Abortion Pill Available For Now In CA, Supreme Court Rules

CALIFORNIA — The U.S. Supreme Court on Friday stopped a lower court’s restrictions on the abortion pill mifepristone from taking effect, a win for the Biden administration and for California women seeking access to the drug that has been in use for more than two decades.

The justices granted emergency requests from the Biden administration and New York-based Danco Laboratories, the maker of the drug to reject limits on mifepristone’s use imposed by lower courts, at least as long as the legal case makes its way through the courts.

The drug has been approved for use in the U.S. since 2000 and more than 5 million people have used it. Mifepristone is used in combination with a second drug, misoprostol, in more than half of all abortions in the U.S.

The case before the high court stems from a Texas judge’s April 7 ruling. Judge Matthew Kacsmaryk ordered a hold on federal approval of mifepristone, the drug that is used to carry out a majority of U.S. abortions and was approved by the FDA in 2000. Kacsmaryk’s decision overruled decades of scientific approval.

Less than a week later, a federal appeals court modified the ruling so that mifepristone would remain available while the case continues but with limits. The appeals court said that the drug can’t be mailed or dispensed as generic and that patients who seek it need to make three in-person visits with a doctor, among other things.

The generic version of mifepristone makes up two-thirds of the supply in the United States, its manufacturer, Las Vegas-based GenBioPro Inc., wrote in a court filing that underscored the perils of allowing the restrictions to be put into effect.

The lower court ruling also said the drug should only be approved through seven weeks of pregnancy for now, even though the FDA since 2016 has endorsed its use through 10 weeks of pregnancy.

Complicating the situation, a ruling by a federal judge in Washington ordered the FDA to preserve access to mifepristone in 17 Democratic-led states and the District of Columbia, which filed a separate lawsuit.

The Biden administration and New York-based Danco Laboratories, the maker of the drug, had asked the Supreme Court to reject limits on mifepristone’s use imposed by lower courts, at least as long as the legal case makes it way through the courts.

The Biden administration has said the rulings conflict and create an untenable situation for the FDA and that women who want the drug and providers who dispense it will face chaos if limits on the drug take effect.

The challenge to mifepristone is the first abortion controversy to reach the nation’s highest court since its conservative majority struck down Roe v. Wade last June. States have since put together a patchwork of abortion laws, a dozen of them enacting laws so restrictive that abortions are effectively banned.

California secured a large shipment of an alternative pill known as misoprostol, Gov. Gavin Newsom announced earlier this month and is set to have a stockpile of 2 million doses of the pill. Newsom said mifepristone is the state's "preferred regimen for medical abortion," but crafted the alternative stockpile plan to ensure the state "remains a safe haven for safe, affordable, and accessible reproductive care."

Even in states like California where abortion is legal and available, providers would have to limit services to in-clinic procedural abortion if mifepristone became unavailable or switch to a misoprostol-only abortion regime, according to the Guttmacher Institute. The drug can be used alone to terminate pregnancies, but medical experts have said it is not as effective as the standard two-pill regimen of mifepristone and misoprostol.

Also, patients whose providers prescribe abortion pills during clinic visits or via telehealth would no longer be able to pick them up from participating pharmacies or in the mail.

The impact would be far greater in 10 states — Colorado, Georgia, Indiana, Iowa, Maine, Montana, New Mexico, Pennsylvania, Vermont and Washington — where women’ access would be even more limited if providers don’t offer a regimen of misoprostol alone, according to Guttmacher.

The Center for Reproductive Rights includes California in its most favorable category for abortion rights, citing the state Supreme Court's pre-Roe decision to protect abortion access and voters' 2022 approval of Prop 1, which adds abortion and contraception rights to the state constitution.

The Associated Press and Patch staffer Lucas Combos contributed reporting.