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Louisiana Lawsuit Threatens Telehealth Abortions Nationwide

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The State of Louisiana and a woman whose ex-boyfriend forced her to take mifepristone sued the Food and Drug Administration (FDA) in October.  They are asking for an injunction against the 2023 FDA rule which allows abortion pills to be prescribed by telehealth or mailed to patients.  The rule also allows pharmacies to apply for certification to dispense mifepristone without doctors' prescriptions:

https://michiganadvance.com/2026/02/24/repub/louisiana-mifepristone-lawsuit-could-hinder-telehealth-abortion-nationwide/

Louisiana mifepristone lawsuit could hinder telehealth abortion nationwide
By Elisha Brown - February 24, 2026

A hearing is set for Tuesday in a federal lawsuit led by Louisiana seeking to further restrict access to mifepristone by asking the courts to stop abortion pills from being mailed across the country.

The Department of Justice has argued plaintiffs lack standing to bring the case and asked the judge to halt legal proceedings until the Food and Drug Administration wraps up a review of the medication.

Hundreds of studies have concluded that the drug is safe and effective for abortions early in pregnancy, but a paper released by a conservative think tank last year compelled Health and Human Services Secretary Robert F. Kennedy Jr. to order a reevaluation of mifepristone.

The state of Louisiana and a woman who said her ex-boyfriend made her take abortion medication sued the FDA in October and asked for a preliminary injunction against a 2023 rule that allows abortion pills to be prescribed through telehealth or mailed to patients, and pharmacies to apply for certification to dispense mifepristone.

Julie Kay, the founder and CEO of legal advocacy group Reproductive Futures, told States Newsroom the lawsuits in Louisiana and elsewhere are “thinly veiled attempts” to block access to telehealth medication abortion.

“We’ve seen that telemedicine abortion has become incredibly popular in all 50 states and particularly vital for women in under-resourced areas,” Kay said.

Missouri, Idaho, Kansas, Texas and Florida are also suing the FDA over mifepristone’s regulations and asking the courts to restrict or rescind approval of the drug altogether.

Nearly 30% of abortions provided in the first half of 2025 were through telehealth, according to the Society of Family Planning’s latest #WeCount report.

By June 2025, about 15,000 abortions per month were provided by physicians shielded by state laws, allowing them to prescribe abortion medication remotely to people living in states where abortion is banned or restricted, the report found. Shield laws protecting health care professionals from out-of-state investigations have held up in court so far, despite efforts from prosecutors in Texas and Louisiana.

Republican Louisiana Attorney General Liz Murrill vowed to defend anti-abortion laws in her state, which has had a ban with no exceptions for rape or incest since August 2022. She indicted a California doctor in January, accusing him of mailing abortion pills to Rosalie Markezich, a plaintiff in the lawsuit before federal courts.

Lawyers for Louisiana argue that the Biden administration’s decision to nix the in-person dispensation requirement for mifepristone is an affront to states that ban abortion.

Alliance Defending Freedom Senior Counsel Erik Baptist framed the lawsuit as an intimate partner violence issue, saying Markezich’s former boyfriend ordered abortion pills online from Dr. Rémy Coeytaux in California without any in-person interaction.

“So what this lawsuit would do is protect women across the country, in particular in Louisiana, from this mail-order abortion scheme that enables and emboldens people in coercive situations, such as men and abusers who can now obtain these drugs through remote means,” Baptist said.

Reproductive coercion — when an abusive partner controls a person’s bodily autonomy — has been brought up in recent legal challenges to abortion pill access by other GOP attorneys general in bids to restrict mifepristone, according to Rachel Rebouché, a University of Texas at Austin law professor who specializes in reproductive rights.

“There’s really not evidence that people are being coerced or forced into taking pills. It’s, of course, awful if someone has felt coerced, but I’m not sure it changes the argument of what the FDA should do as an agency committed to reviewing evidence,” Rebouché said.

