WASHINGTON (AP) — The U.S. Supreme Court on Thursday ruled unanimously to preserve access to the abortion pill mifepristone, a pill used in the most common way to end a pregnancy. The medication was used in nearly two-thirds of all abortions in the United States last year.
The ruling is the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.
The justices ruled that abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s approval of the medication, mifepristone, and the FDA’s subsequent actions to ease access to it.
Justice Brett Kavanaugh wrote for the court that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.” Kavanaugh was part of the majority to overturn Roe.
The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.
Currently:
— Read the full ruling from the Supreme Court here
— The U.S. Supreme Court just ruled on Mifepristone. How safe is the abortion pill?
— What is the case about? The central dispute was whether the FDA overlooked serious safety problems when it made mifepristone easier to obtain
— Key takeaways: Several justices pressed for real-life examples, and other key moments from arguments in March
— Check out the status of abortion rights state by state
Here’s the latest:
Biden: ‘The stakes could not be higher for women’
U.S. President Joe Biden celebrated Thursday’s decision by the U.S. Supreme Court to preserve access to mifepristone, a pill used in the most common method of abortion. He reaffirmed the safety and efficacy of mifepristone, but — echoing the language of many abortion rights groups — said that the ruling “does not change the fact that the right for a woman to get the treatment she needs is imperiled if not impossible in many states.”
He warned that attacks on medication abortion would continue.
“The stakes could not be higher for women across America,” he said.
How mifepristone access impacts people of color
Women of color advocating for abortion access have pointed out that restricting access to mifepristone could worsen racial health disparities. They argue that individuals of color and pregnant people from marginalized communities are more likely to face systemic barriers that limit their access to abortion and other reproductive health care. As a result, they rely on methods like medication abortion.
Monica Simpson, executive director of SisterSong, the nation’s largest organization dedicated to reproductive justice for women of color, said communities of color are more likely to live in reproductive health care deserts, use Medicaid or live in states with abortion bans.
“Having all of our options for abortion access is critically important for our community as attacks on mifepristone impact those who have historically been pushed to the margins the most,” she said.
Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, said mifepristone is “critical” because of “its importance in expanding abortion access for our community members, especially those living at the intersections of systemic oppression disproportionately harmed by abortion bans and restrictions.”
Kavanaugh’s comments point to the stakes of the 2024 election
Justice Brett Kavanaugh’s comments in the U.S. Supreme Court’s ruling on access to the abortion medication mifepristone highlighted what’s at stake in the presidential 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone.
The plaintiffs in the mifepristone case — anti-abortion doctors and their organizations — had argued in court papers that the Food and Drug Administration’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and would “jeopardize women’s health across the nation.”
Kavanaugh acknowledged what he described as opponents’ “sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.”
Federal laws already protect doctors from having to perform abortions, or give any other treatment that goes against their beliefs, Kavanaugh wrote.
“The plaintiffs have not identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience since mifepristone’s 2000 approval,” he wrote.
In the end, Kavanaugh wrote, the anti-abortion doctors went to the wrong forum and should instead direct their energies to persuading lawmakers and regulators to make changes.
Mifepristone ruling referenced another important abortion case
Thursday’s U.S. Supreme Court ruling on access to mifepristone referenced another important abortion case the court is considering — the legality of Idaho’s abortion ban, which only allows doctors to perform abortions if the pregnant woman’s life is at risk.
U.S. President Joe Biden’s administration has argued that Idaho’s law conflicts with a longstanding federal law that has shaped emergency room care.
The Emergency Medical Treatment and Active Labor Act, also called EMTALA, requires emergency rooms to provide all patients who present at their hospital with stabilizing treatment, which might include abortions in extreme cases.
The court appeared sharply divided over the case when it heard arguments in April. But in the ruling released Thursday on mifepristone, the justices referred several times to EMTALA. The justices unanimously agreed with the Biden administration’s point that the federal law does not require doctors to perform an abortion if they object to it.
The law “neither overrides neither overrides federal conscience laws nor requires individual emergency room doctors to participate in emergency abortions,” the justices wrote.
That’s an important point for the justices to agree on, particularly for the conservative members who oppose abortion.
Anti-abortion groups decry Supreme Court ruling
Following the U.S. Supreme Court’s Thursday ruling to preserve access to the abortion pill mifepristone, anti-abortion groups denounced the decision.
