Key facts
- A federal appeals court is hearing arguments on whether to tighten prescribing rules for mifepristone, a key abortion drug.
- The case was brought by Louisiana Attorney General Liz Murrill and another plaintiff.
- The drug mifepristone is used in the most common abortion method in the U.S.
- The FDA is also reviewing its rules for mifepristone.
- The Supreme Court previously blocked changes to prescribing rules until it reviews the case.
- Several other lawsuits are challenging the FDA's rules on mifepristone.
A federal appeals court is set to hear arguments on Wednesday regarding potential restrictions on mifepristone, a key drug used in medication abortions in the United States. The case before the New Orleans-based 5th U.S. Circuit Court of Appeals is one of several legal challenges aiming to limit access to abortion pills, particularly when they are sent across state lines from states where abortion is legal to those where it is banned.
The U.S. Food and Drug Administration (FDA) is also reviewing its prescribing rules for the drug and could implement changes independently, though such actions would likely face legal challenges. The arguments come at a time when abortion opponents are seeking to curtail access, a key issue for supporters of President Donald Trump, while public opinion generally favors abortion access.
At least three in five U.S. abortions are now performed using a two-drug combination, with mifepristone being one of the drugs. The specific case being heard involves Louisiana Attorney General Liz Murrill and plaintiff Rosalie Markezich. A survey suggests a significant number of women in Louisiana obtain abortions monthly using pills prescribed online or by providers in other states.
Previous rulings by lower courts and other panels on the 5th Circuit have found the current FDA rules for mifepristone too lenient. However, the Supreme Court previously rejected an attempt to restrict the drug's availability, not on the merits of the case, but because the plaintiffs were found to lack legal standing. The manufacturers of mifepristone argue that the states also lack standing. Any ruling from the 5th Circuit would not immediately alter access, as the Supreme Court has placed a hold on changes until it further reviews the case.
Other states, including Florida, Texas, Idaho, Kansas, and Missouri, have also filed lawsuits challenging the FDA's regulations. Conversely, federal judges in Hawaii and Virginia have ruled that the existing FDA rules are too restrictive.
Medication abortion has become a primary method of abortion since the Supreme Court overturned Roe v. Wade in 2022. Currently, 13 states ban abortion entirely, and four others do so after approximately six weeks of pregnancy. Many Democratic-controlled states have enacted protections for abortion providers, including measures to support telehealth services that prescribe abortion pills to patients in other states, which opponents argue undermines state bans.
Legal counsel for the plaintiffs believes the case will have a significant impact, potentially restoring state control over abortion regulation as envisioned after the Dobbs decision. Abortion rights advocates warn of major consequences if the plaintiffs prevail, arguing it would impose an in-person requirement for accessing medication nationwide. Anti-abortion groups are urging the FDA to revert prescribing rules to their pre-telehealth state and to enforce an 1873 law to prevent mailing abortion pills.
The administration has remained largely silent on the legal battles, despite the FDA being the defendant. However, President Trump's nominee to lead the FDA, Dr. Heidi Overton, has previously criticized the agency for easing its prescribing guidelines for mifepristone.