The Supreme Court stayed a May 1 ruling from the New Orleans-based, U.S. 5th Circuit Court of Appeals which would have banned mifepristone from being mailed.
The appeals court ruling would have applied to the entire country, not just states like Louisiana that have abortion bans.
The Supreme Court handed down a to keep the status quo in place for medication abortion access.
The high court's order means the abortion pill will remain available via telehealth as a case brought by Louisiana against the Food and Drug Administration proceeds through the lower courts.
Justices Samuel Alito and Clarence Thomas dissented with Alito railing at his fellow justices calling the order 'unreasoned' and 'remarkable.'
'What is at stake is the perpetration of a scheme to undermine our decision in Dobbs,' Alito writes, referring to the majority opinion that he authored that overturned Roe v. Wade. Dobbs 'restored the right of each State to decide how to regulate abortions within its borders.'
The telehealth abortion process starts with a patient connecting with a healthcare provider on the phone or online. If the patient is eligible, the provider can prescribe two medications — mifepristone and another drug called misoprostol. Patients can pick up the medicine at a local pharmacy, or providers can mail the drugs to a patient's home.
That access is a big part of the reason why the number of abortions nationally has increased since the Supreme Court overturned the constitutional right to abortion in 2022. Now, most abortions in the U.S. use this combination of medications, and one quarter happen via telemedicine. Mifepristone is a medication that blocks progesterone, a hormone required to sustain a pregnancy. Without progesterone, the uterine lining breaks down, and the connection between the pregnancy and the uterus is disrupted. It is typically taken alongside a second medicine to terminate an early pregnancy.
After the 5th Circuit ruling on May 1, some providers said they would continue offering telemedicine access to abortion medication using a different protocol that involves higher doses of misoprostol and no mifepristone. Researchers say that method is just as safe and effective, but tends to cause more side effects for patients, like nausea and diarrhea.
Nearly two dozen Democratic-led states submitted an amicus brief in this case, writing that the appeals court decision put the policy choices of states with bans above the choices of states 'that have made the different but equally sovereign determinations to promote access to abortion care.'
A similar number of Republican- led states filed an amicus brief in support of Louisiana's case.