A
panel
of
federal
judges
heard
arguments
Wednesday
over
whether
prescribing
rules
should
be
tightened
for
mifepristone,
a
key
drug
used
in
the
most
common
abortion
method
in
the
U.S.,
one
of
several
ongoing
efforts
to
restrict
abortion
access
4
years
after
the
Supreme
Court
allowed
states
to
decide
the
issue.
The
case
before
the
New
Orleans-based
5th
U.S.
Circuit
Court
of
Appeals
is
one
of
three
making
its
way
through
the
courts
as
abortion
opponents
try
to
block
providers
in
states
where
abortion
is
legal
from
sending
drugs
for
medication
abortions
into
states
where
it
is
not.
The
FDA
also
says
it’s
reviewing
the
rules
and
could
call
for
a
change
—
and
that
the
agency
process
should
take
precedence
over
court
action.
It
comes
in
a
midterm
election
year
in
which
President
Donald
Trump’s
anti-abortion
supporters
are
frustrated
that
a
legal
workaround
to
abortion
bans
remains.
At
the
same
time,
most
voters
favor
legal
abortion
access
in
most
cases.
It
Will
Be
Up
to
the
Supreme
Court
to
Sort
Out
At
least
3
in
5
U.S.
abortions
are
now
obtained
using
a
two-drug
combination.
At
issue
before
the
appeals
court
is
just
one:
mifepristone.
Wednesday’s
arguments
were
part
of
a
case
brought
by
Louisiana
Attorney
General
Liz
Murrill
and
Rosalie
Markezich,
who
says
she
was
coerced
into
taking
abortion
pills.
A
survey
conducted
for
the
Society
of
Family
Planning,
which
supports
legal
abortion
access,
estimates
that
between
770
and
900
women
in
Louisiana
obtained
abortions
each
month
in
2025
by
using
pills
prescribed
online
or
by
doctors
or
nurse
practitioners
in
other
states
that
have
“shield
laws”
intended
to
protect
those
prescribers.
The
three
judges
hearing
the
case
are
two
nominated
by
Democratic
presidents
Barack
Obama
and
Joe
Biden
and
one
nominated
by
Republican
George
W.
Bush.
Three
other
three-judge
panels
on
the
5th
Circuit
—
one
in
this
case
and
two
in
an
earlier
one
—
and
two
district
courts
have
already
agreed
that
rules
for
prescribing
mifepristone
are
too
loose.
But
the
Supreme
Court
unanimously
rejected
an
effort
to
roll
back
availability
in
2024
—
not
because
of
the
core
legal
argument,
but
because
the
court
found
the
anti-abortion
groups
who
brought
the
challenge
didn’t
have
legal
standing
to
make
it.
On
Wednesday,
lawyers
for
the
FDA
and
mifepristone
manufacturers
argued
that
Louisiana
also
lacks
legal
standing.
One
of
the
judges,
Stephen
Higginson,
questioned
whether
the
FDA’s
role
is
a
reason
pills
are
flowing
into
Louisiana.
“Those
are
state
shield
laws,”
he
said.
“The
government
has
nothing
to
do
with
the
shield
laws.”
Benjamin
Aguinaga,
Louisiana’s
solicitor
general,
said
the
state
is
impacted,
though,
because
some
women
who
use
the
pills
seek
treatment
for
complications
and,
he
said,
perhaps
half
also
have
state-funded
Medicaid
health
coverage.
Another
ruling
from
the
5th
Circuit
would
not
immediately
change
the
landscape
because
the
Supreme
Court
has
also
blocked
changes
to
the
prescribing
rules
until
it
sees
the
case
again.
Even
if
the
FDA
makes
changes
without
court
approval,
such
an
action
would
surely
be
challenged.
Other
GOP
state
officials
are
also
challenging
the
FDA’s
rules.
The
attorneys
general
of
Florida
and
Texas
have
filed
one
lawsuit
and
the
top
government
lawyers
of
Idaho,
Kansas,
and
Missouri
have
another.
Separately,
Louisiana
and
Texas
have
attacked
shield
laws
by
bringing
criminal
and
civil
cases
against
some
out-of-state
providers.
Meanwhile,
over
the
past
year,
federal
judges
in
Hawaii
and
Virginia
found
that
current
FDA
rules
for
mifepristone
prescribing
are
too
restrictive.
