Supreme Court Allows Mifepristone Mail Orders While Appeal Plays Out

The U.S. Supreme Court ruled Thursday that mifepristone can continue to be distributed through the mail while an ongoing legal appeal works through the courts, CNBC reported. The court did not disclose the vote count, and the majority offered no written reasoning for its decision.

A Stay Extended, Dissenters Vocal

The ruling extends a temporary stay the court had first issued on May 4. Drugmakers Danco Laboratories and GenBioPro had petitioned the justices to intervene after a lower court moved to halt mail distribution of the medication. The court’s action keeps that lower court order frozen indefinitely while the underlying case proceeds.

Justices Clarence Thomas and Samuel Alito filed written dissents. Thomas argued the companies had not met the legal threshold required for emergency relief. He further contended that shipping mifepristone for use in abortions constitutes a criminal act under the Comstock Act, a 19th-century federal law banning the mailing of materials related to abortion. Thomas wrote the drugmakers could not claim irreparable harm from a ruling that, in his view, simply made it harder to commit crimes.

Alito described the majority’s order as “remarkable” and framed the case as touching on efforts to undermine the court’s own 2022 decision in Dobbs v. Jackson Women’s Health Organization, which eliminated the federal constitutional right to abortion.

How the Case Reached the Court

Louisiana, a state that prohibits abortion in nearly all circumstances, brought the original lawsuit against the Food and Drug Administration. The state challenged an FDA decision made in 2023 to remove a longstanding requirement that mifepristone be dispensed in person rather than mailed to patients. That in-person requirement had been in place for years before being lifted roughly a year after the Dobbs ruling.

Louisiana first lost at the federal district court level, then won at the 5th Circuit on May 1 when that appeals court issued a nationwide ban on mail orders of the drug pending final resolution of the dispute.

What Comes Next

The Supreme Court’s stay means the nationwide 5th Circuit ban remains on hold. Mifepristone can still be prescribed and mailed to patients in states where abortion remains legal. The underlying legal questions, including the Comstock Act argument raised by Thomas, are expected to play out as the appeal moves forward. No timeline for a final ruling has been set.

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