A federal appeals court has curtailed access to an abortion-inducing drug by telemedicine appointment and mail, putting on hold a Biden-era policy that had allowed mifepristone to be prescribed online and delivered by post.
The 5th U.S. Circuit Court of Appeals, arguably the most conservative appeals court in the country, said Friday the Food and Drug Administration has admitted that it rushed the approval of remote dispensation of mifepristone.
The FDA is in the middle of a do-over review, but the appeals court said it’s not clear when that might be completed. And in the meantime, the FDA’s approval must be stayed because it tramples on Louisiana’s broad abortion ban.
“The public interest is not served by perpetuating a medical practice whose safety the agency admits was inadequately studied,” Judge Stuart Kyle Duncan, a Trump appointee, wrote for the court.
The decision reverts availability of mifepristone to in-person visits at a health center.
A lower court had found that the FDA regulation was likely approved in violation of the law, but it delayed enforcement of its ruling, saying both the FDA’s interest in its ongoing review and drug manufacturer Danco’s financial interests outweighed Louisiana’s interests.
The circuit court said that was wrong.
“Danco’s potential financial losses pale beside Louisiana’s sovereign interest in its laws protecting the unborn and the public’s interest in not exposing women to unsafe medical procedures,” Judge Duncan wrote.
He acknowledged that the decision, while arising in a case involving Louisiana, would likely apply to the whole country.
Louisiana Attorney General Liz Murrill hailed the decision.
“The Biden abortion cartel facilitated the deaths of thousands of Louisiana babies (and millions in other states) through illegal mail order abortion pills,” she said in a statement. “Today, that nightmare is over.”
Alliance Defending Freedom, which worked with her to challenge the FDA, said the Biden administration approved sending the drug through the mail as a way to get around state restrictions on abortion after the Supreme Court overturned Roe v Wade in 2022.
“This was a reckless political action that destroys unborn life, puts women’s safety in serious jeopardy, and completely subverts state law,” said Eric Hawley, an ADF lawyer.
The American Civil Liberties Union, though, said Louisiana relied on “shamelessly packaged lies” to undercut mifepristone-by-mail.
“Anti-abortion politicians have just made it much harder for people everywhere in the country to get a medication that abortion and miscarriage patients have been safely using for more than 25 years,” said ACLU lawyer Julia Kaye.
Medication abortions accounted for 63% of abortions in 2023, according to the Guttmacher Institute.
And by the end of 2024, a quarter of all abortions were provided by telemedicine, according to the Society of Family Planning.
The FDA’s broader approval of mifepristone had been challenged in a case that made its way to the Supreme Court in 2024.
The justices ruled that the doctors who sued lacked standing to challenge the FDA.
Sen. Patty Murray, Washington Democrat, complained that women’s abortion rights were being “determined by the whims of a few zealous anti-abortion judges with zero medical or scientific training.”
“Do Americans really want a country where a panel of judges get to decide what medicine we can or can’t take?” she said.
The power the court used to halt the FDA’s rule nationwide is the same power that Democratic judges have used to halt a number of President Trump’s policies, including on immigration and spending cuts.
