The Supreme Court stayed a Fifth Circuit ruling that would have banned mail-order mifepristone, with seven justices granting relief and Alito dissenting in sharp terms.
The Supreme Court on May 14, 2026, issued an indefinite stay blocking a Fifth Circuit ruling that would have required women nationwide to obtain mifepristone in person rather than through telehealth appointments or mail-order pharmacy [1]. The stay preserves the status quo for mail-order access to the drug while the underlying litigation continues [2]. Seven justices voted to grant emergency relief; Justices Clarence Thomas and Samuel Alito publicly dissented [1].
The case arises from a challenge brought by Louisiana Attorney General Liz Murrill contesting Food and Drug Administration rules that authorize telehealth prescribing and mail delivery of mifepristone [2]. The Fifth Circuit ruled on May 1, 2026, siding with Louisiana and holding that FDA's mail-order framework exceeded the agency's authority [3]. Danco Laboratories and GenBioPro, the two FDA-approved manufacturers of mifepristone, sought emergency relief from the Supreme Court after the Fifth Circuit ruling took effect [1]. The Court granted that application, staying the Fifth Circuit's order pending further appellate proceedings [3].
Alito characterized the majority's order as "unreasoned," a pointed criticism of the Court's use of the shadow docket to resolve a high-stakes regulatory dispute without full merits briefing or oral argument [2]. Thomas joined that dissent without separate writing [1]. The public nature of Alito's objection draws attention to ongoing tensions within the Court over emergency docket practice, particularly in cases involving abortion access and federal agency authority [2]. The stay does not resolve the underlying legal questions, including whether FDA acted within statutory limits when it authorized mail delivery of mifepristone and whether Louisiana has standing to bring the challenge at all [3].
The Fifth Circuit must now adjudicate the merits of Louisiana's claims, a process that will likely produce a final circuit judgment subject to further Supreme Court review [1]. Given the Court's prior engagement with mifepristone access in Food and Drug Administration v. Alliance for Hippocratic Medicine, where it dismissed a parallel challenge on standing grounds, the justices are widely expected to take the case again once the Fifth Circuit rules [2][3]. Until then, mifepristone remains available through telehealth and mail in all states where it is not separately restricted by state law [1].