On Wednesday, a three‑judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans will hear arguments in a lawsuit filed by Louisiana Attorney General Liz Murrill and plaintiff Rosalie Markezich. The case seeks to restrict the use of telehealth for prescribing mifepristone, the first drug in the two‑pill regimen that accounts for the majority of abortions in the United States.
Background and stakes
Since the Supreme Court’s 2022 Dobbs decision overturned Roe v. Wade, medication abortions have become the most common method, with roughly three‑quarters of all abortions using the mifepristone‑misoprostol combination. The FDA currently permits the drug to be prescribed via telehealth and mailed to patients, a rule that opponents argue undermines state‑level abortion bans.
Louisiana’s lawsuit claims that the telehealth model coerces women into taking the pills and that the practice should be limited to in‑person visits. A survey by the Society of Family Planning estimates that between 770 and 900 Louisiana women obtained abortions each month in 2025 through out‑of‑state providers using online prescriptions.
Judicial landscape
The 5th Circuit panel includes two judges appointed by Democratic presidents (Barack Obama and Joe Biden) and one appointed by Republican George W. Bush. Earlier this year, two other three‑judge panels on the same circuit, as well as district courts in Hawaii and Virginia, ruled that the FDA’s current prescribing rules are too permissive.
In 2024, the Supreme Court unanimously rejected a challenge to the drug’s availability, not on the merits but because the anti‑abortion groups lacked legal standing. The Court also blocked any immediate changes to prescribing rules pending further review.
Political context
The case arrives in a midterm election year, a period when President Trump’s anti‑abortion supporters have expressed frustration that telehealth remains a legal workaround to state bans. While most voters continue to favor abortion access, the Trump administration has remained largely silent on the litigation.
However, the administration’s stance is hinted at through recent comments from Dr. Heidi Overton, the president’s nominee to lead the FDA. Overton, formerly deputy director of the White House Domestic Policy Council, has publicly criticized the agency for loosening prescribing rules for mifepristone, suggesting a possible shift in policy once confirmed.
Potential impact
If the appeals court sides with Louisiana, the ruling could reinstate an in‑person requirement for the medication nationwide, even in states that have enacted strong protections for abortion access. Pro‑choice advocates warn that such a decision would force patients to travel long distances for care, while anti‑abortion groups see it as fulfilling the promise of Dobbs to let states regulate abortion.
Even if the decision narrows telehealth access, organizations that provide the pills argue they could continue prescribing misoprostol alone, which the FDA labels as effective in many cases, though slightly less so than the full regimen.
What’s next?
The 5th Circuit’s ruling will not take immediate effect because the Supreme Court has already stayed any changes to the prescribing rules. The FDA is also conducting its own safety review of mifepristone and has been ordered by a judge to submit a status update by Oct. 7, just weeks before the midterms.
Other Republican‑led states, including Florida, Texas, Idaho, Kansas, and Missouri, have filed separate lawsuits challenging the FDA’s rules, indicating that the legal battle over medication abortion will continue well beyond this hearing.
Original reporting: Brookhaven News – ABC7 New York — read the source article.
