A federal judge declined to immediately block the federal policy allowing abortion pills to be prescribed via telehealth and mailed to patients, while warning that Louisiana's legal challenge is likely to succeed as regulators revisit the drug's safety rules, according to a memorandum ruling issued by U.S. District Judge David Joseph.
Joseph wrote in his decision that the U.S. Food and Drug Administration should be allowed to complete its ongoing review of the abortion drug mifepristone, but emphasized that the agency must move with "all deliberate speed" to address acknowledged deficiencies in its prior actions.
The ruling came in a case brought by Louisiana Attorney General Liz Murrill, who argued in court filings that the FDA acted unlawfully by loosening restrictions on mifepristone and allowing it to be prescribed remotely and distributed through the mail.
Joseph granted a request from the federal government to pause the litigation while the FDA conducts what government lawyers described in court as a "good-faith, evidence-based and expeditious review" of the drug's safety framework.
At the same time, the judge wrote that Louisiana had established standing to sue and is "likely to succeed" on the merits, signaling potential vulnerability in the federal policy once the pause is lifted.
The decision points to the FDA's 2021 action removing the in-person dispensing requirement for mifepristone and its 2023 decision to make that change permanent, steps the agency previously announced as part of an effort to expand access to medication abortion.
Joseph wrote that there is evidence those decisions may not have fully accounted for safety considerations, citing the administrative record presented by the state.
He also noted that the regulatory changes coincided with a post-Dobbs v. Jackson Women's Health Organization environment in which states have adopted sharply different abortion policies, increasing the likelihood that pills would be mailed across state lines.
Louisiana argued in its complaint that the federal policy undermines its abortion restrictions and imposes financial burdens on the state, including Medicaid costs associated with treating complications from medication abortions.
Joseph wrote that those alleged harms constitute "concrete and ongoing injury," adding that it was foreseeable the policy would enable out-of-state providers to reach patients in states with stricter laws.
The lawsuit also includes claims from a woman who alleged in court filings that she was coerced into taking abortion pills obtained online, which the state cited as an example of risks tied to remote prescribing.
Despite those concerns, Joseph said the FDA should be permitted to finish its review without immediate judicial intervention, writing that agencies are typically given deference when reconsidering their own regulations.
He ordered the FDA to produce the full administrative record underlying its mifepristone decisions within 60 days, file a status report within six months, and notify the court within 14 days of completing its review.
Murrill said in a public statement that she plans to seek relief from a higher court, arguing that the judge's findings confirm Louisiana is suffering irreparable harm while the current policy remains in place.
The case is the latest development in a broader legal fight over mifepristone, which federal data show is used in a majority of abortions in the United States and has become a focal point of litigation since Dobbs overturned Roe v. Wade.
In 2024, the Supreme Court declined to restrict access to the drug in a separate case, ruling that the plaintiffs lacked standing, leaving the FDA's current framework in place without resolving the underlying legal questions.
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