Louisiana Asks Supreme Court to Maintain Restriction on Mailing Abortion Pill

Why it matters locally: The Supreme Court case could affect abortion access nationwide, including in Texas, which has its own restrictions on medication abortion. The outcome may influence how states can challenge federal drug policies.

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The state of Louisiana filed a brief with the Supreme Court on Thursday, urging the justices to keep in place a U.S. Court of Appeals for the 5th Circuit order regarding the accessibility of mifepristone. The 5th Circuit order prohibits mailing the drug, which is one of two medications used in medication abortions. Justice Samuel Alito temporarily suspended the appellate court's order on Monday, providing the Supreme Court time to consider requests from Danco Laboratories and GenBioPro, the drug's manufacturers, to reinstate access to mifepristone. Alito's temporary pause extends until May 11. Louisiana's filing addresses *Danco Laboratories v. Louisiana* and *GenBioPro v. Louisiana*. The state argues that allowing mifepristone to be mailed violates state laws regarding abortion access. The state also requested that if the court opts to pause the 5th Circuit’s order, the court should schedule oral arguments before the summer recess. The current dispute follows the Supreme Court's 2024 ruling in *FDA v. Alliance for Hippocratic Medicine*, which determined that doctors and medical groups opposing abortion lacked standing to challenge the Food and Drug Administration (FDA)'s expanded access to mifepristone. The earlier challenge originated after the FDA broadened access to mifepristone, allowing its use through the tenth week of pregnancy, permitting non-physicians to prescribe the drug, and removing the requirement for an in-person visit. In that case, U.S. District Judge Matthew Kacsmaryk rescinded the FDA's original approval of mifepristone from 2000, along with the agency's subsequent expansions of access from 2016 and 2021. The Fifth Circuit Court of Appeals then upheld part of Kacsmaryk's ruling, specifically reinstating the in-person dispensing requirement. The Supreme Court ultimately reversed the lower court's ruling. Louisiana filed its own lawsuit last fall, seeking to reinstate the in-person dispensing requirement. After the district court paused the case awaiting the FDA's review of mifepristone's safety, Louisiana appealed to the 5th Circuit, which determined that Louisiana has a right to sue because the FDA's policies allowed mifepristone to be prescribed remotely to Louisiana women. Danco told the Supreme Court that the 5th Circuit should have used the same analysis the Supreme Court used in 2024 to conclude that the doctors and medical groups did not have standing to sue. GenBioPro argued that pausing the 5th Circuit's order would maintain the status quo while the FDA completes its review of mifepristone's safety. GenBioPro adds that the lower court's view of standing would allow states to challenge agency action based on alleged downstream costs or interference with state policy. Louisiana asserts it has a legal right to sue, citing injury to its sovereignty and increased expenses due to out-of-state distribution of mifepristone. The state cites over $17,000 in investigative costs and over $92,000 in Medicaid payments for emergency care related to mifepristone-induced abortions in 2025. The Supreme Court is expected to act on the manufacturers' request before May 11 at 5 p.m. EDT.