In a landmark decision on Thursday, the Supreme Court unanimously preserved access to mifepristone, a medication used in nearly two-thirds of all abortions in the United States last year. This ruling marks the court’s first significant abortion decision since the court overturned Roe v. Wade two years ago.
The nine justices ruled that the plaintiffs, a group of anti-abortion doctors and medical associations, lacked the legal standing to challenge the federal Food and Drug Administration’s (FDA) approval and regulation of mifepristone. The decision ensures continued nationwide access to the medication, including in states where abortion remains legal.
Since its approval in 2000, mifepristone has been used by over six million people. The drug works by blocking the hormone progesterone, preparing the uterus for the contraction-causing effects of a second drug, misoprostol. This two-drug regimen is effective for terminating pregnancies up to ten weeks gestation.
President Joe Biden welcomed the ruling, noting that while it keeps mifepristone readily accessible, the broader battle for reproductive rights continues in the wake of Roe v. Wade’s reversal. “The fight for reproductive freedom continues,” he stated, emphasizing that many women face significant barriers to obtaining necessary treatment in numerous states.
Justice Brett Kavanaugh, writing for the court, acknowledged the plaintiffs’ “sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.” However, he noted that such objections do not constitute a federal case. The plaintiffs failed to demonstrate any direct injury from the FDA’s actions, rendering federal courts an inappropriate venue for their grievances.
The court’s ruling also affirmed the FDA’s 2021 decision to permit the mailing of mifepristone to patients, bypassing the need for in-person doctor visits. This is seen as a significant setback for the anti-abortion movement, which had hoped to limit the drug’s accessibility through legal challenges.
“While we’re disappointed the Court did not reach the merits of the FDA’s unlawful actions, nothing in today’s decision changes this fact: women and girls are being harmed by the FDA’s recklessness,” the Alliance Defending Freedom, a pro-life advocacy group, stated following the ruling.
Despite the Supreme Court’s decision, which secures mifepristone’s availability for now, the ruling does not preclude future legal challenges. Three Republican-led states—Idaho, Missouri, and Kansas—have already joined the dispute in lower courts.
According to the Guttmacher Institute, chemical abortions, primarily involving mifepristone, accounted for 63% of all abortions in the United States in 2023, marking the highest level in a decade due to expanding access to the abortion pill.
President Biden underscored the ongoing struggle for reproductive rights, highlighting the persistent threats to women’s access to abortion services. “It does mean that mifepristone, or medication abortion, remains available and approved. Women can continue to access this medication – approved by the FDA as safe and effective more than 20 years ago,” he said, while criticizing efforts by Republican officials to impose nationwide abortion bans.
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