Supreme

WASHINGTON — The Supreme Court is leaving access to a widely used abortion pill untouched until at least Thursday, while the justices consider whether to allow restrictions on the drug, mifepristone, to take effect.

Justice Samuel A. Alito Jr.’s order Monday allows women seeking abortions to continue obtaining the pill at pharmacies or through the mail, without an in-person visit to a doctor. It prevents restrictions on mifepristone imposed by a federal appeals court from taking effect for the time being.

The court is dealing with its latest abortion controversy four years after its conservative majority overturned Roe vs. Wade and allowed more than a dozen states to effectively ban abortion outright.

The case before the court stems from a lawsuit Louisiana filed to roll back the Food and Drug Administration’s rules on how mifepristone can be prescribed. The state claims the policy undermines the ban there, and it questions the safety of the drug, which was first approved in 2000 and has repeatedly been deemed safe and effective by FDA scientists.

Lower courts concluded that Louisiana is likely to prevail, and a three-judge panel of the U.S. 5th Circuit Court of Appeals ruled that mail access and telehealth visits should be suspended while the case plays out.

The drug is most often used for abortion in combination with another drug, misoprostol. Medication abortions accounted for nearly two-thirds of all abortions in the U.S. in 2023, the last year for which statistics are available.

The current dispute is similar to one that reached the court three years ago.

Lower courts then also sought to restrict access to mifepristone, in a case brought by physicians who oppose abortion. They filed suit in the months after the court overturned Roe.

The Supreme Court blocked the 5th Circuit ruling from taking effect over the dissenting votes of Alito and Justice Clarence Thomas. Then, in 2024, the high court unanimously dismissed the doctors’ suit, reasoning they did not have the legal right, or standing, to sue.

In the current dispute, mainstream medical groups, the pharmaceutical industry and Democratic members of Congress have weighed in cautioning the court against limiting access to the drug. Pharmaceutical companies said a ruling for abortion opponents would upend the drug approval process.

The FDA has eased a number of restrictions initially placed on the drug, including who can prescribe it, how it is dispensed and what kinds of safety complications must be reported.

Despite those determinations, abortion opponents have been challenging the safety of mifepristone for more than 25 years. They have filed a series of petitions and lawsuits against the agency, generally alleging that it violated federal law by overlooking safety issues with the pill.

President Trump’s administration has been unusually quiet at the Supreme Court. It declined to file a written brief recommending what the court should do, even though federal regulations are at issue.

The case puts Trump’s Republican administration in a difficult place. Trump has relied on the political support of antiabortion groups but has also seen ballot question and poll results that show Americans generally support abortion rights.

Both sides took the silence as an implicit endorsement of the appellate ruling. Alito is both the justice in charge of handling emergency appeals from Louisiana and the author of the 2022 decision that declared abortion is not a constitutional right and returned the issue to the states.

Sherman, Mulvihill and Perrone write for the Associated Press. Mulvihill reported from Haddonfield, N.J.

WASHINGTON — Democrats on Monday filed an emergency appeal with the U.S. Supreme Court seeking to halt a Virginia ruling invalidating a ballot measure that would have given their party an additional four winnable U.S. House seats.

The move came after the Virginia Supreme Court on Friday struck down a constitutional amendment that voters narrowly passed just last month. The 4-3 state court decision found that the Democratic-controlled legislature improperly began the process of placing the amendment on the ballot after early voting had begun in Virginia’s general election last fall.

Democrats argued unsuccessfully that the U.S. Supreme Court has held that, even if early voting is underway, an election does not happen until election day itself.

The appeal is the latest twist in the nation’s mid-decade redistricting competition. It was kicked off last year by President Trump urging Republican-controlled states to redraw their lines and was supercharged by a recent Supreme Court ruling severely weakening the Voting Rights Act.

“The Court overrode the will of the people who ratified the amendment by ordering the Commonwealth to conduct its election with the congressional districts that the people rejected,” wrote lawyers for Virginia Democrats and Democratic state Atty. Gen. Jay Jones. “The irreparable harm resulting from the Supreme Court of Virginia’s decision is profound and immediate.”

The filing is a sign of Democratic desperation after the Virginia decision. Democrats are still favorites to recapture the U.S. House of Representatives, but their GOP rivals have claimed to have gained more than a dozen seats through redistricting. The voter-approved Virginia map would have partly offset that.

Democrats are taking a legal long shot in asking the justices to reverse the Virginia court’s ruling. The Supreme Court tries to avoid second-guessing state courts’ interpretations of their own constitutions. In 2023, it turned down a request by North Carolina Republicans to overrule a state Supreme Court decision that blocked the GOP’s congressional map.

Politically, the appeal could help a party struggling to compete with Republicans in the unusual mid-decade redrawing of congressional boundaries by providing fodder for election-year messaging about a partisan Supreme Court. The court recently allowed Louisiana Republicans to proceed with redistricting after the justices struck down a majority Black district as an unconstitutional racial gerrymander.

Democrats have been set on their heels because, days after the Virginia ballot measure passed, the Supreme Court’s conservatives reversed decades of rulings and in effect neutered the Voting Rights Act, paving the way for Southern states to eliminate some majority Black districts and further pad Republican margins in Congress.

The Virginia amendment had been launched long before that ruling. It was intended as a response to Republican gains in Texas, Missouri, North Carolina and Ohio, and to blunt a new map in Florida that just became law. Once the Virginia amendment passed, it briefly turned the nationwide redistricting scramble into a draw between the two parties.