For their part, DOJ attorneys have said an injunction would interfere with the FDA review and Risk Evaluation and Mitigation Strategies, setting off an avalanche of other lawsuits.

“Plaintiffs now threaten to short circuit the agency’s orderly review and study of the safety risks of mifepristone by asking this Court for an immediate stay of the 2023 REMS Modification approved three years ago,” they wrote in a memo filed on Jan. 27 in the U.S. District Court for the Western District of Louisiana.

Kay said she views the Trump administration’s motion to pause the case as a legal delay tactic that is more about politics than science, because most Americans believe abortion should be accessible. A Pew Research Center poll from June 2025 showed 63% of respondents said abortion should be legal in all or most cases.

“This federal administration is very aware of that popularity, and I think they’re saying they want to wait until after the midterms,” Kay said.

Baptist said the FDA can conduct their review while the in-person requirement is restored.

Mifepristone’s manufacturers intervened in the case earlier this month, Louisiana Illuminator reported. But unlike the federal government, GenBioPro and Danco, the companies behind the generic and name brand versions of the drug, asked the court to dismiss Louisiana’s lawsuit entirely.

In a memo filed on Tuesday, Feb. 17, lawyers for the plaintiffs argued that the 2023 regulatory change “was intended to authorize a direct attack” on anti-abortion states.

The filing also rejects arguments that Louisiana and Markezich lack standing in the same way that a group of anti-abortion doctors did in a lawsuit against the FDA over mifepristone’s previous regulations, according to a 2024 U.S. Supreme Court ruling. Justices rebuffed the Alliance for Hippocratic Medicine’s requests but did not rule on the merits of the case.

Baptist also said judicial panels on the 5th U.S. Circuit Court of Appeals in Louisiana — a conservative-leaning court where this lawsuit could go next — have twice ruled that it was “arbitrary and capricious” for the FDA to allow abortion medication without an in-person doctor visit.

In Louisiana’s corner are major anti-abortion players: Students for Life of America, 60 Republican members of Congress, 21 GOP attorneys general and the Ethics and Public Policy Center filed briefs backing the state.

Rebouché, the University of Texas professor, said there would be conflict between the federal courts if the district court judge rules in favor of Louisiana. There are nearly a dozen lawsuits over abortion pills seeking to restrict and deregulate mifepristone, States Newsroom reported.

Guttmacher Institute Principal Federal Policy Adviser Anna Bernstein said in a statement Friday that reinstating the in-person dispensation requirement for mifepristone would hinder abortion access.

“If access to telehealth and mifepristone by mail is curtailed, more patients would be pushed toward in-clinic care, straining provider capacity and increasing wait times in an already chaotic landscape,” she said. “Given that travel is out of reach for many people, the result would likely be increased delays and more people unable to get the abortion care they need and deserve.”



   
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The U.S. District Court for the Western District of Louisiana ruled in favor of remote dispensing of mifepristone, but was overruled by the Fifth U.S. Circuit Court of Appeals in Louisiana v. FDA.  The U.S. Supreme Court has "paused" the Fifth U.S. Circuit Court of Appeals' stay three times; the most recent stay being indefinite.  Thus "mail order" mifepristone is still federally legal, even in jurisdictions where it is illegal under state and/or local laws.

This remarkable action on the part of SCOTUS has revived interest the Comstock Act of 1873, which clearly bans abortion-related materials from being sent through the mail. Sen. Tina Smith (D-Minn.) introduced legislation in 2024 that would have repealed the abortion provisions of the Comstock Act, but it was not passed.  The Comstock Act is still U.S. Law, even if seven justices of the U.S. Supreme Court find it inconvenient:

https://thehill.com/regulation/court-battles/5879032-mifepristone-abortion-pills-ruling/

https://law.justia.com/cases/federal/appellate-courts/ca5/26-30203/26-30203-2026-05-01.html

https://www.congress.gov/42/llsb/S.1572v3.pdf

Supreme Court preserves abortion pill access over Alito, Thomas dissents
By Zach Schonfeld and Nathaniel Weixel - May 14, 2026

Abortion pills can remain available through the mail for the immediate future after the Supreme Court on Thursday paused a lower court ruling that would have blocked access while a lawsuit proceeds.

