Court Battles

Alito pauses abortion pill restrictions for 1 week

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by Zach Schonfeld and Nathaniel Weixel - 05/04/26 11:04 AM ET

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by Zach Schonfeld and Nathaniel Weixel - 05/04/26 11:04 AM ET

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Justice Samuel Alito on Monday briefly halted a ruling that would prevent mifepristone, one of two pills used in medication abortion, from being prescribed without an in-person doctor visit.

Alito’s pause will last for one week as the Supreme Court considers the case. It temporarily restores expanded access to the drug but does not necessarily reflect the court’s thinking.

The drug manufacturers filed an emergency appeal at the high court over the weekend after the U.S. Court of Appeals for the 5th Circuit blocked a 2023 regulation allowing it to be prescribed through telehealth, in pharmacies and through the mail.

It brings the issue of abortion back again to the Supreme Court, four years after the conservative majority overturned Roe v. Wade.

Mifepristone access has since emerged as one of the major legal battles over abortion. Other groups have sought to take it off the market entirely, while the new case focuses specifically on telehealth access.

The court in 2024 unanimously upheld access to mifepristone on a technicality, ruling that doctors and medical groups opposed to abortion did not have a legal right to sue.

Alito received the latest case because he handles emergency matters arising from the 5th Circuit by default, but he could ultimately refer it to the full court for a vote.

The parties have until Thursday to respond.

In its brief asking for a pause, mifepristone manufacturer Danco Laboratories wrote that the appeals court ruling injected “immediate confusion and upheaval into highly time-sensitive medical decisions,” adding it is forcing “providers, patients, and pharmacies all to guess at what is allowed and what is not.”

Since the COVID-19 pandemic, mifepristone has been available to women through telehealth. After Roe was overturned, the Biden administration in 2023 permanently ended the in-person dispensing requirement for mifepristone.

Medication abortions have become increasingly common in the aftermath of the Dobbs decision, as conservative states ban or severely limit access to abortion clinics.

Medication abortion accounted for roughly two-thirds of all abortions in the U.S. in 2023, according to the Guttmacher Institute, which tracks abortion policy.

In 2025, online-only clinics accounted for about a quarter of clinician-provided abortions in the United States.

Louisiana filed the lawsuit last year over claims the Food and Drug Administration’s (FDA) move had procedural defects and wasn’t supported by sufficient data.

The Hill has reached out to a spokesperson for Louisiana Attorney General Liz Murrill (R) for comment.

The FDA first approved mifepristone more than 20 years ago. The agency’s website continues to say mifepristone is safe and effective for use up to 10 weeks gestation.

Updated: 11:41 a.m. EDT

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