Justice Samuel Alito on May 4, 2026, issued a one-week administrative stay blocking a Fifth Circuit ruling that had reimposed a nationwide in-person dispensing requirement for mifepristone, the most widely used medication abortion drug in the United States [1][2]. The stay, effective through May 11, temporarily restores telehealth prescribing and mail-order distribution of the drug while manufacturers Danco Laboratories and GenBioPro pursue emergency relief from the full Court [1][3].
The underlying dispute centers on FDA regulatory authority over mifepristone's dispensing conditions. The Biden administration relaxed the agency's Risk Evaluation and Mitigation Strategy requirements for the drug, permitting certified pharmacies, telehealth providers, and mail-order services to dispense it without requiring an in-person clinical visit [2]. On May 1, 2026, the Fifth Circuit granted a request by Louisiana Attorney General Liz Murrill to reinstate the prior in-person dispensing rules, effectively reversing those access expansions and blocking mail-order fulfillment nationwide [1][2]. Mifepristone is used in approximately 63% of all abortions in the United States, giving any change to its distribution conditions broad practical effect [1].
Alito's administrative stay does not resolve the merits. It preserves the status quo while the applicants brief their emergency appeal and gives the full Court time to act before the Fifth Circuit's order takes effect [2][3]. Administrative stays of this kind are procedural, not substantive, and carry no implication that the issuing justice or the Court views the underlying appeal favorably. The stay was issued by Alito in his capacity as Circuit Justice for the Fifth Circuit [2].
The case, styled Danco Laboratories v. Louisiana, now returns to the full Court under expedited pressure. If the justices decline to extend the stay after May 11, the Fifth Circuit order reinstating in-person dispensing requirements will take effect immediately, cutting off mail and telehealth access in states where those channels currently operate [1][3]. If the Court grants broader emergency relief, the case may advance toward merits briefing on whether states may use litigation to collaterally challenge FDA approval and distribution decisions for federally regulated drugs, a question the Court declined to reach in its 2024 mifepristone decision on standing grounds [2].
The May 11 deadline sets the next hard inflection point. Danco and GenBioPro must file their full emergency applications before that date, and the Court must act to prevent a lapse in access [1][2].
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