A unanimous three-judge panel of the U.S. Court of Appeals for the Fifth Circuit on Friday issued a temporary nationwide order that freezes federal rules allowing mifepristone to be prescribed via telemedicine and sent by mail, siding with Louisiana in a lawsuit challenging the FDA’s 2023 changes.
A unanimous three-judge panel of the New Orleans-based U.S. Court of Appeals for the Fifth Circuit on Friday temporarily froze federal rules that allow the abortion drug mifepristone to be prescribed via telehealth and dispensed through the mail, a move that could immediately restrict access nationwide.
The decision came in a case brought by Louisiana, which argued the Food and Drug Administration’s more recent rules undermine the state’s near-total abortion ban and force the state to bear costs when patients seek emergency care. Judge Kyle Duncan, a Trump appointee, wrote that Louisiana had shown a strong likelihood of success and that the state faced ongoing harm if the federal rules remained in place while the lawsuit proceeds.
In language highlighted by the court, the panel said:
“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is human being from the moment of conception and is, therefore, a legal person.’”
The ruling requires that mifepristone be dispensed in person at clinics, rolling back the teleprescribing-and-mail model that expanded during the COVID-19 era and later was incorporated into FDA policy.
The appeals court’s order reverses a recent decision by a federal judge in Louisiana who declined to immediately undo the FDA’s rules and instead paused the litigation while the agency conducts an additional review of mifepristone’s safety at the direction of the Trump administration. The Fifth Circuit said the agency could not say when that review would be finished and noted that the FDA acknowledged it was still collecting data.
The decision is expected to face an emergency appeal. The Supreme Court in 2024 unanimously rejected a separate challenge to mifepristone brought by anti-abortion doctors on the ground that the plaintiffs lacked legal standing, without reaching the merits of the FDA’s scientific judgments.
The Fifth Circuit ruling drew praise from abortion opponents and criticism from abortion-rights advocates, who said limiting telemedicine and mailing would restrict abortion and miscarriage care access nationwide. Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called the order “a huge victory for victims and survivors,” while an ACLU lawyer warned it could affect access “in every state in the nation.”
