Justice Samuel Alito has temporarily blocked a federal appeals court decision that would have restricted mail access to mifepristone, the abortion pill used in medication abortion. The pause remains in effect until at least Thursday, giving the Supreme Court time to decide whether to hear the case or let the lower court ruling stand.
The appeals court had sided with anti-abortion groups challenging FDA approval of mifepristone, which the agency authorized for mail delivery in 2023. That decision expanded access significantly, particularly for people in states with abortion restrictions who cannot easily reach clinics.
Mifepristone is the first drug in a two-drug regimen for medication abortion, which accounts for the majority of U.S. abortions. The FDA approved it decades ago, but restricted its distribution to certain clinics until 2023. The mail-access expansion allowed licensed pharmacies to dispense it by mail, removing a major barrier for many people.
The appeals court decision would have reversed that expansion, essentially returning mifepristone to more limited distribution. The ruling relied on arguments that the FDA lacked authority to approve mail delivery or that the agency exceeded its regulatory power.
Alito's temporary pause buys time for the Supreme Court to decide how to proceed. The Court could grant a stay that extends Alito's pause, reject the request and let the appeals court ruling take effect, or agree to hear the full case later. This decision comes roughly a year and a half after the Supreme Court overturned Roe v. Wade, returning abortion regulation to individual states.
Access to medication abortion remains a pivotal issue. Roughly 20 states have banned or severely restricted abortion, while others protect it. Mail access significantly affects people in restrictive states who may travel to neighboring states or obtain pills through telemedicine providers.
The outcome of this case will determine whether millions of Americans retain access to medication abortion