Top court restores telehealth access to mifepristone for at least one week as legal challenges to medication play out.

The United States Supreme Court has temporarily reinstated a rule allowing an abortion pill to be prescribed through telemedicine and dispensed through the mail, lifting a judicial ban that narrowed access to the medication nationwide.

Justice Samuel Alito issued an interim order on Monday, pausing for one week a decision by the New Orleans-based 5th US Circuit Court of Appeals to reimpose an older federal rule requiring an in-person clinician visit to receive mifepristone.

The 5th Circuit acted in a challenge to the rule by the Republican-led state of Louisiana.

The Supreme Court’s action, called an “administrative stay”, gives the justices more time to review emergency requests by two manufacturers of mifepristone to ensure that the drug can be provided via telehealth and the mail while the legal challenge plays out.

Alito ordered Louisiana to respond to the drugmakers’ requests by Thursday and indicated that the administrative stay would expire on May 11. The court would be expected to extend the interim stay or formally decide the requests by that time.

Alito, one of the nine-member court’s six conservative justices, acted because he is designated by the court to oversee emergency matters that arise in a group of states that includes Louisiana.

The case puts the contentious issue of abortion back in front of the justices, who must confront another effort by abortion opponents to scale back access to mifepristone, with the November US congressional elections looming.

The court in 2024 unanimously rejected an initial bid by anti-abortion groups and doctors to roll back Food and Drug Administration (FDA) regulations that had eased access to the drug, ruling that these plaintiffs lacked the necessary legal standing to pursue the challenge.

Mifepristone, given FDA regulatory approval in 2000, is taken with another drug called misoprostol to perform medication abortions, a method that now accounts for more than 60 percent of all abortions in the US.

The ongoing battles over abortion rights follow the court’s 2022 ruling that overturned its 1973 Roe v Wade precedent that had legalised abortion nationwide.

That ruling has prompted 13 states to enact near-total bans on the procedure, while several others have sharply restricted access.

Louisiana sued the FDA last year, claiming that a rule adopted during the administration of former US President Joe Biden, a Democrat – a rule that eased access to mifepristone by eliminating the in-person dispensing requirement – is illegal and undermines the state’s abortion ban.

The pill’s manufacturer, Danco Laboratories, and GenBioPro, which makes a generic version, intervened in the litigation to defend the 2023 regulation. The administration of current US President Donald Trump, a Republican, cited an ongoing review of safety regulations concerning mifepristone and opposed the state’s challenge.

In April, US Judge David Joseph in Lafayette, Louisiana, declined to block the regulation but agreed with the administration to put the case on hold pending the review. The 5th Circuit blocked the rule on May 1.

The legal and political fight over access to mifepristone has dominated the debate over abortion in the US over the past few years.

The American Civil Liberties Union (ACLU) called the top court’s decision on Monday a “positive short-term development”.

“The Supreme Court needs to put an end to this baseless attack on our reproductive freedom, once and for all,” Julia Kaye, senior lawyer for the Reproductive Freedom Project of the ACLU, said in a statement.

Since the Supreme Court revoked the right to abortion in 2022, Democrats have been seizing on the unpopularity of bans on the procedure and emphasising the issue in their electoral platforms.

Chuck Schumer, the top Democrat in the Senate, welcomed the top court’s decision on Monday, but said, “This fight is just beginning.”

“We will stop at nothing to prevent the Republicans from putting a national abortion ban into effect,” Schumer wrote on X.

On Monday, Republican Senator Josh Hawley cited disputed findings on the health risks associated with mifepristone, urging lawmakers to act.

“Now it’s time for Congress to ban it completely for use in abortion,” he said in a social media post.