Supreme Court pauses in-person mifepristone requirement, mail telehealth allowed
In a brief order Thursday, the Supreme Court allowed mifepristone to remain available through telehealth visits and by mail, putting a temporary stop to a lower-court ruling that would have required in-person access. Justices Clarence Thomas and Samuel Alito d
When the Supreme Court stepped in Thursday, it did so without explanation, but the stakes were immediate: whether patients would have to show up in person to get mifepristone, or whether telehealth and mail delivery could continue.
In a brief order, the nation’s highest court paused a lower court decision that had required in-person visits to obtain the abortion pill. The court did not spell out its reasoning.
Justices Clarence Thomas and Samuel Alito dissented. Alito called the order “remarkable,” arguing that the majority’s move effectively lets states work around the Supreme Court’s earlier decision overturning Roe v. Wade.
The fight over mifepristone has been central to abortion policy since the Supreme Court’s shift in constitutional law. The pills are now used in nearly two-thirds of abortions in the U.S., and about one-quarter involve telehealth, according to The New York Times.
Louisiana’s lawsuit put the question back on the Court’s docket, after the state sued the FDA over Biden-era rules that expanded access to mifepristone by mail. Louisiana says the federal policy undermines its strict abortion ban and puts women at risk.
Abortion rights groups and drugmakers counter that restricting access would create nationwide disruption for patients and providers.
The legal dispute rests on a regulatory change that began in 2021. when the FDA lifted a rule requiring patients to see a provider in-person before obtaining the abortion pill.. Earlier this month, the U.S.. Court of Appeals for the Fifth Circuit reimposed that in-person requirement in response to Louisiana’s suit.
The Supreme Court’s pause is temporary, and the issue is expected to return to the Court again.
Behind the scenes, the Trump administration has pressed for more time. Lawyers for the Trump administration said the FDA is conducting a review of mifepristone’s safety and asked lower courts to delay Louisiana’s lawsuit until the review is complete.
After Thursday’s Supreme Court order, the FDA said in a post on social media it will “press forward to complete its science-based safety review” of the pill.
Sen.. Josh Hawley, R-Mo., has also been pushing for a broader rollback.. In March, he introduced a bill that would revoke the FDA’s approval of mifepristone.. The measure would make labeling and distributing mifepristone for pregnancy termination a violation of federal law and create a pathway for women to sue drug manufacturers for damages.
The bill would still allow the drug’s use to treat other conditions, including Cushing’s syndrome.
For now, the Supreme Court has kept the telehealth and mail channels open—just long enough to ensure the question remains unresolved in the courts, with Louisiana’s challenge and the FDA’s review set to keep pulling the policy toward another legal confrontation.
Supreme Court mifepristone telehealth mail delivery Louisiana FDA abortion pill Fifth Circuit Josh Hawley