That was unraveled by the Virginia Supreme Court’s decision. The justices are appointed by the legislature, which has flipped between the two parties in recent decades, and the body is generally not seen as having a clear ideological bent.

Whitehurst writes for the Associated Press.

The last time the Supreme Court threatened to end access to the country’s most popular abortion method, California’s network of online providers and their pharmaceutical suppliers scrambled to respond.

Now, with the fate of the cocktail used in roughly two-thirds of U.S. terminations once again in the balance, they’re not even breaking a sweat.

Dr. Michele Gomez, co-founder of the MYA Network, a consortium of virtual reproductive healthcare providers, said the supply chain is “ready to switch in a day” to an alternative drug combination.

“It’s not going away and it’s not going to slow down,” Gomez said.

On May 1, the 5th U.S. Circuit Court of Appeals ruled to block the drug mifepristone from being prescribed virtually and shipped through the mail, making such deliveries illegal across the country. On Monday, the Supreme Court stayed that decision, allowing prescriptions to resume until the court issues an emergency ruling next week.

Mifepristone is the first half of a two-drug protocol for medication abortion, which made up 63% of all legal abortions in the U.S. in 2023.

Between a quarter and a third of those abortions are now prescribed by healthcare providers over the internet and delivered by mail — a path Louisiana and other ban states are fighting to bar.

“Abortion access has gone up with all the telehealth providers,” Gomez said. “We uncovered an unmet need.”

But the cocktail’s second ingredient, misoprostol, can be used to produce abortion on its own — a method that’s often more painful and slightly less effective.

It would be easy for suppliers to switch to a misoprostol-only protocol — and much harder for courts to block it, experts said.

“We heard about this on Friday and organizations that mail pills were mailing misoprostol on Saturday,” Gomez said. “They already knew what to do.”

After the Supreme Court overturned Roe vs. Wade in 2022, California became one of the first states to enshrine abortion rights for residents in its Constitution and legislate protection for clinicians who prescribe abortion pills to women in states with bans.

Last fall, legislators in Sacramento expanded those protections by allowing pills to be mailed without either the doctor or the patient’s name attached.

But cases like the one being decided next week could still sharply limit abortion rights even in states with extensive legal protections, experts warned.

“Even though California has built a fortress around its own constitutional protections of reproductive freedom, those [protections] become vulnerable to the whims of antiabortion states if the Supreme Court gives those states their imprimatur,” said Michele Goodwin, professor at Georgetown Law and an expert on reproductive justice.

Coral Alonso sings in Spanish as protesters rally on the three-year anniversary of the U.S. Supreme Court decision overturning Roe vs. Wade on June 24, 2025, in Los Angeles. The ruling ended the federal right to legal abortion in the United States.

(David McNew / Getty Images)

Legal experts are split over how the justices will decide the medication’s mail-order fate.

“This is a case where law clearly won’t matter,” Eric J. Segall, a law professor at Georgia State University and an expert on the Supreme Court.

“In a very important midterm election year, I think there’s at least two Republicans on the court who will decide that upholding the 5th Circuit would really hurt the Republicans at the polls,” he said. “If women can’t get this by mail in California or other blue states where abortion is legal, it’s going to have devastating consequences, and I think the court knows that.”

But he and others believe it’s no longer a matter of if — but when and how — the drugs are restricted, including in California.

“This is curating a backdrop for a legal showdown that may surely come,” Goodwin said.

The court’s most conservative justices could find grounds to act in the long-forgotten Comstock Act of 1873. The brainchild of America’s zealously anti-porn postmaster Anthony Comstock, the law not only banned the mailing of the “Birth of Venus” and “Lady Chatterley’s Lover,” but also condoms, diaphragms and any drug, tool or text that could be used to produce an abortion.

Though it hasn’t been enforced since the 1970s, the antiabortion provision of the law remains on the books, experts said.

“The next move is with the Comstock Act, which Justices Alito and Thomas have already been hinting at,” Goodwin said. “In that case, it’s like playing Monopoly — we could skip mifepristone and go straight to contraception. The goal is to make sure none of that gets to be in the mail.”

That move would upend how Americans get both abortions and birth control, and put an unassuming L.A. County pharmacy squarely in the government’s crosshairs.

Although doctors in nearly two dozen states can safely prescribe medication abortion to women anywhere in the U.S., only a handful of specialty pharmacies actually fill those mail orders, Gomez explained. Among the largest is Honeybee in Culver City, which did not reply to requests for comment.

Even if the justices don’t reach for Comstock, a decision in Louisiana’s favor next week could create a two-tiered system of abortion across California and other blue states, experts said.

“The people this case hurts the most are the poor and the rural,” said Segall, the Supreme Court expert.

National data show that abortion patients are disproportionately poor. Most are also already mothers. Losing mail access to mifepristone would leave many with the more painful, less effective option while those with the time and means to reach a clinic continue to get the gold standard of care.

“There are fundamental questions of citizenship at the heart of this,” said Goodwin, the constitutional scholar. “Under the 14th Amendment, women are supposed to have equality, citizenship, liberty. It’s as though the Supreme Court has taken a black marker and pressed it against all of those words.”

For Gomez and other providers, that’s tomorrow’s problem.

“The lawyers and the politicians are just going to do their thing,” the doctor said. “The healthcare providers are just trying to get medications to people who need them.”