![\"A](\"https:\/\/www.motherjones.com\/wp-content\/uploads\/2026\/05\/20260514_mifepristone-pause_2000.jpg?w=990\")
<\/p>\nMother Jones illustration; Erin Hooley\/Chicago Tribune\/Tribune News Service\/Getty<\/span><\/p>\n<\/div>\n The Supreme Court has rejected<\/span> a federal appeals court\u2019s attempt to end telemedicine and mail-order abortions, hitting pause on a fast-moving case that threatened to decimate access to abortion pills nationwide.<\/p>\n The one-paragraph SCOTUS order, issued late Thursday afternoon, means that for the foreseeable future, the abortion pill mifepristone can continue to be prescribed via telehealth and sent through the mail, even to patients living in states where abortion is banned.<\/p>\n \u201cThe number one message that we want to get across is that telehealth care is still available across the country,\u201d said\u00a0Lizzy Hinkley, legal director of the Abortion Coalition for Telemedicine<\/a>.<\/p>\n Abortion patients, providers, and advocates have been in turmoil<\/a> since May 1, when the far-right<\/a> Fifth Circuit Court of Appeals issued an order<\/a> suspending FDA rules that allowed online dispensing of mifepristone. That order was stayed <\/a>by Justice Samuel Alito for 10 days while the Supreme Court struggled to decide how to proceed in a potentially monumental\u2014and politically explosive\u2014case.<\/p>\n Since the 2022 Dobbs<\/em> decision overturning Roe v. Wade<\/em>, more than a dozen Republican-dominated legislatures have enacted laws that severely restrict or ban abortion within their borders. But over the past four years, the number of abortions has risen<\/a> nationwide, including in states<\/a> where abortion is almost entirely illegal.\u00a0<\/p>\n Abortion foes blame Obama- and Biden-era FDA rule changes expanding access to mifepristone, one of two drugs used in the standard abortion-pill regimen, including a 2023 rule that eliminated a requirement for in-person dispensing. Now, almost two-thirds of<\/a> abortions in the US happen with abortion pills, and nearly 30 percent occur<\/a> by telemedicine.<\/p>\n Louisiana sued the FDA last fall, arguing that the 2023 rule change was arbitrary, capricious, and \u201cavowedly political\u201d\u2014not based on sound science, the suit claimed, but on Democrats\u2019 determination to negate the Supreme Court\u2019s intent in Dobbs<\/em> to return abortion policy to the states.<\/p>\n The FDA argued that the lawsuit would disrupt its own, ongoing review of mifepristone\u2019s safety, announced<\/a> last fall. Mifepristone\u2019s manufacturers, Danco Laboratories and GenBioPro Inc., warned of the potentially dire consequences of allowing states to upend drug regulations put in place years or even decades ago.<\/p>\n On Thursday, Alito\u2014the arch-conservative who authored the Dobbs<\/em> decision\u2014was one of two justices who wrote in favor of letting the Fifth Circuit\u2019s order go into effect. That would have cut off the supply of mail-order mifepristone to states like Louisiana, where telehealth providers are sending nearly 1,000 packages of abortion pills every month.<\/p>\n \u201cEven this conservative Supreme Court is not willing to endorse anti-abortion extremists\u2019 latest desperate attempt to deprive women of needed healthcare.\u201d<\/p>\n<\/blockquote>\n<\/figure>\n Alito blasted his fellow justices\u2019 decision to pause the Fifth Circuit order as \u201cunreasoned\u201d and \u201cremarkable.\u201d He also ranted about blue-state shield laws<\/a>, which provide the legal protections that make it possible for telehealth providers to care for patients in states where abortion is restricted or banned. Such laws, he said, are \u201ca scheme\u201d to thwart states like Louisiana, which has some of the toughest anti-abortion restrictions in the country.<\/p>\n In his dissent, Justice Clarence Thomas brought up the Comstock Act, a Victorian-era federal criminal statute that conservatives argue remains the law of the land. If enforced, it would amount to a national abortion ban.<\/p>\n Comstock \u201cbans using \u2018the mails\u2019 to ship any \u2018drug . . . for producing abortion,\u2019\u201d\u00a0Thomas wrote, and suggested that Danco and GenBioPro are engaged in a \u201ccriminal enterprise.\u201d He said the drug companies\u2014which appealed the Fifth Circuit ruling to SCOTUS\u2014\u201dcannot be irreparably harmed by [an] order that makes it more difficult for them to commit crimes.\u201d<\/p>\n Abortion advocates expressed relief that the other justices\u2014including several who have repeatedly ruled against abortion rights\u2014did not let the Fifth Circuit ruling take effect. \u201cEven this conservative Supreme Court is not willing to endorse anti-abortion extremists\u2019 latest desperate attempt to deprive women of needed healthcare,\u201d Hinkley said. She called the case \u201ca deliberate effort to disrupt access to telemedicine abortion across the country and cause undue confusion among patients and providers.\u201d<\/p>\n \u201cThe ban on mifepristone through telemedicine was never about safety,\u201d said Dr. Angel Foster, a telemedicine provider and co-founder of The Massachusetts Medication Abortion Access Project<\/a>, or The MAP. \u201cIt was about controlling people\u2019s bodies and lives.\u201d<\/p>\n But the reprieve is only temporary, she added. \u201cLawmakers have made it clear they are desperate to block access to medication abortion by any means necessary.\u201d<\/p>\n<\/p><\/div>\n\n