Supreme Court maintains mail access to abortion pill mifepristone for now

The Supreme Court is keeping mifepristone available by mail for at least three more days, making Thursday the next deadline to watch for the full court to weigh in on the nationwide issue.

The drug’s manufacturers brought emergency appeals to the justices after a federal appellate panel issued an order on May 1 that would stop the abortion pill from being mailed nationwide. The companies, Dance and GenBioProcalled the lower court order unprecedented and warned of chaos if it wasn’t halted. The order came from a three-judge panel of all GOP appointees, including two Trump appointees, on the U.S. Court of Appeals for the 5th Circuit.

Justice Samuel Alito, who fields emergency appeals from that circuit, granted temporary relief for the drug companies on May 4, pending further review from the full court. He issued what’s known as an administrative stay, which wasn’t a ruling saying that he agreed or disagreed with the companies, but its practical effect was to keep the drug available while he and his colleagues considered the matter further.

Alito had set a deadline of Monday at 5 p.m. ET, which raised the possibility that the full court would weigh in by then. But as that deadline neared on Monday afternoon, he extended the administrative stays in Dance’s and GenBioPro’s appeals through Thursday at 5 p.m. ET.

So now Thursday will be the next deadline to watch for the full court to weigh in. As is typically the case for these administrative orders, no explanation accompanied them.

Louisiana is urging the justices to let the circuit’s order stand while the state’s lawsuit continues against the drug’s remote availability without an in-person doctor visit. The Republican-led state argued that the issue stemmed from the Biden administration’s attempt to undermine the 2022 Dobbs ruling that overturned Roe v. Wade, and that the companies merely wanted to “increase their profits by selling more abortion drugs” and avoid compliance costs.

During previous litigation that also came from the 5th Circuit, the Supreme Court in 2023 issued an order that kept the drug available and, in 2024, the court unanimously held that anti-abortion doctors lacked legal standing to sue. Justice Brett Kavanaugh wrote for the court that “a plaintiff ’s desire to make a drug less available for others does not establish standing to sue.”

In this latest litigation, the drug companies argue that Louisiana’s claimed injuries — to its sovereignty and finances — are likewise insufficient to establish standing and that the state’s lawsuit can likewise be thrown out on that basis. The suit stemmed from the state’s claim that the Food and Drug Administration violated federal law when it said the drug can be dispensed remotely.

When it sided with the state in the order that the companies challenged, the 5th Circuit panel noted that Louisiana said it paid $92,000 in Medicaid costs for two women who needed emergency care in 2025 from complications caused by out-of-state mifepristone. “Such costs will almost certainly continue because nearly 1,000 women monthly — many of whom are on Medicaid — have mifepristone-induced abortions in Louisiana,” the panel said in the ruling by Trump-appointed Judge Kyle Duncan.

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Jordan Rubin is the Deadline: Legal Blog writer. He was a prosecutor for the New York County District Attorney’s Office in Manhattan and is the author of “Bizarro,” a book about the secret war on synthetic drugs. Before he joined MS NOW, he was a legal reporter for Bloomberg Law.