Supreme Court extends brief pause on abortion pill ruling

Access to a common abortion pill mifepristone will remain unchanged through at least Friday after the Supreme Court extended its brief pause until the end of the workweek.

Justice Samuel Alito, who handles emergency requests from the 5th U.S. Circuit Court of Appeals, announced the move in a brief order, extending the administrative pause until Friday at 11:59 p.m. EDT.

The order doesn’t give any indication of how the high court will proceed; it effectively gives the justices a few more days to decide whether they will pause a ruling that would roll back access to the drug.

The Biden administration and the company that manufactures a brand name version of mifepristone have asked the high court to intervene and pause a ruling from U.S. District Judge Matthew Kacsmaryk earlier this month.

Kacsmaryk’s decision suspended the Food and Drug Administration’s 23-year-old approval of mifepristone, ruling that the agency’s approval process was improperly rushed and resulted in an unsafe drug regimen getting on the market.

The 5th U.S. Circuit Court of Appeals last week preserved the FDA’s original approval of mifepristone as the Biden administration appeals, but the 5th Circuit allowed other portions of Kacsmaryk’s decision to go into effect, which blocked steps the FDA has taken since 2015 to ease access to mifepristone.

Those preserved changes include allowing mifepristone to be sent through the mail, lifting a requirement for three in-person visits, approving a generic, and approving the drug’s use up to 10 weeks into a pregnancy, rather than seven weeks.

Alito’s order is procedural and briefly keeps the status quo until the high court can decide whether to pause the remaining portions of Kacsmaryk’s decision from going into effect, until the 5th Circuit issues its ruling on the administration’s appeal.

Alito can technically act on the administration’s emergency request alone, though major applications like this one typically are referred to the full court.

If the Supreme Court declines to extend the pause after Friday, the Justice Department has warned of “chaos.”

The brand-name version of mifepristone would have to apply for a new label and packaging, which could take months. The generic version of the medication, which accounts for two-thirds of the market, would become unapproved.

Abortion providers would need to decide whether to offer the drug off-label to women further along in their pregnancies because it would only be approved for use up to seven weeks into a pregnancy.