Mifepristone ruling – live: Supreme Court legal battle leaves abortion rights at stake

The future of a widely used abortion drug at the centre of the nation’s biggest legal battle over abortion rights since the end of Roe v Wade could be in the hands of the US Supreme Court.

Justices on the nation’s highest court will weigh in on a case targeting the federal government’s 23-year-old approval of mifepristone, part of a two-drug protocol for medication abortion, the most common form of abortion in the US.

Following an appeal from the Biden administration and drugmakers, the court paused a lower court ruling that would strip the US Food and Drug Administration’s approval of mifepristone, which was first approved by the government agency in 2000.

The Supreme Court’s order expires at midnight on Friday, and the justices are expected to issue a decision in the case before then, but the latest pause ensures that the drug can still be accessed, for now.

It is unclear how the Supreme Court will rule on the appeal, but a ruling to strike down the FDA’s approval of the drug could drastically impact access to abortion and miscarriage care for millions of Americans across the country, including in states where it is legally protected, and

Key Points

• Supreme Court delays decision in abortion drug case until Friday

• What is mifepristone?

• How the challenge to mifepristone landed at the Supreme Court

• What will the Supreme Court decide, and what happens next?

Can the FDA just ignore the ruling?

09:00 , Alex Woodward

That’s what several members of Congress have argued, though President Joe Biden’s administration and abortion rights advocates have stressed that the case must play out in court and affirm the FDA’s ability to make such decisions.

Democratic senator Ron Wyden, the chair of the Senate Finance Committee, which oversees the FDA, has repeatedly argued that the administration ignore a ruling that undermines the FDA’s regulatory powers.

US Rep Alexandria Ocasio-Cortez has argued that an increasingly partisan-driven federal judiciary weaponised by right-wing activist groups has undermined its legitimacy in making such decisions.

Republican US Rep Nancy Mace also has suggested that a ruling that revokes the FDA’s approval of the drug should be ignored or tossed out.

What happens if mifepristone is not available?

08:00 , Alex Woodward

Abortion providers and civil rights groups have warned of grave consequences to the loss of widely used abortion drugs from the market.

Providers could turn to a misoprostol-only medication abortion regimen, though that would be considered an “off-label” pharmaceutical use for the drug in the US. Misoprostol is currently approved by the FDA for the prevention and treatment of gastric ulcers but also is administered for other obstetric or gynecologic care.

Several Democratic-led states are stocking up on mifepristone and proposing legal protections for pharmacists and providers who dispense the drug.

A ruling that undermines the FDA’s drug approval process could also open the door for other activist-driven legal battles over other drugs, potentially inviting other destabilising lawsuits to Covid-19 vaccines, contraception, HIV medication, gender-affirming care, and other life-saving drugs.

The Biden administration will “continue to fight” for abortion rights regardless of the court’s decision, White House press secretary Karine Jean-Pierre told reporters on 19 April.

Abortion access has been nearly eliminated across the South

05:00 , Alex Woodward

Abortion is effectively outlawed in more than a dozen states, mostly in the South, following the US Supreme Court’s decision to strike down the constitutional right to abortion care last June.

Florida Governor Ron DeSantis has signed a bill into law that bans abortions in the state at six weeks of pregnancy, before many people know they are pregnant.

Abortion patients will now have to travel more than 1,000 miles for legal access to abortion care in the region.

Florida’s latest anti-abortion law will nearly eliminate access across the South

Wyoming abortion clinic opens after arson attack and legal threats

03:00 , Alex Woodward

Weeks after the state’s governor banned abortion drugs, becomgin the first state to do so, a full-service abortion clinic has opened in the state despite an arson attack and laws that could force it to shut down in a state with some of the most severe restrictions on care.

Wellspring Health Access clinic provide both medication abortions and procedural abortions and surgical abortions, at least for now.

The state’s law against mifepristone will take effect from 1 July. The law makes it illegal to “prescribe, dispense, distribute, sell or use any drug for the purpose of procuring or performing an abortion”.

The law states that doctors or anyone else found guilty of prescribing the medication could be charged with a misdemeanour, punishable by up to six months in prison and a $9,000 (£7,387) fine.

GOP megadonor leaps to defend Clarence Thomas over real estate disclosures

01:00 , Alex Woodward

Republican megadoor Harlan Crow defended his friendship with Supreme Court Justice Clarence Thomas in an interview with The Dallas Morning News and denied any impropriety regarding their relationship.

Mr Crow’s friendship with the most-senior jurist on the Supreme Court has come under intense scrutiny ever since investigative news outlet ProPublica reported that Mr Thomas had vactioned in luxury on Mr Crow’s dime without disclosing it. ProPublica later reported that Mr Thomas sold a home to Mr Crow but did not disclose it, despite a 1978 law that required such transactions be disclosed.