Abortion
Methods
Have
Changed
Since
Roe
Was
Overturned
Abortion
pills
were
already
widely
used
before
the
Supreme
Court
overturned
Roe
v.
Wade
in
the
2022
Dobbs
v.
Jackson
Women’s
Health
Organization
case
that
allowed
states
to
enforce
abortion
bans.
Currently,
13
states
ban
abortion
at
all
stages
of
pregnancy.
Another
four
do
so
after
about
the
first
6
weeks,
before
many
women
realize
they’re
pregnant.
Opponents
say
the
shield
laws
in
some
Democratic-controlled
states,
along
with
the
rules
allowing
mifepristone
to
be
mailed
to
patients,
have
undermined
the
bans.
“This
case
is
going
to
have
a
huge
impact,”
said
Gabriella
McIntyre,
legal
counsel
at
Alliance
Defending
Freedom,
which
is
representing
Murrill
and
the
other
plaintiff
in
the
case.
“The
promise
of
the
Dobbs
decision
was
that
states
would
be
able
to
decide
on
their
own
how
to
regulate
abortion.”
A
lawyer
for
mifepristone
maker
Danco
Laboratories,
though,
told
judges
Wednesday
that
the
2023
rules
were
not
intended
to
do
so.
Abortion
rights
advocates
also
believe
major
consequences
would
arise
if
Louisiana
eventually
prevails.
“They’re
asking
to
restore
an
in-person
requirement
for
every
person
across
the
country
to
access
this
medication
regardless
of
whether
they
live
in
a
state
with
strong
legal
protection
for
abortion
access,”
said
Amanda
Allen,
executive
director
of
the
Abortion
Coalition
for
Telemedicine.
The
Political
Situation
Is
Tricky
for
Trump
Anti-abortion
groups
who
want
to
rein
in
pill
access
have
been
Trump’s
key
supporters.
Abortion
opponents
have
called
on
the
FDA
to
settle
the
lawsuit
with
Louisiana
and
roll
back
prescribing
rules
to
how
they
were
before
telehealth
prescriptions
were
allowed.
They
also
want
the
administration
to
enforce
an
1873
“anti-vice”
law
to
bar
mailing
the
pills.
Some
states,
including
Mississippi
and
Texas,
have
adopted
laws
with
civil
or
criminal
penalties
for
those
who
prescribe
abortion
pills.
But
on
state
ballot
questions
and
in
public
opinion
polls,
voters
have
generally
supported
legal
abortion
access
in
most
cases.
The
administration
has
been
mostly
quiet
through
the
legal
battles,
even
though
the
FDA,
whose
scientists
have
repeatedly
found
mifepristone
to
be
safe
and
effective,
is
the
defendant
in
the
cases.
The
FDA
says
it’s
studying
mifepristone’s
safety
and
reviewing
prescribing
rules
around
the
drug.
But
Trump’s
latest
nominee
to
head
the
agency,
Heidi
Overton,
MD,
the
deputy
director
of
the
White
House
Domestic
Policy
Council,
has
publicly
criticized
the
agency
for
relaxing
its
prescribing
rules
for
the
drug
—
the
most
recent
change
coming
in
2023.
One
judge
ordered
the
agency
to
provide
a
status
update
by
Oct.
7,
less
than
a
month
before
the
midterm
elections
in
which
control
of
Congress
is
in
play.
It’s
not
clear
how
detailed
an
update
might
be
—
or
when
the
full
study
could
be
completed.
Prescribers
Are
Preparing
to
Shift
Which
Drug
They
Ship
Even
if
mifepristone
access
is
curtailed,
advocates
say
it
won’t
end
access
to
abortion
pills.
The
most
common
regimen
for
pills
in
the
U.S.
is
a
combination
of
mifepristone
and
misoprostol.
Misoprostol,
which
is
commonly
used
to
treat
stomach
ulcers
and
has
never
been
formally
approved
for
abortion,
can
cause
abortions
on
its
own.
According
to
the
FDA
label
on
mifepristone,
the
combination
completes
medical
abortion
97.4%
of
the
time.
Some
studies
have
found
misoprostol’s
individual
effectiveness
at
around
80%
or
higher.
Organizations
that
prescribe
abortion
pills
by
telehealth
for
women
who
are
in
states
with
bans
say
they
would
shift
to
sending
misoprostol
alone
if
mifepristone
could
be
dispensed
only
at
medical
clinics
rather
than
at
pharmacies
and
through
the
mail.
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