The majority of the United States Supreme Court appeared poised to reject blocking access or further restricting the widely used abortion pill mifepristone in a case that could have the biggest impact on abortion access since the overturning of Roe v Wade.
The nation’s highest court heard oral arguments Tuesday in the case of FDA v. Alliance for Hippocratic Medicine, a group of anti-abortion medical professionals who filed a lawsuit in an attempt to block access to the drug.
Mifepristone is used in more than half of abortions in the United States and has been used by more than 5.6 million women since its approval in 2000.
The case looks at actions the FDA took to loosen restrictions around the pill in 2016 and 2021, making the pill more readily available across the country as many states have moved to further restrict abortion since Roe in 2022 fell.
The Supreme Court had to consider two questions: First, whether the group had standing to bring the case and, if so, whether the FDA’s actions to make it easier to obtain the drug are legal.
But during arguments Tuesday, a majority on the court indicated they are unwilling to limit access to the abortion pill based on the conscientious objections of some medical professionals.
Erin Hawley of the Alliance Defending Freedom speaks outside the Supreme Court after speaking on behalf of the Alliance for Hippocratic Medicine
Jessica Ellsworth also argued in court on behalf of Danco, a manufacturer of mifepristone. She warned that the anti-abortion group’s positions would not only impact mifepristone, but could also disrupt the approval of any drug
The majority of Supreme Court justices questioned the plaintiffs’ standing to bring the lawsuit and appeared ready to reject a further restriction on the abortion pill mifepristone.
Attorney General Elizabeth Prelogar made arguments on behalf of the FDA stating that rolling back changes to mifepristone would restrict access to the drug without safety concerns. She also argued that medical complications from abortion pills are very rare.
Attorney Erin Hawley argued on behalf of the plaintiffs. She argued that the drug was dangerous and claimed that anti-abortion doctors object to having to treat women who have taken abortion pills when they come to the emergency department with complications.
During the hearing, Judge Amy Coney Barrett asked Hawley, wife of Sen. Josh Hawley, R-Mo., whether the doctors in the lawsuit have an example of “actually engaging in an abortion to end the life of the embryo or fetus.” , what would cause the emotional or moral damage. Barrett even noted that she hadn’t read of either of them ever saying they took part.
Judge Gorsuch also raised questions about standing, stating that there was a discrepancy between the objections of a few doctors and the restriction on the pill’s availability to all Americans.
“This case seems like a good example of turning what could be a small lawsuit into a state legislature over an FDA rule or other federal government action,” Gorsuch said as he questioned Hawley.
By the end of the nearly two-hour arguments, it appeared that only Justice Samuel Alito accepted the legal status of the case.
Mifepristone is one of the medications used in the medication abortion process and is used in more than half of all abortions in the US. More than 5.6 million women have used mifepristone since its approval in 2000
The Alliance for Hippocratic Medicine first challenged the FDA on a number of grounds in November 2022 in the conservative U.S. District Court for the Northern District of Texas.
Judge Matthew Kacsmaryk sided with the plaintiffs on April 7, 2023, seeking to block the FDA’s approval of mifepristone. But the Justice Department appealed the decision to the Fifth Circuit Court of Appeals.
In August 2023, the Fifth Circuit court ruled that some of the pre-2016 restrictions should be reinstated, but the drug should not be withdrawn from the market, and a Supreme Court stay remained in effect.
The top court will rule near the end of the hearing, so the decision will likely be announced in late June or early July before the court rules before the summer.
Mifepristone is used in more than half of all abortions in the United States.
Research from the Guttmacher Institute, a research organization that studies pro-abortion rights, found that medication abortions in the United States accounted for 63 percent of all abortions last year.
Medicinal abortion is more accessible than procedural abortion. In 2021, 40 percent of facilities offering abortions only offered medication abortions.
The use of telemedicine and the mailing of abortion pills has also increased in recent years. In 2020, only 7 percent of all providers used telemedicine and sent abortion pills by mail. In 2022, 31 percent sent abortion pills in the mail.
While 14 states have had near-total abortion bans since the Supreme Court overturned Roe v. Wade in 2022 and more than a handful of additional states have introduced additional restrictions on abortion ranging from six to 18 weeks, several states that still have some access to abortion , further restrictions on medication abortion.
Even though the FDA has relaxed rules to allow additional doctors, such as physician assistants and nurses, to prescribe abortion pills in addition to physicians, 15 states have laws requiring them to be dispensed by a doctor, according to tracking by Guttmacher.
They also found that at least five states require patients to have an in-person visit with a doctor and that at least one state, Arizona, has banned the shipment of abortion pills.
Pro-abortion rights protesters gathered outside the Supreme Court with signs and chants. They warned that the case would impact abortion access not only in states that have banned abortion, but for all 50 states, including those that have expanded access.
Protesters against abortion rights gathered with signs targeting women’s health and arguing that “abortion pills kill.”
Abortion is also expected to be a top issue in the 2024 presidential election, after the overturning of Roe v Wade played a pivotal role in the midterm elections
At least thirteen people were arrested near the Supreme Court as arguments over mifepristone took place inside
Ahead of Tuesday’s hearing, abortion rights advocates warned that the Supreme Court’s decision could have national ramifications.
If the justices had indicated they would side with the Alliance for Hippocratic Medicine, it would result in access to the widely used abortion drug being restricted not just in states where abortion was already restricted or banned, but in all fifty states.
Abortion has been a galvanizing issue since the Supreme Court overturned the landmark Roe v. Wade ruling and returned the issue of abortion rights to the states.
As arguments unfolded inside the court, hundreds of protesters, both for and against abortion rights, gathered outside, chanting and carrying signs.
At least thirteen activists were arrested for blocking roads and a sidewalk.