What You Need to Know about Today’s Mifepristone Case at the U.S. Supreme Court

For previous Pro-Choice North Carolina statements on the U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine case, see here and here

Today the U.S. Supreme Court will hear oral arguments in the  Food and Drug Administration v. Alliance for Hippocratic Medicine, a political case devised by anti-abortion extremists and moved forward by hyperpartisan anti-abortion judges. With unsound legal and scientific arguments—including the fact that multiple “studies” the court case was based on have now been redacted—the Alliance for Hippocratic Medicine, an anti-abortion organization founded shortly before this case was filed, is attempting to further upend abortion access in all states, not just states that have banned abortion.  

The arguments in today’s hearing will focus on the unfounded claims that the FDA did not follow its own established protocols and must therefore remove two specifications that have increased access to abortion since 2016: That mifepristone can be used to terminate pregnancies up to ten weeks instead of seven, and that the medication can be prescribed via telehealth. Both of these are best practices that have been approved by numerous established and trusted medical organizations as well as the World Health Organization. 

After today’s oral arguments we may have a better idea of what may come out of this case, but we won’t know until the ruling is released, likely sometime in June. To avoid confusion, we need to shout it from the rooftops that until the U.S. Supreme Court releases its decision, nothing about the availability of mifepristone and medication abortion changes in North Carolina or in the U.S. 

It’s also critical to note that no matter what happens with this case, the medical science remains the same:

  • Mifepristone was approved by the FDA in 2000 after a long and rigorous review process. Since that time, it has safely and effectively been used to provide abortion care.
  • This case is focused on mifepristone, the first drug in the medication abortion process. The second drug in that process, misoprostol, has long been used on its own worldwide to safely and effectively terminate pregnancies, and remains available even if mifepristone is further restricted.
  • Mifepristone was approved in the U.S. well after its approval and use in European countries, a delay solely due to anti-abortion political ideologies in our country. Today’s case is just more of those same ideologies. 

The anti-abortion plaintiffs have also argued that mifepristone should be completely removed from the market; and that the 1873 “zombie law” Comstock Act should be revived, making it illegal to mail anything related to abortion. While these arguments are not what is being heard today at the U.S. Supreme Court, the Trump-appointed and anti-abortion justices on the Court may unfortunately still consider these points as they attempt to craft a ruling based on their own interests, rather than on legal and scientific facts. 

All of these arguments are based on anti-abortionists’ efforts to ban all abortions everywhere, and they have no basis in patient well-being, patient safety, medical science, research, administrative law, or legal precedent. Medication abortion now comprises 63% of all abortions in the U.S., and it is a proven, safe, and effective method that is increasingly popular among patients. Medication abortion has improved access for numerous patients and empowered them to choose the care that best suits their needs. It is solely for this reason—the increase in access and autonomy—that anti-abortionists are targeting mifepristone.

Today’s case is the first abortion case to appear before the U.S. Supreme Court since the 2022 Dobbs v. Jackson Women’s Health Organization case that overturned Roe v. Wade. Like Dobbs, which escalated an unworkable and chaotic landscape of abortion access across the country, this case has the potential to further undermine established healthcare and administrative standards, processes, and best practices. As with Dobbs, a ruling that unnecessarily restricts mifepristone will be felt first and most acutely by those with the least access to any reproductive health care, including those living in rural areas, people living on low incomes, young people, immigrant communities, and Communities of Color and Indigenous people. 


Access to abortion is a key part of the continuum of comprehensive reproductive healthcare, and like the Dobbs decision, it’s unlikely the impacts of this ruling will be confined to abortion care. The U.S. Supreme Court and its anti-abortion enablers are playing political games with our lives. No matter what happens, we must continue to demand that elected officials and political actors stay out of our healthcare decisions.

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