The Supreme Court will preserve telehealth access to a widely used abortion drug mifepristone for now, while a case brought by the state of Louisiana against the Food and Drug Administration wends its way through lower courts.
Providers and politicians in Massachusetts cautiously celebrated the high court’s ruling to at least temporarily keep the drug mifepristone available by telemedicine — a method of abortion that has rapidly grown in popularity since it first became an option during the COVID-19 pandemic.
“Access to mifepristone never should have been on the chopping block to begin with,” Massachusetts Attorney General Andrea Joy Campbell said in a statement. “I’m glad to see SCOTUS did the right thing — but we know this isn’t over. I’ll keep fighting to protect access to this essential health care.”
The case resurrects issues raised in a 2024 legal battle, brought by Texas clinicians, that targeted the same abortion drug. The Supreme Court ultimately dismissed that case, finding that the Texas providers did not have a legal right to sue because they were not sufficiently harmed by the policy.
Today’s lawsuit focuses more narrowly on how mifepristone, one of two drugs commonly used in the medication abortion regimen, can be distributed. Louisiana’s attorney general takes aim at the FDA’s decision under the Biden administration to permanently allow mifepristone to be dispensed by telehealth.
“I feel relieved that we are back to the status quo,” said Dr. Angel Foster, who co-founded a Cambridge telemedicine abortion practice called The MAP. “And, of course, we know that this is not the end of anti-abortion rights actors trying to restrict access to medication abortion pills.
“Medication abortion is here to stay,” she added. “All of these different kinds of interventions to restrict access to mifepristone, or to medication abortion, they won’t ultimately be successful. People will still be able to get the pills that they need.”
If access to mifepristone were ever limited, Foster said, her practice would simply switch to a similarly effective regimen of medications to cause an abortion that does not use mifepristone.
Telehealth has rapidly revolutionized abortion access over the last five years — especially since state-level bans went into place following the fall of Roe v. Wade in 2022. More than 90,000 abortions were performed by telehealth in states with abortion bans last year, estimates from the reproductive health advocacy group the Guttmacher Institute show. For the first time last year, Guttmacher estimates that abortion by telehealth was more popular than traveling across state lines for people in states with bans.
Massachusetts is one of a handful of states where providers regularly and prolifically prescribe abortions by telehealth out-of-state. More than 30,000 abortions were provided by telehealth in Massachusetts in 2024, the last year comprehensive data is available. That same year, nearly 28,000 abortions were provided to people who live out of state — whether they traveled to Massachusetts for an abortion or not.
The commonwealth has legislation known as a shield law that effectively protects local abortion providers from out-of-state litigation.
That very practice — of abortion pills being sent by mail, and the alleged injury that causes to the state of Louisiana — is the basis of the lawsuit.
Foster says that her practice prescribes 3,000 to 3,500 abortions by telehealth every month, and that 90% go to states with severe restrictions on abortion.
“There are pregnant people in Louisiana, and in Texas, and in Georgia, and in Oklahoma who need abortion care — irrespective of what the restrictions on abortion are in that state,” she said. “And we’re grateful that we’re able to provide them high-quality, safe, effective and affordable abortion care because of the Massachusetts shield law.”
Louisiana argued before a federal court last October that the FDA acted unlawfully by allowing mifepristone to be sent via the mail. The district court opted to pause the case and not make any further decisions because the Food and Drug Administration is already conducting a review of mifepristone. But the state’s attorney general appealed up to the Fifth Circuit Court of Appeals, which decided to suspend the telehealth provision of mifepristone until the case was resolved.
The Supreme Court intervened, and once again allowed providers to send abortion pills by mail.
Dominique Lee, the CEO and president of the Planned Parenthood League of Massachusetts, said the ruling was a “relief” but said the matter shouldn’t be decided in court.
“A court has no place in the relationship between a patient and their clinician and no place in determining the course of clinical care using a long-approved drug,” she wrote in a statement Thursday night.
Gov. Maura Healey called the Supreme Court’s decision an important victory, and vowed that Massachusetts will “keep protecting access to reproductive health care.”
“Women deserve the freedom to make their own decisions about their bodies and their futures, and we will never stop fighting to protect that right,” Healey wrote.
Members of Congress, led by lawmakers including Massachusetts’ own Katherine Clark and Ayanna Pressley, urged the Supreme Court to permanently restore telehealth access to mifepristone. In a brief filed last week, lawmakers argued that letting the pause stay in place would undermine Congress’s statutory framework that demands the FDA’s decisions be based in science.
The case will now proceed in the lower courts.
