Supreme Court temporarily restores access to abortion pill by mail

WASHINGTON -- The Supreme Court on Monday restored nationwide access to a widely used abortion medication in a temporary order that will, for now, allow women to once again obtain the pill mifepristone by mail.

In a brief order, Justice Samuel Alito paused a lower-court ruling from Friday that had prevented abortion providers from prescribing the pills by telemedicine and shipping them to patients, causing confusion for providers and patients. The one-sentence order imposes a pause until at least May 11. He requested that the parties file briefs by Thursday, and then the full court will determine how to proceed.

The state of Louisiana sued the Food and Drug Administration to restrict access to mifepristone, saying the availability of the medication by mail has allowed abortions to continue in the state despite its near-total ban.

Medication is now the method used in nearly two-thirds of abortions in the United States, and is typically delivered in the form of a two-drug regimen through the first 12 weeks of pregnancy.

Friday’s ruling from the conservative 5th U.S. Circuit Court of Appeals temporarily reinstated an FDA requirement that patients visit medical providers in person to obtain mifepristone while the litigation continues. That rule was first lifted in 2021.

Two manufacturers of mifepristone, Danco Laboratories and GenBioPro, on Saturday asked the Supreme Court to intervene. In court filings, Danco’s lawyers said the 5th Circuit ruling “injects immediate confusion and upheaval into highly time-sensitive medical decisions” and forces the companies, the FDA, providers, patients and pharmacies “all to guess at what is allowed and what is not.”

About one-fourth of abortions in the United States are now provided through telemedicine.

Alito’s order, known as an administrative stay, was provisional and expected, but an important interim step for women seeking to obtain mifepristone in the next week. The order does not signal how the full court may eventually handle the case.

Alito acted on his own at this stage because he is the justice assigned to handle emergency applications from the region of the country covered by the 5th Circuit.

The Trump administration has defended the FDA in court, but has not said whether it supports keeping in place the regulations that make it easier for women to obtain the pills. The FDA is conducting a review of mifepristone and the administration had asked the lower court to put the litigation on hold until that review is complete.

The case over access to the abortion pill puts the Trump administration in an awkward political position in the lead-up to the midterm elections because many of President Donald Trump’s allies and supporters oppose abortion. A spokesperson for the Department of Health and Human Services, which oversees the FDA, declined to comment on Saturday, citing the “ongoing litigation.”

The administration recently told The New York Times that the FDA’s review of mifepristone would probably be finished toward the end of 2026, making it less of an issue in the elections if the case is paused until then.

After the Supreme Court’s decision in 2022 to eliminate the nationwide right to abortion, Republican-led states like Louisiana imposed strict bans. In response, many Democratic-led states passed shield laws that protect abortion providers who prescribe pills by telemedicine and send them to patients in states with abortion bans. Providers in some of the states that support abortion rights are prescribing and sending pills to about 100,000 patients per year in states with abortion bans.

Louisiana and opponents of abortion have asserted in court that the FDA’s decision to allow abortion pills to be available by mail posed safety risks to women and increased healthcare costs for states that had banned abortion.

In a statement Monday, Liz Murrill, Louisiana’s attorney general, emphasized that the Supreme Court’s order was temporary and said, “I am confident life and the law will win in the end.”

Major medical organizations and supporters of reproductive rights have pointed to more than 100 studies that have found the pills to be safe and effective, with serious side effects rare.

Julia Kaye, a lawyer with the American Civil Liberties Union’s Reproductive Freedom Project, called the court’s order a “positive short-term development,” but said in a statement that the court must “put an end to this baseless attack on our reproductive freedom.”

Two years ago, the Supreme Court unanimously rejected a similar attempt to restrict access to mifepristone in a case brought by anti-abortion physicians. Justice Brett Kavanaugh, writing for the court, said the doctors did not have legal grounds to sue because they did not prescribe mifepristone and had not suffered any direct harm from the FDA’s loosening of regulations for obtaining the drug.

The physicians “want FDA to make mifepristone more difficult for other doctors to prescribe and for pregnant women to obtain,” Kavanaugh wrote, adding that under the Constitution, a group’s “desire to make a drug less available for others does not establish standing to sue.”

In the Louisiana case, the state says it has a legal basis to challenge the regulations because it is defending a strict law against abortion that it began enforcing after the Supreme Court overturned Roe v. Wade in 2022.

Lawyers for the state argue that “streams of mifepristone” are being mailed into the state despite its abortion laws. The pills, the state also asserts, have added to Medicaid costs when public hospitals must treat patients experiencing complications from pills received by mail.

In response, the companies told the Supreme Court in filings on Saturday that the harms cited by the state are too indirect and insufficient to establish grounds to sue.

This article originally appeared in The New York Times.

Copyright 2026 The New York Times Company

This story was originally published May 4, 2026 at 11:03 AM.