Access to Abortion Medication Remains Unchanged After Ruling by the U.S. Supreme Court

Access to a popular abortion medication remains unchanged after the United States Supreme Court ruled today that the plaintiffs suing the Food and Drug Administration (FDA) did not have standing to bring the case. 

The Court’s 9-0 ruling in Alliance for Hippocratic Medicine v. FDA allows the widely used medication, mifepristone, to remain accessible through telemedicine and pharmacies—distribution permitted under the FDA’s recent actions to expand access to the drug. In states where abortion is illegal though, all abortion methods—including medication abortion—are banned. 

In deciding the case on the issue of standing, the Court did not weigh in on the merits of the case.

Commenting about the ruling, Nancy Northup, president and CEO of the Center for Reproductive Rights, said: 

“I have both relief and anger about this decision. Thank goodness the Supreme Court unanimously rejected this unwarranted attempt to curtail access to medication abortion, but the fact remains that this meritless case should never have gotten this far. . . The FDA’s rulings on medication abortion have been based on irrefutable science.”

The Center for Reproductive Rights and its partners submitted an amicus brief in this case in support of the FDA’s actions to expand access to mifepristone. The brief highlighted how lower court rulings in the case relied on “patently unreliable witnesses” and “ideologically tainted junk science.”

In the U.S., medication abortion accounts for 63% of all abortions and has become crucial for abortion access as states continue to restrict access to abortion care. Since the Court overturned Roe v. Wade and eliminated the constitutional right to abortion in 2022, almost half the U.S. states have banned or severely restricted access to abortion care.  

Despite the Court’s ruling today, threats to the drug’s access remain: Kansas, Idaho and Missouri were allowed to intervene in the trial court in this case and may attempt to have it continue. In addition, anti-abortion lawmakers are working to pass state laws restricting access to medication abortion. (Recently, Louisiana reclassified two abortion drugs as controlled substances, making possession without a prescription a crime punishable by jail time and fines.)

“Unfortunately, the attacks on abortion pills will not stop here—the anti-abortion movement sees how critical abortion pills are in this post-Roe world, and they are hell bent on cutting off access,” added Northup. “In the end, this ruling is not a ‘win’ for abortion—it just maintains the status quo, which is a dire public health crisis in which 14 states have criminalized abortion.”

Lawsuit Threatened Access to Abortion Medication Nationwide 

Seeking to remove mifepristone from the market nationwide—even in states where abortion is protected—in 2022, anti-abortion advocates sued the FDA to challenge the agency’s initial approval of the drug, as well as its more recent actions to expand access to it.  

Among those actions was the FDA’s permanent removal of the in-person dispensing requirement, which had required patients to take the abortion medication under a clinician’s supervision at a doctor’s office, hospital, or health center. 

In November 2022, plaintiffs filed the case before Judge Matthew Kacsmaryk, a federal district judge in Amarillo, Texas, known for his anti-abortion views. Judge Kacsmaryk decided in favor of the plaintiffs, ruling to block the FDA’s approval of mifepristone nationwide. 

The Department of Justice appealed the case to the Fifth Circuit Court of Appeals—which ruled to keep the drug on the market but to reinstate burdensome restrictions on mifepristone—and finally, to the U.S. Supreme Court, which heard oral arguments in March 2024. 

For a timeline and more details on Alliance for Hippocratic Medicine v. FDA, click here.