May 4, 2026 

Courts Again Disregard Clinical Evidence, Science, and Regulatory Authority to Restrict Access to Mifepristone

WASHINGTON, D.C. –  In 2021 responding to the COVID-19 pandemic, the FDA allowed mifepristone to be prescribed via telemedicine and dispensed by mail, a change later formalized in its 2023 REMS update and supported by extensive evidence demonstrating the medication’s continued safety and effectiveness. In October 2025, Louisiana challenged these changes in Louisiana v. FDA, arguing that expanded access undermines state abortion restrictions following Dobbs v. Jackson Women’s Health Organization.  Recently the U.S. Court of Appeals for the Fifth Circuit sided with Louisiana and moved to immediately require in-person prescribing requirements, not just in its district, but nationwide, eliminating telemedicine and mail dispensing. 

Danco Laboratories, the manufacturer of Mifeprex, warned that the decision would create “immediate confusion and upheaval” in “highly time-sensitive medical decisions” and sought emergency relief from the U.S. Supreme Court. On May 4, 2026, the Court temporarily paused the ruling. Justice Samuel Alito issued an administrative stay for a week allowing telemedicine prescribing and mail dispensing to continue while the Court considers the case.

Doctors for America finds the Fifth Circuit’s ruling wrong on the facts, with its sweeping nationwide implications likely to result in a major impairment in the legal clinical management of pregnant people in much of our nation. By reimposing medically unnecessary restrictions on mifepristone, the decision disregards decades of clinical evidence and undermines the FDA’s role in regulating medications based on science. Although the U.S. Supreme Court has temporarily stayed the ruling, the underlying legal reasoning remains concerning. If implemented, it would restrict access to evidence-based care and impose disproportionate burdens on pregnant patients with the least resources.

Mifepristone is part of a medication regimen used in more than 60% of abortions in the United States and has a well-established safety profile. Telemedicine access to mifepristone now accounts for more than one-quarter of abortion care nationwide and has expanded access, particularly for patients in rural and underserved communities.

Reinstating in-person dispensing requirements would create significant barriers to care without improving safety. Patients may be forced to travel long distances, delay care, or forgo care altogether. For time-sensitive conditions such as miscarriage management and abortion, these delays can have serious physical, emotional, and economic consequences. Frequent and abrupt legal changes disrupt clinical care. Physicians must navigate shifting legal requirements while trying to provide timely, evidence-based care, increasing uncertainty and the risk of delayed or fragmented treatment.

Physicians working at the intersection of policy and patient care have emphasized the harm caused by ongoing legal instability. As Dr. Anita Somani, OBGYN and Ohio State Representative, notes, “The ping pong effect of court decisions only impacts our patients and physicians negatively. It is extremely difficult to provide care in a changing legal environment. It will hurt patients at the time when they are most vulnerable. Physicians will err on the side of caution if they are worried about their medical liability and this will impact the patient’s ability to get timely care. There should be a limit to how many times something can be litigated in court.”

Doctors for America urges the courts to review the robust scientific record, place a priority on the patients seeking care, and ensure that access to mifepristone remains guided by the FDA’s authority to regulate medications based on science, not politics, ideology, or religion.

‍

###

About Doctors for America:

Doctors for America (DFA) is a national nonprofit that mobilizes over 40,000 physicians and medical trainees to advocate for policies that improve the health of patients and communities. Through advocacy training and action at the state and federal levels, DFA works to expand access to affordable care, strengthen community health and prevention, and advance health justice and equity. We do not accept funding from pharmaceutical, insurance, or for-profit health care entities, ensuring our work remains fiercely independent and patient-centered. DFA puts patients over politics–and over profits. Find out more at doctorsforamerica.org and on X @drsforamerica or Bluesky drsforamerica.bsky.social.