Supreme Court unanimously strikes down legal challenge to abortion pill mifepristone

The U.S. Supreme Court on Thursday ruled a group of doctors lacked legal standing to challenge the Food and Drug Administration's regulation of the abortion pill mifepristone, preserving access to the medication nationwide.

The unanimous opinion was authored by Justice Brett Kavanaugh.

The case put abortion access back in the spotlight for the court for the first time since its conservative majority voted to overrule Roe v. Wade in 2022.

"Plaintiffs are pro-life, oppose elective abortion, and have sincere legal, moral, ideological, and policy objections to mifepristone being prescribed and used by others," Kavanaugh wrote in the ruling. "Because plaintiffs do not prescribe or use mifepristone, plaintiffs are unregulated parties who seek to challenge FDA's regulation of others."

"Plaintiffs advance several complicated causation theories to connect FDA's actions to the plaintiffs' alleged injuries in fact," Kavanaugh added. "None of these theories suffices to establish Article III standing."

Mifepristone is the first pill taken in a two-drug regimen for medication abortion, which is the most common method of abortion in the country.

The court's ruling means mifepristone will remain available under preexisting conditions, which include allowing women to receive the medication by mail and without any in person dispensation requirement.

But the Supreme Court did not address the doctors' claims the FDA erred in those regulations, which were enacted in 2016 and 2021. Instead, it leaves those questions to be resolved another time.

Already, similar challenges against mifepristone are being brought by three Republican-led states: Missouri, Kansas and Idaho. Their attorneys claim they will fare better on legal standing.

Justice Kavanaugh suggested that while the Alliance for Hippocratic Medicine "failed to demonstrate that FDA's relaxed regulatory requirements likely would cause them to suffer an injury," there was another avenue for challenging the abortion pill.

"The plaintiffs may present their concerns and objections to the President and FDA in the regulatory process," he wrote.

Drug maker Danco, which fought to defend the pill, said the ruling was a huge win for the pharmaceutical industry which had warned against courts overriding the judgment of scientists and experts at FDA.

The court "maintained the stability of the FDA drug approval process, which is based on the agency's expertise and on which patients, healthcare providers and the US pharmaceutical industry rely," a Danco spokeswoman Abigail Long, said in a statement.

Abortion opponents decried the decision as "deeply disappointing."

"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 Susan B. Anthony Pro-Life America policy director Katie Daniel.

Alliance Defending Freedom Senior Counsel Erin Hawley, who argued before the court on behalf of the doctors, also expressed dismay that the justices did not dive into the merits of the case.

Hawley said the group "will continue to advocate for women and work to restore commonsense safeguards for abortion drugs."

The Supreme Court did deliver a forceful endorsement of conscience protections for doctors who oppose abortion -- perhaps a sign of how it might rule in another major abortion case this term: Moyle v. U.S.

That case focuses on Idaho's abortion ban and whether a federal law governing emergency care protects access to abortion at hospitals when a woman's health is at risk. The court appeared fractured on the issue when it heard arguments on April 24. A decision is expected by the end of June.

"Federal conscience laws definitively protect doctors from being required to perform abortions or to provide other treatment that violates their consciences," Kavanaugh wrote in Thursday's opinion.

President Joe Biden said the court's mifepristone decision "does not change the fact that the fight for reproductive freedom continues."

"Women are being turned away from emergency rooms, or forced to go to court to plead for care that their doctor recommended or to travel hundreds of miles for care," Biden said in a statement. "Doctors and nurses are being threatened with jail time, including life in prison, for providing the health care they have been trained to provide. And contraception and IVF are under attack."