Louisiana mifepristone lawsuit could hinder telehealth abortion nationwide

This story was originally published by States Newsroom.

A hearing is set for Tuesday in a federal lawsuit led by Louisiana seeking to further restrict access to mifepristone by asking the courts to stop abortion pills from being mailed across the country. 

The Department of Justice has argued plaintiffs lack standing to bring the case and asked the judge to halt legal proceedings until the Food and Drug Administration wraps up a review of the medication. 

Hundreds of studies have concluded that the drug is safe and effective for abortions early in pregnancy, but a paper released by a conservative think tank last year compelled Health and Human Services Secretary Robert F. Kennedy Jr. to order a reevaluation of mifepristone.  

The state of Louisiana and a woman who said her ex-boyfriend made her take abortion medication sued the FDA in October and asked for a preliminary injunction against a 2023 rule that allows abortion pills to be prescribed through telehealth or mailed to patients, and pharmacies to apply for certification to dispense mifepristone. 

Julie Kay, the founder and CEO of legal advocacy group Reproductive Futures, told States Newsroom the lawsuits in Louisiana and elsewhere are “thinly veiled attempts” to block access to telehealth medication abortion. 

“We’ve seen that telemedicine abortion has become incredibly popular in all 50 states and particularly vital for women in under-resourced areas,” Kay said. 

Missouri, Idaho, Kansas, Texas and Florida are also suing the FDA over mifepristone’s regulations and asking the courts to restrict or rescind approval of the drug altogether.

Nearly 30% of abortions provided in the first half of 2025 were through telehealth, according to the Society of Family Planning’s latest #WeCount report. 

By June 2025, about 15,000 abortions per month were provided by physicians shielded by state laws, allowing them to prescribe abortion medication remotely to people living in states where abortion is banned or restricted, the report found. Shield laws protecting health care professionals from out-of-state investigations have held up in court so far, despite efforts from prosecutors in Texas and Louisiana. 

Republican Louisiana Attorney General Liz Murrill vowed to defend anti-abortion laws in her state, which has had a ban with no exceptions for rape or incest since August 2022. She indicted a California doctor in January, accusing him of mailing abortion pills to Rosalie Markezich, a plaintiff in the lawsuit before federal courts. 

Lawyers for Louisiana argue that the Biden administration’s decision to nix the in-person dispensation requirement for mifepristone is an affront to states that ban abortion. 

Alliance Defending Freedom Senior Counsel Erik Baptist framed the lawsuit as an intimate partner violence issue, saying Markezich’s former boyfriend ordered abortion pills online from Dr. Rémy Coeytaux in California without any in-person interaction. 

“So what this lawsuit would do is protect women across the country, in particular in Louisiana, from this mail-order abortion scheme that enables and emboldens people in coercive situations, such as men and abusers who can now obtain these drugs through remote means,” Baptist said. 

Reproductive coercion — when an abusive partner controls a person’s bodily autonomy — has been brought up in recent legal challenges to abortion pill access by other GOP attorneys general in bids to restrict mifepristone, according to Rachel Rebouché, a University of Texas at Austin law professor who specializes in reproductive rights. 

“There’s really not evidence that people are being coerced or forced into taking pills. It’s, of course, awful if someone has felt coerced, but I’m not sure it changes the argument of what the FDA should do as an agency committed to reviewing evidence,” Rebouché said. 

For their part, DOJ attorneys have said an injunction would interfere with the FDA review and Risk Evaluation and Mitigation Strategies, setting off an avalanche of other lawsuits. 

“Plaintiffs now threaten to short circuit the agency’s orderly review and study of the safety risks of mifepristone by asking this Court for an immediate stay of the 2023 REMS Modification approved three years ago,” they wrote in a memo filed on Jan. 27 in the U.S. District Court for the Western District of Louisiana. 

Kay said she views the Trump administration’s motion to pause the case as a legal delay tactic that is more about politics than science, because most Americans believe abortion should be accessible. A Pew Research Center poll from June 2025 showed 63% of respondents said abortion should be legal in all or most cases.

“This federal administration is very aware of that popularity, and I think they’re saying they want to wait until after the midterms,” Kay said.

Baptist said the FDA can conduct their review while the in-person requirement is restored. 

Mifepristone’s manufacturers intervened in the case earlier this month, Louisiana Illuminator reported. But unlike the federal government, GenBioPro and Danco, the companies behind the generic and name brand versions of the drug, asked the court to dismiss Louisiana’s lawsuit entirely. 

In a memo filed on Tuesday, Feb. 17, lawyers for the plaintiffs argued that the 2023 regulatory change “was intended to authorize a direct attack” on anti-abortion states. 

The filing also rejects arguments that Louisiana and Markezich lack standing in the same way that a group of anti-abortion doctors did in a lawsuit against the FDA over mifepristone’s previous regulations, according to a 2024 U.S. Supreme Court ruling. Justices rebuffed the Alliance for Hippocratic Medicine’s requests but did not rule on the merits of the case.

Baptist also said judicial panels on the 5th U.S. Circuit Court of Appeals in Louisiana — a conservative-leaning court where this lawsuit could go next — have twice ruled that it was “arbitrary and capricious” for the FDA to allow abortion medication without an in-person doctor visit. 

In Louisiana’s corner are major anti-abortion players: Students for Life of America, 60 Republican members of Congress, 21 GOP attorneys general and the Ethics and Public Policy Center filed briefs backing the state. 

Rebouché, the University of Texas professor, said there would be conflict between the federal courts if the district court judge rules in favor of Louisiana. There are nearly a dozen lawsuits over abortion pills seeking to restrict and deregulate mifepristone, States Newsroom reported.

Guttmacher Institute Principal Federal Policy Adviser Anna Bernstein said in a statement Friday that reinstating the in-person dispensation requirement for mifepristone would hinder abortion access. 

“If access to telehealth and mifepristone by mail is curtailed, more patients would be pushed toward in-clinic care, straining provider capacity and increasing wait times in an already chaotic landscape,” she said. “Given that travel is out of reach for many people, the result would likely be increased delays and more people unable to get the abortion care they need and deserve.” 

Kelcie Moseley-Morris contributed to this report.