Latest Supreme Court Decision Preserves Access to Mifepristone

On June 13, 2024, the Supreme Court issued a decision preserving widespread access to mifepristone, a medication whose primary intent is to aid in medical termination of early pregnancy. This unanimous decision by the Supreme Court determined that the plaintiffs in the case did not have legal standing^[1] to sue.

This most recent decision by the Supreme Court follows an earlier decision by the Supreme Court in April 2023, which blocked two lower court rulings that would have limited access to mifepristone. Risk Strategies first reported on the April 2023 Supreme Court decision here.

Mifepristone is a medication first approved by the Federal Drug Administration (FDA) in 2000 under a pathway used for medications that treat serious or life-threatening illnesses.

In 2016 and 2021, the FDA approved certain changes to mifepristone including:

• Extending approval of pill through up to 10 weeks of pregnancy, rather than the previous limit of up to seven weeks.
• Permitting the medication to be sent to patients through the mail, rather than the previous in-person dispensing requirement.
• Permitting follow-up telehealth visits, rather than requiring follow-up in-person visits.

On April 7, 2023, two federal courts issued competing decisions regarding mifepristone access. A Texas district court suspended the FDA’s approval of mifepristone, restricting access on a nationwide basis. A Washington district court simultaneously affirmed the FDA’s approval of mifepristone and blocked the government from restricting access to the medication in 17 states and Washington, D.C.

On April 12, 2023, the U.S. Court of Appeals for the Fifth Circuit ruled that the Texas court decision was partially overturned; this ruling maintained access to mifepristone but reinstated restrictions from prior to 2016.

The Supreme Court’s April 21, 2023 ruling allowed the current FDA rules (including the changes made in 2026 and 2021 as outlined above) to remain in effect, maintaining mifepristone availability as litigation continued.

On August 16, 2023, the U.S. Court of Appeals for the Fifth Circuit, once again, ruled that the Texas court decision was partially overturned; this ruling maintained access to mifepristone but reinstated restrictions from prior to 2016. This decision was appealed to the Supreme Court, which heard oral arguments regarding this matter on March 26, 2024.

As a result of this most recent Supreme Court decision on June 13, 2024, widespread access to mifepristone remains available under the current FDA rules.

See below for a general timeline of events around access to mifepristone from its FDA approval in 2000 to the present day.

Risk Strategies is committed to keeping our clients informed and will provide any updates when available. Contact us directly at benefits@risk-strategies.com.

[1] Standing” is a legal concept that essentially determines whether a party has a sufficient “stake” in a dispute to obtain resolution of the dispute by a court.