Supreme Court Unanimously Decides to Maintain Abortion Pill Access

The Supreme Court ruled unanimously not to limit access to mifepristone, stating that anti-abortion providers have no legal basis to challenge its access. After the Supreme Court overturned Roe v Wade in 2022, mifepristone has emerged as a key mode of executing abortions before the 10th week of pregnancy. Because of the Supreme Court’s decision, mifepristone will continue to be mailed, allowing for access without an in-person visit.^1,2

What’s the Issue?

On Thursday, June 13, the Supreme Court delivered its ruling on the anti-abortion plaintiffs’ case against the medication mifepristone. Striking down the request to limit access of the drug, the court ruled on the plaintiffs’ claim that the FDA overstepped its boundaries by loosening restrictions. It ruled that further access to mifepristone would not personally or physically harm the anti-abortion providers who brought up the case.¹

Mifepristone was first approved by the FDA for abortion back in 2000. | image credit: Carl / stock.adobe.com

In 2023, over 60% of all abortions used mifepristone and more than 6 million people have used the drug in the 21st century.³ While it’s been 1 of 2 key abortion medications for over 2 decades, mifepristone has come under immense scrutiny from anti-abortion advocates in the past 2 years. After the overturn of Roe v Wade in June 2022, 14 states have since issued a total ban of abortion, with several other states participating in partial bans based on terms of pregnancy.⁴

Mifepristone and misoprostol have stood as the most accessible ways to conduct the abortion, especially in states that have issued bans. However, mifepristone has been known to be more effective and in higher demand than misoprostol.³

Why It Matters

• Since the issue of abortion was moved to the states in 2022, mifepristone has become a hot commodity within the prescription drug industry. With total abortion bans and abortion access decreasing over the past 2 years, anti-abortion states then moved to limiting mifepristone. Just last month, Louisiana became the first state to criminalize abortion medications that aren’t accompanied by valid prescriptions.⁵ And Louisiana being a state that has outlawed abortions, it is now virtually impossible to get one anywhere in the state.
• While the plaintiffs’ opinions, as well as conservative anti-abortion groups, are well-known in the political world, the companies and regulators supporting abortion drugs gave their opinions on why access to mifepristone should not be limited. “Leading up oral arguments, pharmaceutical companies and FDA law experts urged the court not to second-guess the agency’s expertise and side with the plaintiffs. A ruling against the administration could have undermined the entire drug approval process,” wrote Nathaniel Weixel for The Hill.¹ Despite anti-abortion groups arguing that the drugs are physically dangerous to those being prescribed, it was unlikely at the start that the Supreme Court would rule against a drug with existing FDA approval for almost 25 years.¹

READ MORE: Supreme Court Considers Mifepristone Limits in First Case Since Dobbs

Expert Commentary

• “This should be a warning to all of us: if anti-abortion operatives came this close to undermining long-standing approvals for mifepristone, what will come next?” said Haydee Morales, interim president of the National Institute for Reproductive Health.¹
• “We are pleased with the Supreme Court’s decision in this incredibly important case. By rejecting the Fifth Circuit’s radical, unprecedented and unsupportable interpretation of who has standing to sue, the justices reaffirmed longstanding basic principles of administrative law. The decision also safeguards access to a drug that has decades of safe and effective use,” said Abigail Long, a spokeswoman for Danco, the manufacturer for the brand-name version of mifepristone.¹

In-Depth Insights

• “Under Article III of the Constitution, a plaintiff’s desire to make a drug less available for others does not establish standing to sue,” wrote Justice Brett Kavanaugh on the court’s decision. Despite the decision, anti-abortion advocates claim that it is only a “temporary setback.”¹ As the year progresses and election day comes closer, it’s easy to assume that abortion issues will continue to take center stage as Americans prepare to hit the ballots.
• Mifepristone was first approved by the FDA for abortion back in 2000. Since then, the group has made a series of changes regarding the use of mifepristone, including a raise of the gestational age from 7 weeks to 10 weeks of pregnancy, permitting the medication to be mailed, lowering dosage, allowing telehealth prescribing, and permitting providers outside of just physicians to prescribe the drug.¹

Extra Reading

• Supreme Court preserves abortion pill access, rejecting mifepristone challenge (CBS News)
• Supreme Court upholds broad access to key abortion pill mifepristone (The Washington Post)

READ MORE: Misoprostol Alone Can be Effective Abortion Method

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References

1. Weixel N. Supreme Court upholds access to mifepristone abortion pill in unanimous decision. The Hill. June 13, 2024. Accessed June 13, 2024. https://thehill.com/policy/healthcare/4703010-supreme-court-upholds-access-abortion-drug-mifepristone/

2. Supreme Court ruling rejecting challenge to abortion pill mifepristone. CNN. June 13, 2024. Accessed June 13, 2024. https://www.cnn.com/2024/06/13/politics/supreme-court-abortion-drug-ruling-read/index.html

3. Sherman M. Supreme Court upholds access to key abortion drug. WGXA. June 13, 2024. Accessed June 13, 2024. https://wgxa.tv/news/supreme-court-upholds-access-to-key-abortion-drug-mifepristone-roe-v-wade-food-and-drug-administration-fda-emergency-treatment-progesterone-uterus-misoprostol-gestation

4. State bans on abortion throughout pregnancy. Guttmacher Institute. April 9, 2024. Accessed June 13, 2024. https://www.guttmacher.org/state-policy/explore/state-policies-abortion-bans

5. Polus S. Louisiana becomes first state to criminalize abortion pills without prescription. The Hill. May 24, 2024. Accessed June 13, 2024. https://thehill.com/policy/healthcare/4685327-louisiana-criminalizes-abortion-pills-without-prescription/