NEW ORLEANS — A federal appeals court on Friday temporarily blocked the mailing of prescriptions for the abortion drug mifepristone nationwide, requiring that the medication be dispensed in person at clinics and reversing Food and Drug Administration rules that had expanded access through telehealth and pharmacies.
The unanimous order from a three-judge panel of the New Orleans-based 5th U.S. Circuit Court of Appeals granted a request by Louisiana in its ongoing lawsuit against the FDA. The state argued that the agency’s 2021 and 2023 decisions allowing remote prescriptions undermined its abortion ban and lacked sufficient safety data on mail-order dispensing.
The ruling immediately affects patients seeking medication abortion, which now accounts for roughly two-thirds of abortions in the United States. It also applies to use of mifepristone for miscarriage management.
Abortion-rights advocates said the change will hit hardest in rural areas, among low-income people, those with disabilities and survivors of intimate partner violence, many of whom relied on the convenience of telehealth and mailed prescriptions after the Supreme Court’s 2022 decision overturning Roe v. Wade.
The decision sets up a likely appeal to the Supreme Court, which in 2024 unanimously preserved access to mifepristone in a separate case on procedural grounds but has not yet ruled on the core regulatory issues.
Mifepristone was approved by the FDA in 2000. The agency relaxed restrictions over time, first in 2016 and then during the COVID-19 pandemic in 2021 to allow telehealth prescriptions. In 2023, it made permanent changes permitting certified pharmacies to dispense the drug by mail without an in-person visit.
Louisiana and other states with abortion bans sued, contending the FDA acted arbitrarily and that mail delivery conflicts with state laws and the Comstock Act, a 19th-century anti-obscenity statute. A lower-court judge in Louisiana had paused parts of the case to allow the Trump administration’s FDA to complete a new safety review, but the appeals court stepped in with the temporary stay.
Washington state law continues to protect abortion access, including medication abortion, and the state’s mifepristone stockpile (held by the Department of Corrections) remains available for distribution to licensed providers. However, the 5th Circuit’s order means Washingtonians can no longer obtain mifepristone by mail or through purely telehealth prescriptions under the previous FDA rules. Patients will need an in-person visit for to be dispensed mifepristone.
Former Gov. Jay Inslee directed the state Department of Corrections — which holds a pharmacy license — to purchase a stockpile as insurance against federal restrictions. In 2023, the state bought 30,000 doses of mifepristone for about $1.275 million. An additional 17,600 doses were purchased in early 2025. Some of the original 2023 batch expired in early 2026 and was returned or destroyed. The later supply does not expire until late 2028 or 2029.
In March 2026, Gov. Bob Ferguson signed Senate Bill 5917, which removes previous requirements that the state sell the stockpile at cost plus a $5 fee. The law lets the Department of Corrections coordinate with the Department of Health to distribute or provide the medication more easily to licensed providers at lower or no cost, ensuring a steady supply for in-person dispensing.
Author: Mario Lotmore
