WASHINGTON (AP) — The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all U.S. abortions last year, in the court's first ruling on abortion since the conservative justice overturned Roe v. Wade two years ago.
The nine justices ruled that abortion opponents lacked legal standing to sue over the Federal Food and Drug Administration's approval of the drug, mifepristone, and the FDA's subsequent actions to ease access to it. The case had threatened to limit access to mifepristone across the country, including in states where abortion remains legal.
Abortion is prohibited at all stages of pregnancy in 14 states, and after about six weeks of pregnancy in three others, often before women know they are pregnant.
Justice Brett Kavanaugh, who was part of the majority to overturn Roe, wrote for the court Thursday that "federal courts are the wrong forum to address plaintiffs' concerns about the FDA's actions."
The opinion highlighted the risks of the 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone, including banning it from being sent through the mail.
Kavanaugh's opinion managed to unite a deeply divided court on abortion and many other socially divisive issues by using a minimalist approach that focused only on the technical legal issue of standing and reached no judgment on the FDA's actions. Kavanaugh's seven 'pro-life' references to abortion opponents may have been the only language he thought revealed any of his views on abortion.
While praising the decision, President Joe Biden signaled that Democrats will continue to campaign heavily on abortion before the November elections. "It doesn't change the fact that a woman's right to get the treatment she needs is compromised if not impossible in many states," Biden said in a statement.
Marjorie Dannenfelser, president of SBA Pro-Life America, expressed disappointment with the decision but trained her fire on Democrats. "Joe Biden and the Democrats are determined to mandate abortion on demand at any time for any reason, including DIY mail-order abortions, in every state in the country," Dannenfelser said.
About two-thirds of US adults oppose a nationwide ban on the use of mifepristone, or medication abortion, according to a KFF poll conducted in February. About a third would support a nationwide ban.
The Supreme Court is separately hearing another abortion case, whether the federal emergency hospital treatment law overturns state bans on abortion in rare emergency cases in which a pregnant patient's health is at serious risk.
More than 6 million people have used mifepristone since 2000. Mifepristone blocks the hormone progesterone and causes the uterus to respond to the contraction-inducing effect of a second drug, misoprostol. The two-drug regimen has been used to terminate pregnancies up to 10 weeks' gestation.
Jillian Phillips, of North Brookfield, Massachusetts, took mifepristone after suffering a miscarriage eight years ago. She eventually passed away the remains of her nine-week pregnancy, which she buried in a memorial garden.
"It should never have been something we had to earn," said Phillips, a 42-year-old mother of three. "These are decisions that should happen in a medical examination room, not in courtrooms."
Health care providers have said that if mifepristone is no longer available or is too difficult to obtain, they would switch to using misoprostol alone, which is somewhat less effective at terminating pregnancies.
The Biden administration and drugmakers had warned that supporting abortion opponents in this case could undermine the FDA's drug approval process beyond the abortion context, inviting judges to second-guess the agency's scientific judgments. The Democratic administration and New York-based Danco Laboratories, which makes mifepristone, argued that the drug is among the safest the FDA has ever approved.
The decision "protects access to a drug that has decades of safe and effective use," Danco spokeswoman Abigail Long said in a statement.
The plaintiffs in the mifepristone case, anti-abortion doctors and their organizations, argued in court documents that the FDA's decisions in 2016 and 2021 to ease restrictions on the drug were unreasonable and "put at risk the health of women across the the world". the nation.â€
Kavanaugh acknowledged what he described as "the sincere legal, moral, ideological and political objections of opponents to elective abortion and the FDA's quiet regulation of mifepristone."
Federal laws already protect doctors from being forced to perform abortions or provide any other treatment that goes against their beliefs, Kavanaugh wrote. "Plaintiffs have not identified any instances where a physician was required, despite conscientious objection, to perform an abortion or provide other abortion-related treatments that violated the physician's conscience since the approval of mifepristone in 2000," he wrote.
Ultimately, Kavanaugh wrote, anti-abortion doctors went to the wrong forum and should instead direct their energies to convincing lawmakers and regulators to make changes.
Abortion rights advocates mostly breathed a sigh of relief after the ruling, but they echoed Biden about the impact of the ruling two years ago.
"Ultimately, this decision is not a 'winner' for abortion — it simply maintains the status quo, which is a dire public health crisis in which 14 states have criminalized abortion," Nancy Northup, president. CEO of the Center for Reproductive Rights, said in a statement.
The mifepristone case began five months after the Supreme Court overturned Roe. Abortion opponents first won a sweeping ruling nearly a year ago from U.S. District Judge Matthew Kacsmaryk, a Trump running mate in Texas, that would have completely revoked the drug's approval. The 5th US Circuit Court of Appeals upheld the FDA's initial approval of mifepristone. But it would change regulatory changes made in 2016 and 2021 that eased some conditions for administering the drug.
The Supreme Court put the appeals court's modified decision on hold, then agreed to hear the case, although Justices Samuel Alito, the author of the decision overturning Roe, and Clarence Thomas would have allowed some restrictions to take effect while the case continued. . But they also joined the court's opinion on Thursday.
The push to limit abortion pills likely won't stop with the Supreme Court's decision, said the lawyer representing anti-abortion doctors and their organizations in the case.
The ruling that the doctors do not have legal standing to sue leaves the way open for lawsuits from others, including three other states that Kacsmaryk had previously allowed to join the suit, said Erin Hawley, an attorney with the group Defense Alliance Freedom. .
Hawley said she expects Idaho, Kansas and Missouri to continue the lawsuit originally filed in Texas.
Kansas Attorney General Kris Kobach, a Republican, asserted in a statement that the state has "maintained that the doctors did not," confirming that he will proceed with the case in Kacsmaryk's court.
Associated Press writers Lindsay Whitehurst, Linley Sanders and Kimberlee Kruesi contributed to this report. Kruesi reported from Nashville, Tennessee.
Follow AP's coverage of the US Supreme Court at https://apnews.com/hub/us-supreme-court.
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