Last Updated: September 10, 2026 
A federal appeals court is considering whether to restore stricter requirements for prescribing and dispensing mifepristone, a medication commonly used in abortions.
A three-judge panel of the Fifth U.S. Circuit Court of Appeals heard arguments in New Orleans on September 9. The case was brought by Louisiana Attorney General Liz Murrill and Rosalie Markezich, who says she was coerced into taking abortion pills.
The lawsuit challenges federal rules permitting eligible patients to obtain mifepristone prescriptions through telehealth and receive the medication without an in-person dispensing visit.
Louisiana argues that these rules make it more difficult to enforce the state’s abortion restrictions because providers in states with abortion “shield laws” can prescribe and send medication to Louisiana patients.
Fifth Circuit Questions Louisiana’s Standing
During the hearing, the judges examined whether Louisiana had established the legal standing required to challenge the FDA’s regulations.
Louisiana argued that the state may incur costs when patients who take abortion medication later seek treatment for complications through Medicaid or other state-funded healthcare programs.
Lawyers representing the FDA and mifepristone manufacturers disputed that theory. They argued that Louisiana had not shown that any claimed injury was directly caused by the federal prescribing rules.
Judge Stephen Higginson questioned whether the FDA could be held responsible for abortion pills entering Louisiana when out-of-state prescriptions may instead be facilitated by state shield laws.
The panel did not decide the standing issue during the hearing.
Louisiana Seeks Nationwide Restrictions
The FDA approved mifepristone in 2000. The medication is generally used with misoprostol as part of a two-drug regimen for terminating a pregnancy.
The agency later modified its regulations governing the drug. Rules finalized in 2023 allowed certified pharmacies to dispense mifepristone and enabled eligible patients to obtain prescriptions through telehealth without an in-person dispensing requirement.
Louisiana is seeking to restore more restrictive conditions. Because the lawsuit challenges federal regulations, the requested relief could affect mifepristone access nationwide, including in states where abortion is legal.
The FDA has maintained that mifepristone is safe and effective when used under its approved conditions. The agency is also conducting a new review of the medication’s safety and prescribing requirements.
Lawyers defending the existing rules argued that the FDA should be allowed to complete that regulatory process before a court orders any changes.
Current Mifepristone Rules Remain in Effect
The September 9 arguments did not result in an immediate ruling or change to mifepristone access.
The current federal rules remain in effect while the Fifth Circuit considers the case. Applicable state laws may still restrict whether the medication can legally be prescribed, distributed, or used within a particular state.
The dispute follows a separate mifepristone case decided by the U.S. Supreme Court in 2024. In that case, the justices unanimously rejected a challenge because the plaintiffs lacked legal standing. The Court did not decide whether the FDA acted lawfully when it expanded access to the medication.
The Fifth Circuit could similarly resolve Louisiana’s case on standing grounds without reaching the legality of the FDA’s regulatory decisions.
No date has been announced for the appellate court’s ruling. The case could eventually return to the Supreme Court depending on the Fifth Circuit’s decision and any further appeals.
Disclaimer: This article is provided for general informational purposes and reports on publicly available legal proceedings concerning mifepristone. The Fifth Circuit had not issued a decision following the September 9 hearing, and the existing federal access rules remained in effect at the time of publication. This article does not constitute medical or legal advice.
