The Supreme Court on Thursday kept mifepristone abortion pills available for now, pending further litigation, siding with the drug’s manufacturers over Louisiana in an emergency appeal that called nationwide access to the widely used medication into question.
Justices Clarence Thomas and Samuel Alito dissented.
The manufacturers brought emergency appeals to the justices after a federal appellate panel issued an order on May 1 that would stop the pills from being mailed nationwide without needing an in-person visit to a doctor. The companies, Danco and GenBioPro, called the lower court order unprecedented and warned of chaos if it wasn’t halted. The order came from a three-judge panel of all GOP appointees, including two Trump appointees, on the U.S. Court of Appeals for the 5th Circuit.
Alito, who fields emergency appeals from that circuit, granted temporary relief for the drug companies on May 4 through May 11 and then extended that relief through Thursday at 5 p.m. ET. He issued what are known as administrative stays, which weren’t statements about his position on the merits of the issue, but the practical effect was to keep the drug available while he and his colleagues considered the matter further. The court missed Alito’s deadline on Thursday and issued the order closer to 5:30 p.m. ET.
Louisiana urged the justices to let the circuit’s order stand while the state’s lawsuit continues against the drug’s remote availability without seeing a doctor in-person. The Republican-led state argued that the issue stemmed from the Biden administration’s attempt to undermine the 2022 Dobbs ruling that overturned Roe v. Wade, and that the companies merely wanted to “increase their profits by selling more abortion drugs” and avoid compliance costs.
During previous litigation that also came from the 5th Circuit and featured administrative stays before the full Supreme Court weighed in, the court in 2023 issued an order that kept the drug available and then, in 2024, the court unanimously held that anti-abortion doctors lacked legal standing to sue. Justice Brett Kavanaugh wrote for the court that “a plaintiff ’s desire to make a drug less available for others does not establish standing to sue.”
In this latest litigation, the drug companies argued that Louisiana’s claimed injuries — to its sovereignty and finances — are likewise insufficient to establish standing and that the state’s lawsuit can be thrown out on that basis. The suit stemmed from the state’s claim that the Food and Drug Administration violated federal law when it said the drug can be dispensed remotely.
When it sided with the state in the order that the companies challenged, the 5th Circuit panel noted that Louisiana said it paid $92,000 in Medicaid costs for two women who needed emergency care in 2025 from complications caused by out-of-state mifepristone. “Such costs will almost certainly continue because nearly 1,000 women monthly — many of whom are on Medicaid — have mifepristone-induced abortions in Louisiana,” the panel said in the ruling by Judge Kyle Duncan, a Trump appointee.
This is a developing story. Check back for updates.
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