GOP megadonor leaps to defend Clarence Thomas over real estate disclosures

‘Biden should order Clarence Thomas’s cases to be reviewed'

Friday 21 April 2023 00:00 , Alex Woodward

Noah Berlatsky writes:

What Biden must do about Clarence Thomas | Voices

Federal judge at centre of mifepristone case failed to disclose interviews with Christian talk radio shows

Thursday 20 April 2023 23:00 , Alex Woodward

US District Judge Matthew Kacsmaryk failed to disclose during his Senate confirmation process that he gave two interviews with a Christian talk radio programme where he discussed contraception and gay rights.

He referred to being gay as a “lifestyle” and claiming that social norms around “people who experience same-sex attraction” would lead to clashes with religious institutions, a collapse that began with “no-fault divorce” and “permissive policies on contraception,” according to CNN.

The comments were made in 2014 on Chosen Generation, a radio show that offers “a biblical constitutional worldview,” while Ms Kacsmaryk was deputy general counsel as conservative Christian legal group First Liberty Institute.

The revelation of his failure to disclose the appearances, as required during federal judicary hearings, follows reporting that he also failed to disclose that he drafted or helped draft an article attacking abortion rights and transgender healthcare in a right-wing legal journal.

Supreme Court chief justice asked to testify before Senate on ethics rules after Clarence Thomas revelations

Thursday 20 April 2023 22:00 , Alex Woodward

US Supreme Court Chief Justice John Roberts has been summoned to appear before the Senate Judiciary Committee to testify about the court’s ethnics rules following recent revelations about Justice Clarence Thomas’ finances.

Senate Judiciary Committee Chairman Dick Durbin has asked Roberts to appear before the committee on 2 May.

Supreme Court chief justice asked to testify in Senate after Clarence Thomas scrutiny

What is mifepristone?

Thursday 20 April 2023 21:30 , Alex Woodward

The future of abortion access is back in the hands of the Supreme Court, which is reviewing a challenge from anti-abortion activists to reverse the federal government’s approval of mifepristone, a widely used drug for medication abortion procedures and miscarriage care.

Stripping the government’s approval could devastate access to abortion and miscarriage care for millions of Americans across the country, including in states where access is legally protected.

The widely used drug in the abortion rights battle at the Supreme Court

‘One of the most brazen attacks on Americans’ health'

Thursday 20 April 2023 20:45 , Alex Woodward

Federal court rulings that undermine the FDA’s two-decade approval of a widely used abortion drug could upend the government’s drug regulatory process into chaos in ways that extend far beyond the fight over mifepristone, according to Dr Jack Resneck Jr, presidentof the American Medical Assocation.

He writes in an essay for The New York Times on Thuesday that the political volatility surrounding the drug over the last few years could open up the FDA to challenges to “many vaccines, including those that reduce the risks of serious illness from Covid-19.”

“We should expect lawsuits against common types of safe and highly effective hormonal birth control, including emergency contraception,” he added. “Also at risk: drugs used to treat cancer and arthritis that can incidentally affect unexpected pregnancies, drugs to prevent or treat HIV, and medications aimed at providing gender-affirming care.”

The women suing Texas over the state’s ‘barbaric’ abortion restrictions

Thursday 20 April 2023 20:11 , Alex Woodward

Last month, five women who were denied abortions under several overlapping anti-abortion laws in Texas filed a lawsuit against the state, marking the first time that pregnant women have sought legal action themselves after a wave of restrictions following the US Supreme Court’s decision to strike down Roe v Wade.

The plaintiffs, two of whom are pregnant, told their stories outside the Texas capitol, warning that the state’s anti-abortion measures expose pregnant patients to severe risk of illness, injury and death.

Women denied emergency abortion care in Texas sue state over ‘barbaric’ restrictions

Republican lawmaker tells women to ‘get off the abortion conversation’ as future of critical drug in jeopardy

Thursday 20 April 2023 18:19 , Alex Woodward

A Republican congressman from Texas dodged questions about a federal court decision to revoke a more than 20-year-old approval for a commonly used abortion drug, instead suggesting that “women have a whole lot of other issues than just abortion” and the US should “talk about the other things that are happening in this world.”

US Rep Tony Gonzales told CNN’s State of the Union earlier this month that the issue was about “states’ rights,” but he stumbled when asked how that accounts for a federal court ruling that will have a dramatic impact to abortion access across the country if it goes into effect.

GOP lawmaker tells women to ‘get off the abortion conversation’ after drug ruling

What will the Supreme Court decide, and what happens next?

Thursday 20 April 2023 17:15 , Alex Woodward

The order from Supreme Court Justice Samuel Alito, who presides over the district where the mifepristone challenge was filed, was published on the so-called “shadow docket” where the court handles both procedural manners and emergency motions that can have profound implications.

Alito’s brief order to pause a federal court’s decision that would reverse the FDA’s approval for mifepristone keeps the status quo in place until midnight on Friday, at the latest.

