A federal appeals court dealt a severe blow to abortion access Friday, temporarily reinstating a nationwide requirement that women obtain abortion pills in person, significantly curtailing mail-order access to medication abortion for millions of Americans.
The ruling from the 5th U.S. Circuit Court of Appeals, written by Trump-appointed Judge Kyle Duncan, is a major victory for the anti-abortion movement. While the ruling does not ban Mifepristone outright, women can no longer obtain it through telehealth appointments or by mail while the case proceeds.
"Referring to Louisiana abortion prohibitions, they wrote that the current federal regulations create 'an effective way for an out-of-state prescriber to place the drug in the hands of Louisianans in defiance of Louisiana law,'" CNN reported.
Medication abortion now accounts for roughly two-thirds of all abortions in the United States. Since the COVID-19 pandemic, women have been able to obtain mifepristone through telehealth visits without an in-person doctor's appointment, an option the Biden administration formally enshrined in 2023 rules. Friday's temporary ruling significantly curtails that access.
The FDA conceded its prior regulations were marred by "procedural deficits" and a "lack of adequate consideration" — and launched a review of mifepristone protocols in September that remains incomplete. The appeals court ruled that the ongoing review was not sufficient reason to leave the regulations in place.
The case was brought by Louisiana, which argued that mail-order abortion pills were undermining the state's near-total abortion ban. The court agreed, ruling that federal regulations created an end-run around Louisiana's prohibition.
The ACLU immediately condemned the decision.
“This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people,” Julia Kaye, senior staff attorney for the Reproductive Freedom Project of the ACLU, said in a statement. “For countless people, especially those who live in rural areas, face intimate partner violence, or live with disabilities, losing a telemedicine option will mean losing access to this vital medication altogether.”
The ruling comes despite years of data showing mifepristone is overwhelmingly safe, with fewer reported side effects than Viagra or penicillin, according to a CNN analysis.
The case is expected to continue in lower courts before potentially returning to the Supreme Court, which previously ruled on standing issues in a related challenge two years ago.