contract – can be used safely on its own, it is less effective. Misoprostol-only abortions result in successful abortions 88% of the time, and have more complex side effects and a greater need for follow-up care, Recent research has shown,
Some of the main abortion providers — including Planned Parenthood, Carafem and Abortion Delivered — have confirmed they are prepared to prescribe a misoprostol-only diet for abortion In case mifepristone is withdrawn from the market. Aid Access, the international group that ships abortion pills to the US, successfully tested misoprostol-only regimens for abortions during the pandemic.
What could this case mean for abortion access?
if mifepristone is decreased available, and since medication is the cause of abortion in more than half of American abortions, providers fear that a surge in demand At clinics providing surgical procedures. Many are already stressed by an increase in the number of patients coming from states where abortion is banned or heavily restricted.
Online pharmacies and other telehealth providers have proliferated since Roe v Wade was overturned, which is enabled by the FDA’s 2021 decision to allow abortion pills. sent in the mail, If the courts eventually decide that mifepristone cannot be mailed, it could lead to the closure of those businesses.
Why did the Supreme Court stay the order?
Many abortion advocates have been anticipating this moment, given the conservative court’s decision last summer to overturn Roe v. Wade. While Friday’s order did not include any reasoning for the decision, Supreme Court precedent has generally been condescending to the FDA when it comes to regulating drugs.
The Biden administration, along with a coalition of pharmaceutical companies, warned of impending regulatory chaos around drug approval should the judiciary be allowed to order rules on mifepristone opposed by the FDA.
“If this ruling is upheld, there will be virtually no prescription, approved by the FDA, that is safe from these types of political, ideological attacks,” Biden said in a statement. written statement After the decision of Kacsmaryk in early April.
While reproductive rights groups celebrated the Supreme Court’s action to temporarily block the lower court’s decision, they also said it has no bearing on how the case will be decided.
“This is very welcome news, but it is appalling to think that Americans came within hours of losing access to the drug used in most abortions in this country and to safely prevent pregnancy by the millions for decades. abortion,” said Jennifer Dalven, director of the Reproductive Freedom Project at the American Civil Liberties Union. “Make no mistake, we are by no means out of the woods. This case, which should have been laughed out of court from the start, will continue.
