Supreme Court agrees to decide on abortion pill access, approval process

The Supreme Court decided on Wednesday to hear a case on access to the abortion bill and its approval process, which has been defended by the Biden administration. 

The nation’s highest court agreed to consider appeals from the Biden administration and drug manufacturer Danco defending several moves by the U.S. Food and Drug Administration intended to make it easier to access and use the mifepristone pill in the wake of the overturning of Roe v. Wade last year.

In overturning Roe v. Wade in June 2022, the Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization that the U.S. Constitution does not guarantee the right to an abortion and that the matter should be decided by the states. In the aftermath, 14 states have banned abortion at all stages of pregnancy, with some exceptions, and two others have banned abortion once a fetal heartbeat is detected, which is around six weeks of gestation. 

The Biden administration and the maker of the drug mifepristone are asking the high court to reverse an appellate ruling that would cut off access to the drug through the mail and impose other restrictions, even in states where abortion remains legal. The restrictions include shortening from the current 10 weeks to seven weeks the time during which mifepristone can be used in pregnancy. The nine justices rejected a separate appeal from abortion opponents who challenged the FDA’s initial approval of mifepristone as safe and effective in 2000.

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The case will be argued in the spring, with a decision likely by late June, in the middle of the 2024 presidential and congressional campaigns.

Mifepristone pill

Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion.  (Soumyabrata Roy/NurPhoto via Getty Images)

Mifepristone, made by New York-based Danco Laboratories, is one of two drugs used in medication abortions, which account for more than half of all abortions in the United States. More than 5 million people have used it since 2000, according to The Associated Press. The second is misoprostol, which some health care providers say is less effective alone in ending pregnancies. 

Pro-life advocates filed their challenge to mifepristone in November 2022 and initially won a sweeping ruling six months later revoking the drug’s approval entirely. The appeals court left intact the FDA’s initial approval of mifepristone. But it would reverse changes regulators made in 2016 and 2021 that eased some conditions for administering the drug.

The justices blocked that ruling from taking effect while the case played out, though Justices Samuel Alito, the author of last year’s decision overturning Roe, and Clarence Thomas said they would have allowed some restrictions to take effect while the case proceeded.

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supreme court exterior

The U.S. Supreme Court will hear a case on the abortion pill in the spring of 2024. (AP Photo/Mariam Zuhaib, File)

The FDA has eased the terms of mifepristone’s use over the years, including allowing it to be sent through the mail in states that allow access. In its appeal, the Democratic administration said the appeals court ignored the FDA’s scientific judgment about mifepristone’s safety and effectiveness since its approval in 2000.

Lawyers for the pro-life medical groups and individual physicians who have challenged the use of mifepristone had urged the Supreme Court to turn away the appeals.

“The modest decision below merely restores the common-sense safeguards under which millions of women have taken chemical abortion drugs,” wrote lawyers for the Alliance Defending Freedom, which describes itself as a Christian law firm. The lead attorney on the Supreme Court filing is Erin Hawley, wife of Sen. Josh Hawley, R-MO.

Abortion pill, Mifepristone, in boxes on a shelf

Boxes of the drug mifepristone sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., on March 16, 2022.  (AP Photo/Allen G. Breed, File)

U.S. District Judge Matthew Kacsmaryk, an appointee of former President Trump in Texas, initially revoked FDA approval of mifepristone.

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Responding to a quick appeal, two more Trump appointees on the 5th U.S. Circuit Court of Appeals said the FDA’s original approval would stand for now. But Judges Andrew Oldham and Kurt Engelhardt said most of the rest of Kacsmaryk’s ruling could take effect while the case winds through federal courts.

This is a breaking news story. Check back for updates. The Associated Press contributed to this report.

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