A federal appeals court temporarily blocked a key rule allowing abortion pills to be prescribed and delivered by mail, requiring patients to obtain the medication in person while a legal challenge continues.
The ruling, issued by the 5th US Circuit Court of Appeals on Friday, May 1, reinstates a nationwide in-person dispensing requirement for mifepristone, one of the drugs used in medication abortions.
The decision stems from a lawsuit filed by Louisiana against the US Food and Drug Administration, challenging changes made during the COVID-19 pandemic that allowed patients to access abortion pills through telehealth appointments and mail delivery.
A panel of judges wrote that current federal rules allow providers outside Louisiana to prescribe and ship the drug into the state in ways that conflict with its abortion laws.
The ruling marks a significant shift in access to medication abortion, which now accounts for a majority of abortions in the United States.
Since 2023, federal regulations finalized under the Biden administration have allowed mifepristone to be prescribed via telehealth and delivered by mail, removing the need for an in-person visit. The policy change expanded access, particularly for patients in rural areas or states with limited clinic availability.
Louisiana argued the policy undermined its abortion ban by allowing residents to obtain the medication from out-of-state providers.
“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions,” the court wrote in its opinion.
Supporters of abortion access criticized the ruling, warning it could limit care for vulnerable populations.
“This decision defies clear science and settled law and advances an anti-abortion agenda,” Julia Kaye, a senior staff attorney with the ACLU’s Reproductive Freedom Project, said in a statement.
The case is part of an ongoing legal battle over access to abortion medication following the US Supreme Court’s 2022 decision overturning Roe v. Wade.
A lower court previously declined to block the FDA’s rules while the case moved forward, but the appeals court reversed that approach with Friday’s order.
The decision is temporary and will remain in place as the lawsuit proceeds.
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