The justices halted a May 1 order from the conservative U.S. Court of Appeals for the 5th Circuit that reinstated a requirement that women must visit a healthcare provider in-person to obtain mifepristone. If it had taken effect, the order would have severely curtailed abortion access across the country.

Conservative Justices Clarence Thomas and Samuel Alito dissented separately.

“The Court’s unreasoned order granting stays in this case is remarkable. What is at stake is the perpetration of a scheme to undermine our decision” overturning constitutional abortion rights, Alito wrote.

Thomas referenced the Comstock Act, an 1873 anti-obscenity law, to argue that federal law already makes mailing mifepristone a criminal offense.

“Applicants are not entitled to a stay of an adverse court order based on lost profits from their criminal enterprise. They cannot, in any legally relevant sense, be irreparably harmed by a court order that makes it more difficult for them to commit crimes,” Thomas wrote.

Thomas and Alito repeatedly referenced Comstock during oral arguments in a 2024 case about mifepristone.

It is not a final decision in the high-stakes dispute. The case now heads back to the New Orleans-based 5th Circuit, and it could ultimately return to the justices on their normal docket.

The Supreme Court was asked to weigh in by Danco and GenBioPro, two drugmakers that manufacture mifepristone and a generic version of the drug. The companies argued the 5th Circuit’s decision was unprecedented and would cause confusion.

“With today’s Supreme Court decision, Americans’ access to mifepristone remains unchanged for now. GenBioPro is continuing to serve its customers and is committed to providing our evidence-based, essential medication to all who need it,” GenBioPro CEO Evan Masingill said in a statement.

The 5th Circuit’s ruling came after Louisiana sued the Food and Drug Administration (FDA) to restrict access to mifepristone. The state objected to a 2023 FDA regulation that allowed mifepristone to be prescribed through telehealth, in pharmacies and through the mail.

The state argued that the FDA’s permissive rules undercut its near-total abortion ban and were a violation of the state’s sovereignty. Louisiana also asserted the FDA didn’t have enough safety data to roll back the in-person dispensing requirement, a claim the manufacturers reject.

Alito, who by default handles emergency matters arising from the 5th Circuit, had briefly put the ruling on hold until the Supreme Court decided what to do.

“It’s shocking that the Supreme Court would block this common-sense return to medically ethical practices and oversight,” Louisiana Attorney General Liz Murrill (R) said in a statement. “DOJ did not defend Big Pharma, which is profiting from the illegal and unethical distribution of abortion pills. We will keep fighting.”

The emergency case marked one of the biggest disputes over abortion in years at the Supreme Court, which nearly four years ago overturned the constitutional right established in Roe v. Wade.

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.

Medication abortion is the most common pregnancy termination method, and abortion opponents have grown frustrated with the wide availability of mifepristone, which is typically used as part of a two-drug combination for medication abortion.

Mail-order pharmacies, combined with blue state “shield laws” protecting clinicians from prosecution, have helped women maintain access even as conservative states ban or severely limit access to abortion clinics.

As a result, abortions have increased despite the end of Roe.

Notably, the Trump administration did not take a position when the battle landed at the Supreme Court, though other GOP states and members of Congress did.

The FDA is reviewing the safety protocols for mifepristone, but it’s unclear when that review will be complete. The Justice Department told the appeals court that Louisiana’s lawsuit “would disrupt FDA’s ongoing review, and usurp FDA’s scientific role, but would also threaten chaos.”

“Over the years, FDA has reviewed extensive safety and effectiveness data from dozens of clinical trials and decades’ worth of real-world experience in millions of patients,” Danco said in a statement. “Danco also is confident that a review of all recent, reliable data by FDA will continue to show that Mifeprex is very safe and effective.”



   
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