The US Supreme Court has issued a ruling preserving access to a commonly used abortion pill, mifepristone, while a legal case against it continues. The court also rejected restrictions on the drug implemented by a lower court, maintaining the status quo. The future of the drug was called into question after a Texas judge sought to invalidate its long-standing approval.
The case could have significant implications for abortion access in the country. Mifepristone is part of a two-drug regimen that now accounts for more than half of all abortions in the US. Over five million women in the country have used the drug to end their pregnancies.
The FDA approved mifepristone over twenty years ago after four years of review and placed it in a category of 60 drugs regulated under a system of extra restrictions and regular evaluations. Mainstream medical organizations, including the American College of Obstetrics and Gynaecologists and the World Health Organization, have said the drug is safe and effective.
However, earlier this month, Texas court judge Matthew Kacsmaryk ruled to suspend the FDA approval of mifepristone, stating that the agency had violated federal rules allowing for the accelerated approval of some drugs and had erred in its scientific assessment of the drug. His preliminary decision came after a group of anti-abortion health professionals challenged the safety of mifepristone.
Kacsmaryk’s ruling was made just minutes before a decision from a judge in Washington state ordered the FDA to make no changes to the drug’s availability, preserving access to mifepristone in 17 US states. President Joe Biden’s administration appealed the Texas ruling and asked for the court’s order to be placed on hold.
A divided appeals court said mifepristone could remain available, but with certain restrictions, while the appeal was underway. Among the restrictions imposed by the 5th Circuit Court of Appeals was a limit on sending the pills by mail, effectively requiring in-person visits.
Friday’s Supreme Court ruling overturned these restrictions, at least for now. Two of the Court’s conservative members, Justice Clarence Thomas and Justice Samuel Alito, publicly dissented to the decision.
The ruling was welcomed by medical experts and organizations like the American College of Obstetricians and Gynecologists, who had previously stated that restrictions on mifepristone would cause immeasurable harm to the drug approval process in the US. Pro-choice politicians also applauded the top court’s decision, including President Biden, who said he would continue to defend the FDA’s independence and fight political attacks on women’s health.
The decision drew immediate reactions from anti-abortion advocates, who have concentrated their efforts on abortion pills since the fall of Roe v. Wade.
The Alliance Defending Freedom, the conservative advocacy group that filed the initial lawsuit, said the FDA “must answer for the damage it has caused to the health of countless women and girls.” Meanwhile, Kristan Hawkins, president of anti-abortion group Students for Life, called the Supreme Court’s decision a “tragedy.”
Oral arguments for the case will begin before the 5th Circuit Court of Appeals in mid-May, and it is likely that the case will come before the Supreme Court once again, setting up the most significant ruling on the issue of abortion since Roe was overturned.
Nonetheless, for now, Friday’s ruling has the immediate effect of reassuring healthcare providers that access to the drug will continue, at least for the time being.