But it is unclear what the court will do next.

The court will not be ruling on the merits of the case, but it will determine how or if mifepristone can be dispensed while the case continues to play out.

After the court makes a decision, the case returns to the Fifth Circuit Court of Appeals in Louisiana. Both parties will have a chance to file briefs, and the case will be argued before a three-judge panel on 17 May.

Judge who wants to block mifepristone removed his name from anti-abortion article before Senate confirmation

Thursday 20 April 2023 16:45 , Alex Woodward

The judge presiding over a challenge to a widely used abortion drug reportedly failed to disclose to members of Congress that he authored an article attacking abortion rights and transgender healthcare in a right-wing legal journal while he was in the running for his Trump-appointed position on the federal judiciary.

Judge in mifepristone case failed to disclose writing anti-abortion article

The latest: Florida’s latest anti-abortion law will nearly eliminate access across the South

Thursday 20 April 2023 16:15 , Alex Woodward

Abortion is effectively outlawed in more than a dozen states, mostly in the South, following the US Supreme Court’s decision to strike down the constitutional right to abortion care last June.

Shortly after the state’s Republican-controlled legislature passed the measure on 13 April, Florida Governor Ron DeSantis signed a bill into law that outlaws abortion at six weeks of pregnancy.

The law will strand Florida residents “in a vast abortion desert” and force patients to travel more than 1,000 miles for legal access to abortion care, according to Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights.

Florida’s latest anti-abortion law will nearly eliminate access across the South

How the challenge to mifepristone landed at the Supreme Court

Thursday 20 April 2023 15:30 , Alex Woodward

Following the Supreme Court’s decision to overturn Roe v Wade last year, marking a significant victory for the anti-abortion movement and Christian conservative legal groups who have fuelled that campaign, anti-abortion activists took aim at medication abortion, the most common form of abortion care in the US.

Here’s how the case played out over the last several months:

• In November, the group Alliance Defending Freedom filed a lawsuit in US District Court in Amarillo, Texas on behalf of a group of anti-abortion activists incorporated at the Alliance for Hippocratic Medicine, which was organised that month with an address in Amarillo.

• Judge Matthew Kacsmaryk – a former right-wing activist lawyer who was appointed to the federal judiciary by Donald Trump – held a hearing in the case on 15 March in Amarillo.

• Earlier this month, Judge Kacsmaryk issued a ruling to suspend the FDA’s approval of mifepristone. His order was set to take effect a week later, pending a decision from on appeal.

• But in a separate ruling in Washington state, a federal judge ruled that the FDA cannot change the status quo when it comes to mifepristone’s approval, setting up potentially duelling decisions over the drug.

• Abortion rights advocates, providers, major medical groups and legal analysts condemned the ruling, and the US Department of Justice and Danco Laboratories, which manufactures mifepristone, filed an appeal.

• That appeal landed at the US Court of Appeals for the Fifth Circuit, which has jurisdiction over the Amarillo court.

• A three-judge panel on the Fifth Circuit blocked a part of the judge’s ruling, but struck against mail-in prescriptions and rules that expanded the drug’s approval for use up to 10 weeks of pregnancy.

• The Supreme Court blocked the Texas ruling while it considers the case.

Abortion advocates and providers brace for Supreme Court decision in major drug case

Thursday 20 April 2023 15:09 , Alex Woodward

Abortion providers, clinics and abortion rights advocates and patients are anticipating a US Supreme Court decision that could provide some clarity about the fate of a widely used drug at the centre of the biggest legal battle for abortion care since the fall of Roe v Wade last year.

Advocates and civil rights legal groups were stunned by lower court rulings that took aim at the FDA’s approval of mifepristone, decisions that they say are “unmoored” by both the law and science, including decades of research and guidance from major medical and public health organisations.

Abortion advocates and providers brace for Supreme Court decision in major drug case

The latest: Supreme Court delays decision in abortion drug case until Friday

Thursday 20 April 2023 15:07 , Alex Woodward

The US Supreme Court has extended its pause on a lower court ruling that would strip the government’s approval of a widely used abortion drug, which will remain available, at least for now.

An order from the nation’s highest court that put the ruling on hold was set to lapse at midnight on Wednesday. An order issued on Wednesday afternoon extended that hold until midnight on Friday.

Supreme Court delays decision in abortion drug case until Friday

Who is Matthew Kacsmaryk, the Trump-appointed judge trying to ban abortion drug?

Thursday 20 April 2023 15:06 , Alex Woodward

A Trump-appointed federal judge in Texas whose decision to halt approval of the most commonly used abortion drug in the US has trigged a legal battle posing the most significant threat to abortion rights since the Supreme Court revoked a constitutional right to abortion care last year.

Who is Trump-appointed judge Matthew Kacsmaryk trying to ban abortion drug?