On January 16, 2025, U.S. District Judge Matthew Kacsmaryk in Amarillo, Texas, ruled that Idaho, Missouri, and Kansas can continue their lawsuit against the U.S. Food and Drug Administration (FDA) seeking to restrict the availability of the abortion pill mifepristone.
Mifepristone, approved by the FDA in 2000 for use with misoprostol to terminate pregnancies, accounts for a majority of abortions in the United States. In 2022, the Alliance for Hippocratic Medicine and other anti-abortion groups filed a lawsuit aiming to remove mifepristone from the market. In April 2023, Judge Kacsmaryk granted their request, but the 5th U.S. Circuit Court of Appeals reversed the decision, stating it was too late to challenge the original approval.
The 5th Circuit did find that the FDA acted unlawfully in loosening restrictions on mifepristone since 2016, such as extending its use to the first 10 weeks of pregnancy and permitting prescriptions via telemedicine and mail. However, the Supreme Court later determined that the plaintiffs lacked standing, as the FDA’s actions did not harm them, without addressing the case’s merits.
The Republican-led states argue they have standing because their Medicaid programs may incur costs treating complications from mifepristone use. They also contend that continuing the case in Texas is efficient after over two years of litigation.
Separately, Democratic-led states are pursuing a case to prevent the FDA from imposing further restrictions on mifepristone. As President-elect Donald Trump prepares to take office, it remains uncertain how his administration will address mifepristone and related lawsuits. During his campaign, Trump stated he would not ban the drug.
