Highlights of the Supreme Court decision on the abortion pill

The Supreme Court on Thursday upheld access to a widely available abortion pill, rejecting an attempt by a group of anti-abortion organizations and doctors to overturn the Food and Drug Administration’s approval of the drug.

In a unanimous decision, written by Justice Brett M. Kavanaugh, the court found that anti-abortion groups did not have a direct interest in the litigation, a necessary condition for challenging the FDA’s approval of the pill, mifepristone.

“Defendants do not prescribe or use mifepristone,” Judge Kavanaugh wrote. “And the FDA is not asking them to do or refrain from doing anything.”

He added: “A plaintiff’s desire to make a drug less accessible to others does not constitute standing to bring a lawsuit. »

The case originally sought to erase the FDA’s approval of mifepristone. But by the time the case reached the Supreme Court, the question had narrowed to whether the agency had acted legally in 2016 and 2021, when it expanded distribution of the pill, eventually including telemedicine and mail options.

The ruling delivered a quiet victory to abortion rights groups. Although they welcomed the decision to change tough restrictions on the pill’s availability, they warned the result could be short-lived.

Anti-abortion groups vowed to move forward, vowing that the fight was far from over and raising the possibility that other plaintiffs, particularly from states, would challenge the drug.

The ruling did not affect separate restrictions on the pill in more than a dozen states that have adopted near-total bans on abortion since the court stripped away a constitutional right to the procedure in the Dobbs case vs. Jackson Women’s Health Organization. (The bans do not distinguish between medical and surgical abortion.)

Access to abortion remains widely popular and since the court overturned Roe v. Wade two years ago, prompting some states to quickly enact bans, the issue has been a focus of political campaigns. Democrats have successfully galvanized voters to reject anti-abortion measures and plan to advance abortion rights in the November election.

By dodging a decision on the merits of the case, the justices avoided giving either political party a clear and substantial victory or a decision they could use to motivate their base.

President Biden said in a statement that “the decision does not change the fact that the fight for reproductive freedom continues.”

He added: “It doesn’t change the fact that the Supreme Court overturned Roe v. Wade Two years ago, women lost a fundamental freedom.”

The Biden campaign also raised concerns that the ruling would not be enough to protect access to abortion medications if former President Donald J. Trump wins a second term, saying his administration would take steps to enforce new restrictions through executive action.

Mr. Trump wondered what position to take on access to abortion after the Supreme Court, whose vast conservative majority he named, overturned Roe v. Landmark Wade abortion rights case. A few weeks ago, he said it was up to states to set their own policies.

His campaign suggested he took a similar stance on the abortion pill decision, without addressing how his administration would handle regulation of the drug. “The Supreme Court ruled unanimously 9-0; the matter is settled,” said Danielle Alvarez, a Trump update.

Abortion rights groups warned that the decision merely maintained the status quo.

“The anti-abortion movement sees how critical abortion pills are in this post-Roe world, and they are determined to cut off access to them,” Nancy Northup, president of the Center for Reproductive Rights, said in a statement.

Erin Hawley, senior attorney for Alliance Defending Freedom, the conservative legal organization that represented the plaintiffs, suggested the case could be revived through three Republican-led states, Idaho, Kansas and Missouri, who intervened as plaintiffs in the lower courts.

“We are grateful that three states are willing to hold the FDA accountable for endangering the health and safety of women and girls across this country,” Hawley said in a statement.

Mifepristone, part of dual therapy, is used in nearly two-thirds of abortions in the United States. Numerous studies have shown that the pill is safe, and years of research have shown that serious complications are rare.

After the FDA eased restrictions on the drug’s availability during the pandemic, allowing it to be prescribed online or sent by mail, its use only increased. An increasing number of abortion medications are prescribed via telemedicine. By one count, about one in six abortions, or about 14,000 per month, took place via telehealth between July and September 2023.

Medical abortion has become a convenient form of abortion for women in states where the procedure is banned. Clinicians, protected by so-called safe harbor laws in several states where abortion is legal, mailed pills to women based in banned states.

Justice Kavanaugh focused part of the majority opinion on why the justices disagreed with lower court rulings, all of which determined that the groups had standing to sue.

Citing Justice Antonin Scalia, Justice Kavanaugh wrote that to file a lawsuit, a plaintiff must first answer a basic question: “What does this make you?”

Plaintiffs must demonstrate “a foreseeable chain of events leading from the government action to the alleged harm,” Justice Kavanaugh wrote.

In this case, he wrote, doctors and medical associations attempting to challenge the FDA’s regulations failed to demonstrate actual harm because the plaintiffs did not include the people actually involved in using the pill, such as doctors who prescribed mifepristone or pregnant women who took it.

The plaintiffs’ claims that they have “sincere legal, moral, ideological and political objections to mifepristone being prescribed and used by others” do not meet the threshold for standing to bring a lawsuit, the plaintiff wrote. Justice Kavanaugh.

The justices also rejected the anti-abortion doctors’ argument that they had standing to sue because they might be forced to perform emergency abortions against their conscience.

Federal conscience laws already protect doctors from being forced to perform abortions or other treatments that violate their conscience, and none of the doctors have demonstrated otherwise, Judge Kavanaugh wrote.

In a concurring opinion, Justice Clarence Thomas said he “fully” supported the decision, but cautioned that the court should take a limited view of when it is permissible for organizations to claim standing on behalf of their members. members.

The case sent the issue of abortion back to the Supreme Court, even though the conservative majority had declared it, overturning Roe v. Wade, that he would cede the issue of access “to the people and their elected representatives.”

Its ruling Thursday appears to confirm that promise, even though the court will soon decide another major abortion case involving a conflict between federal law and heightened state restrictions.

The Abortion Pill Case, FDA v. Alliance for Hippocratic Medicine, reflected a new front in the fierce fight against abortion.

In fall 2022, a group of anti-abortion medical organizations, along with several doctors, challenged the FDA’s approval of mifepristone more than two decades ago. In a preliminary ruling, a Texas federal judge, Matthew J. Kacsmaryk, said the FDA’s approval of the drug should be stayed, effectively removing mifepristone from the market.

Judge Kacsmaryk, a Trump appointee, joined the federal bench after years of litigating at a conservative religious liberty firm, First Liberty Institute.

A New Orleans appeals court overturned the part of Judge Kacsmaryk’s ruling that invalidated the FDA’s approval of the pill, but it placed some restrictions on its distribution. These restrictions included a ban on sending the drug by mail or prescribing it via telemedicine.

Maggie Haberman And Lisa Lerer Reporting contributed from New York.

Leave a Comment