Supreme Court Blocks Restrictions on Abortion Drug Mifepristone — For Now

The U.S. Supreme Court has once again shielded access to mifepristone, the most commonly used abortion medication in the United States, by temporarily blocking a lower court’s attempt to restrict its distribution.

The Court issued a brief order on Thursday evening, indefinitely staying a decision from the Fifth Circuit Court of Appeals that sought to limit how mifepristone could be prescribed and distributed. While the order is not permanent, it will remain in effect until the case is fully litigated and the justices have had time to fully consider the matter.

In practical terms, this means mifepristone will likely remain available to patients until at least June 2027, barring new restrictions from Congress or the Food and Drug Administration (FDA).

How the Supreme Court’s Order Works

The Supreme Court’s action comes through what is known as the “shadow docket” — a process for handling emergency motions and other matters on an expedited basis. The Court did not disclose how each justice voted on the order. However, Justices Clarence Thomas and Samuel Alito both filed dissenting opinions, indicating they supported the Fifth Circuit’s restrictions. At least five justices must have voted to block the lower court’s decision.

Background: The Fifth Circuit’s Repeated Challenges to Mifepristone

This is the second time the far-right U.S. Court of Appeals for the Fifth Circuit has attempted to restrict access to mifepristone. In 2024, the same court ruled in FDA v. Alliance for Hippocratic Medicine that federal courts lacked jurisdiction to hear the case. The Supreme Court unanimously agreed, leaving mifepristone’s regulatory framework intact.

Legal experts note that the Fifth Circuit’s latest order in Danco Laboratories v. Louisiana suffers from similar jurisdictional flaws, making the Supreme Court’s intervention less surprising. Still, given the Court’s history of overturning abortion rights precedents, such as Roe v. Wade, each abortion-related case remains a source of significant concern for providers and patients.

What the Fifth Circuit’s Order Would Have Done

Had the Supreme Court not stepped in, the Fifth Circuit’s order would not have banned mifepristone outright. Instead, it would have prohibited the drug’s distribution by mail and invalidated FDA rules governing how doctors can prescribe it. Without a replacement regulatory framework, it remained unclear whether mifepristone would have remained available at all.

Dissenting Justices Compare Drug Makers to ‘Criminal Enterprise’

In their dissents, Justice Thomas went so far as to call the pharmaceutical companies that manufacture mifepristone a “criminal enterprise.” He cited the Comstock Act, an 1873 law that bans the mailing of various items related to sex, which has not been repealed despite being largely defunct.

Justice Alito, meanwhile, suggested that one of the two companies producing mifepristone is engaged in an “unlawful conspiracy” because the drug is banned in Louisiana, even though it is legal in many other states and approved by the FDA for medical use.

Despite these strong objections from the dissenting justices, their views did not prevail in the Court’s order. For now, mifepristone remains accessible to patients across the United States.