Supreme Court rejects challenge to abortion pill in unanimous ruling
The Supreme Court unanimously rejected a bid Thursday to restrict access to mifepristone, part of a two-drug regimen used to induce medical abortions.
The high court concluded a group of anti-abortion doctors that brought the case forward lacked standing to challenge the Food and Drug Administration’s prior regulatory approval of the pill.
“The plaintiffs have sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone. But under Article III of the Constitution, those kinds of objections alone do not establish a justiciable case or controversy in federal court,” Justice Brett Kavanaugh wrote in the opinion.
“A plaintiff’s desire to make a drug less available for others does not establish standing to sue,” he went on, noting that the group could still take their concerns to the executive and legislative branches.
As a result of the ruling, women may continue to access mifepristone via online prescriptions and receive shipments of the drug through the mail.
However, the high court’s rejection based on standing does leave the door open for future challenges to the FDA’s approval of the drug.
“Today’s decision does not change the fact that the fight for reproductive freedom continues. It does not change the fact that the Supreme Court overturned Roe v. Wade two years ago, and women lost a fundamental freedom,” President Biden said in a statement.
“It does not change the fact that the right for a woman to get the treatment she needs is imperiled if not impossible in many states,” the 81-year-old added. “It does mean that mifepristone, or medication abortion, remains available and approved. Women can continue to access this medication – approved by the FDA as safe and effective more than 20 years ago.
“But let’s be clear: attacks on medication abortion are part of Republican elected officials’ extreme and dangerous agenda to ban abortion nationwide.”
Back in March when the Supreme Court heard oral arguments in the matter, justices sounded deeply skeptical about upending the FDA’s approval of mifepristone.
The agency initially approved the drug in 2000 before relaxing the rules to expand access in 2016 and 2021.
The plaintiffs argued that the FDA flouted standards set in federal law for making regulatory decisions, and did not sufficiently examine mifepristone when giving the go-ahead for expanded access.
Mifepristone is typically used alongside misoprostol to induce abortions and was responsible for an estimated two-thirds of all abortions in the country last year.
In April of 2023, after a challenge backed by the conservative Alliance Defending Freedom (ADF), a Texas federal judge issued a preliminary ruling overturning the FDA’s initial 2000 approval of mifepristone.
Then, in August, the New Orleans-based Fifth Circuit Court of Appeals imposed a stay on the FDA’s 2016 rule changes that made the drug more easily accessible.
The ADF raised concerns about doctors who had ethical qualms about prescribing the drug and argued that federal policies making allowances for such objections were too weak — but the court found they hadn’t shown that to be the case.
“In short, given the broad and comprehensive conscience protections guaranteed by federal law, the plaintiffs have not shown – and cannot show – that FDA’s actions will cause them to suffer any conscience injury,” Kavanaugh wrote.
“EPA rolls back emissions standards for power plants—does a doctor have standing to sue because she may need to spend more time treating asthma patients?” he asked.
“The government repeals certain restrictions on guns — does a surgeon have standing to sue because he might have to operate on more gunshot victims?”
Justice Clarence Thomas penned a concurring opinion in which he addressed the plaintiffs’ pitch for associational standing — in which organizations can sue over injuries caused to its membership.
“The Alliance and other plaintiff associations claim that they have associational standing to sue for their members’ injuries,” he wrote. “I am particularly doubtful of associational-standing doctrine because the Court has never attempted to reconcile it with the traditional understanding of the judicial power.
FDA v. Alliance for Hippocratic Medicine marks the high court’s most consequential decision on abortion since the overturn of Roe v. Wade in June 2022.
The Supreme Court is also weighing a separate abortion case out of Idaho.
That case examines whether doctors have federal protection to provide abortions in emergency situations, even in states with strict bans on the procedure.
