The Supreme Court has stepped in—for now—to keep access to the abortion medication mifepristone largely unchanged across the United States.

On Monday, Justice Samuel Alito issued a short-term administrative pause blocking a lower court ruling that would have restricted how the drug is distributed nationwide. His order, which did not include an explanation, allows patients to continue receiving the medication through telehealth appointments and by mail—policies put in place by the Food and Drug Administration and made permanent in 2023. The temporary measure is set to expire at 5 p.m. on May 11, giving the full court time to decide whether to extend the pause while the legal battle plays out.

The case stems from a challenge brought by Louisiana, a state that bans abortion in nearly all circumstances. Officials there argue that federal regulators failed to properly evaluate safety concerns when they removed the requirement for patients to obtain the drug in person. A federal appeals court—the 5th U.S. Circuit Court of Appeals—sided with the state last week, issuing a sweeping order that would have immediately halted telehealth prescriptions and mail delivery of mifepristone nationwide.

That ruling prompted urgent appeals from the drug’s manufacturers, Danco Laboratories and GenBioPro, who warned the Supreme Court that the decision created widespread confusion. “The resulting chaos for patients, providers, pharmacies, and the drug-regulatory system is a quintessential irreparable harm that underscores the need for emergency relief from this Court,” lawyers for Danco wrote.

The companies argued that the abrupt shift left both patients and healthcare providers uncertain about what was allowed, potentially interrupting ongoing care. In a separate filing, GenBioPro said the lower court’s decision had “unleashed regulatory chaos” and could delay or block access to time-sensitive treatment—even in states where abortion remains legal.

Medication abortions account for roughly half of all abortions in the U.S., and mifepristone has been approved by the FDA since 2000. During the COVID-19 pandemic, regulators temporarily allowed the drug to be prescribed remotely; that flexibility was later made permanent after studies found it could be used safely without in-person visits. The dispute marks the second time in recent years that mifepristone has reached the Supreme Court. In 2024, the justices unanimously rejected a separate challenge, ruling that the groups bringing the case lacked legal standing.

This latest lawsuit focuses more narrowly on the federal government’s decision to expand access to the drug through telehealth and mail distribution—changes that have become increasingly significant since the court’s 2022 decision overturning Roe v. Wade allowed states to impose sweeping abortion restrictions.

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