“It is a sad day for all who value women’s health and unborn children’s lives, but the fight to stop dangerous mail-order abortion drugs is not over,” said Kate Daniel, state policy director for SBA Pro-Life America.
Kristan Hawkins, president of Students for Life of America: Hawkins called the decision “disappointing but not surprising,” expressing concern for the “conscience rights of the pro-life doctors.”
Reproductiverights groups call decision a small win
Reproductive rights groups across the country expressed relief over Thursday’s ruling from the U.S. Supreme Court, but almost all stressed that the decision marked but a small win in the long-term battle over abortion access.
“Even with this baseless challenge defeated, we must remain vigilant,” said Destiny Lopez, acting co-CEO of the Guttmacher Institute. “The anti-abortion movement is ruthlessly pursuing its end goal of banning abortion nationwide.”
Jennifer Dalven, director of the ACLU Reproductive Freedom Project, warned that attacks on medication abortion are still taking place even after the court’s ruling, saying that “anti-abortion politicians are waiting in the wings to attempt to continue pushing this case before an extremist judge in Texas in an effort to deny people access to medication abortion care.”
Many others pointed out that it was hard to celebrate the dismissal of the case when several states have enacted their own abortion restrictions.
“Despite the Supreme Court’s decision today, millions of people will still have restricted access to the health care they deserve,” The Democratic Legislative Campaign Committee said in a statement.
How safe is mifepristone?
When the U.S. Supreme Court heard oral arguments for the case in March, the safety of mifepristone was at the heart of the debate.
There are rare occasions when mifepristone can cause dangerous, excessive bleeding that requires emergency care. Because of that, the Food and Drug Administration imposed strict safety limits on who could prescribe and distribute it.
The doctors also had to be capable of performing emergency surgery to stop excess bleeding and an abortion procedure if the drug didn’t end the pregnancy. Over the years, the FDA reaffirmed mifepristone’s safety and repeatedly eased restrictions, culminating in a 2021 decision doing away with any in-person requirements and allowing the pill to be sent through the mail.
Abortion rights groups respond to abortion pill ruling
Nancy Northup, president and CEO of the Center for Reproductive Rights, expressed relief at Thursday’s decision by the U.S. Supreme Court on access to mifepristone but also expressed frustration that the case made it the court at all, calling it “meritless.”
“Unfortunately, the attacks on abortion pills will not stop here — the anti-abortion movement sees how critical abortion pills are in this post-Roe world, and they are hell-bent on cutting off access,” she added.
Mini Timmaraju, president and CEO of the national abortion rights group Reproductive Freedom for All, echoed similar feelings. While expressing relief she also said, “This baseless push to block abortion access should never have been heard by them in the first place.”
How the case ended up at the US Supreme Court
The mifepristone case began five months after the Supreme Court overturned Roe v. Wade. Abortion opponents initially won a sweeping ruling nearly a year ago from U.S. District Judge Matthew Kacsmaryk, a Trump nominee in Texas, that would have revoked the drug’s approval entirely.
The 5th U.S. Circuit Court of Appeals 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 Supreme Court put the appeals court’s modified ruling on hold and agreed to hear the case. However, Justices Samuel Alito — the author of the decision overturning Roe — and Clarence Thomas would have allowed some restrictions to take effect while the case proceeded.
Here’s what each side argued in the case
Health care providers have said that if mifepristone is no longer available or is too hard to obtain, they would switch to using only misoprostol, which is somewhat less effective in ending pregnancies.
U.S. President Joe Biden’s administration and drug manufacturers had warned that siding with abortion opponents in the case could undermine the FDA’s drug approval process beyond the abortion context by inviting judges to second-guess the agency’s scientific judgments. The Democratic administration and New York-based Danco Laboratories, which makes mifepristone, argued that the drug is among the safest the FDA has ever approved.
The abortion opponents argued in court papers that the FDA’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and “jeopardize women’s health across the nation.”
What is mifepristone?
More than 6 million people have used mifepristone since 2000. Mifepristone blocks the hormone progesterone and primes the uterus to respond to the contraction-causing effect of a second drug, misoprostol. The two-drug regimen has been used to end a pregnancy through 10 weeks gestation.
US Supreme Court rules to preserve access to abortion medication
The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.
The justices ruled that abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s approval of the medication, mifepristone, and the FDA’s subsequent actions to ease access to it.
The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.
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