Abortion Pill Available For Now In MD, Supreme Court Rules

MARYLAND — The U.S. Supreme Court on Friday stopped a lower court’s restrictions on the abortion pill mifepristone from taking effect, seen as a win for the Biden administration and for women seeking access to the abortion drug in Maryland.

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 it way through the courts.

That means things won’t change for Maryland women seeking medical abortions — at least not for now.

Maryland voters will decide next year whether to enshrine abortion rights in the state's constitution as lawmakers aim to make the state a safe haven for those seeking the procedure, according to a Washington Post report.

U.S. Senator Chris Van Hollen, in a statement following the Supreme Court’s decision to stay the restrictions on access to mifepristone, said the issue isn't settled.

“Mifepristone has been proven safe and effective and has been used by Americans for years. This decision – while temporary – will maintain critical access to reproductive health care, " Van Hollen said. "We must continue fighting against these restrictions and those targeting reproductive rights everywhere.”

The court has yet to rule on the Biden administration’s emergency request to reject any limits on the use of the drug until cases make their way through the Supreme Court.

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 underlying issue in the case is whether the Food and Drug Administration went through the proper procedures in approving the drug. Although the court maintained FDA approval of mifepristone for now, it’s likely not the last time the court will weigh in on the issue.

Essentially, the court said, medical abortions are a state issue.

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 a 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 court 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 that filed a separate lawsuit.

The Biden administration and New York-based Danco Laboratories, the maker of the drug, have 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 Supreme Court struck down Roe v. Wade last June, and states have since put together a patchwork of abortion laws. A dozen states have enacted laws so restrictive that abortions are effectively banned.

Maryland To Vote On Adding Abortion Access To Constitution

In Maryland, the right to abortion already is protected by law. The state approved legislation in 1991 to protect abortion rights if the Supreme Court allowed abortion to be restricted. Adding abortion protection to the state constitution would make it harder for opponents to limit access.

In 2022, Maryland enacted a law that allows trained nurse practitioners, nurse midwives, licensed midwives, and physician assistants to provide abortion care in addition to physicians, according to the Center for Reproductive Rights. The state also enacted a law requiring public medical assistance programs to cover abortion services and private insurance plans that cover labor and delivery to also pay for abortion services.

Even in states 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 Associated Press contributed reporting.