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Supreme Court Keeps Abortion Pill Mifepristone Legal—But GOP States Could Still Sue. Here’s What Happens Next.

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Topline

The Supreme Court ruled Thursday anti-abortion rights medical groups do not have standing to challenge the legality of abortion drug mifepristone, delivering a win to abortion rights advocates—but the ruling is unlikely to end the legal battle over the pill’s future, as the legal group behind the lawsuit suggested Thursday three GOP-led states are likely to continue the case.

Key Facts

Justices ruled unanimously that the challengers—who do not prescribe or use mifepristone themselves—do not have standing to bring the case, meaning nothing will change in terms of how the abortion drug is regulated, and the drug’s expanded Food and Drug Administration approvals won’t be rolled back.

However, the Supreme Court’s ruling did not consider the merits of whether mifepristone should be restricted, and sent the case back to the lower courts without dismissing it entirely.

Alliance Defending Freedom attorney Erin Hawley, who represented the challengers at the Supreme Court through the conservative legal group, told reporters Thursday she expected the litigation “will presumably continue” with three states at the helm.

The three states—Kansas, Idaho and Missouri—intervened in the case in lower court, and tried to intervene in the Supreme Court case, but the court did not allow them to do so.

The states argued in a court brief they have standing to challenge mifepristone’s legality, arguing the drug’s current approvals cause “direct monetary harm to state-run insurance programs and hospitals, and harm to the States’ sovereign interests in creating and enforcing laws.”

The GOP-led states will likely “consider their alternatives” and continue the case with a new argument on standing, Hawley said on a press call, though she did not commit firmly to the case continuing or what the next steps would be.

Offices for the attorneys general in Kansas, Idaho and Missouri have not yet responded to requests for comment.

What To Watch For

It’s still unclear when states could revive the mifepristone case—or whether they’ll do so at all—and how long it could take the case to make its way through the court system with the GOP-led states now at the helm. The states have argued they “plainly have standing” in the case, though it still remains unclear whether courts could rule in their favor, and the Supreme Court did not give any indication on that in its ruling.

Tangent

Hawley, the lawyer who argued the challengers’ case, is the wife of Sen. Josh Hawley, R-Mo.

Surprising Fact

While Idaho and Missouri both ban abortion, access to the procedure is protected in Kansas after a majority of the state’s voters backed a ballot measure protecting abortion rights. Lawmakers in the state have still sought to restrict and ban abortion despite the vote, however, and enacted laws in April that impose measures like requiring abortion providers to ask patients why they’re getting an abortion and banning the act of coercing someone into having the procedure.

Key Background

Medication abortion has come under fire from the right in the years since the Supreme Court overturned Roe v. Wade in 2022, as abortion pills have become a key way for Americans in states where abortion is banned to access the procedure more covertly and without clinics nearby. Mifepristone is one of two drugs usually taken during a medication abortion, along with misoprostol, and studies have shown the drug is broadly safe and effective at terminating a pregnancy. Misoprostol, which is also used for other conditions, has not faced the same legal attacks as mifepristone. Anti-abortion medical groups first filed their lawsuit against mifepristone in 2022, and a Trump-appointed district judge blocked the drug’s government approval entirely before an appeals court somewhat walked his ruling back, keeping mifepristone legal but undoing more recent approvals of the drug that made it available via telehealth. The Supreme Court found the challengers hadn’t presented any compelling reasons for why they had standing to sue, striking down claims the medical groups made like doctors being harmed because they could have to treat patients who have complications from medical abortions.

Further Reading

ForbesSupreme Court Upholds Abortion Drug Mifepristone

ForbesAbortion Pills: What To Know About Mifepristone As Supreme Court Upholds Drug
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