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U.S. Supreme Court to hear case about access to the abortion pill mifepristone


The Supreme Court has agreed to hear a case about an abortion pill. The court says it will review lower court decisions that would make it harder to get mifepristone next year. Let's talk about this with Sarah Varney, who is a journalist who covers reproductive rights. Sarah, good morning.


INSKEEP: What's at issue here?

VARNEY: So just to walk through what's happened so far, there was a federal judge in Amarillo, Texas. He was appointed by former President Trump, and he actually revoked the approval of mifepristone entirely. Then that decision was appealed to the Fifth Circuit, which is in New Orleans. And that court didn't agree with that sweeping decision. But it did agree with a group of anti-abortion organizations that argued the FDA's approval process of mifepristone was flawed and that the FDA erred when it made the drug more widely available, including through telemedicine and through the mail. So yesterday, the Supreme Court justices agreed to take up an appeal to that decision from the company that makes mifepristone and the Biden administration. And they're asking the Supreme Court to reverse that ruling by the Fifth Circuit.

INSKEEP: This is really interesting. So it's not just a yes-no decision on whether the FDA properly approved this pill. There are also questions about how it's accessible and a variety of FDA choices over a variety of years. So how could access to the pill be affected?

VARNEY: Sure. Well, you know, just to start, abortion pills account for more than half of all abortions in this country. And they're really used also by OB-GYNs to manage early miscarriages, so they're hugely important. If the Supreme Court upholds the appellate ruling by the Fifth Circuit, then patients would not be able to get mifepristone through the mail, even if they live in states like Massachusetts or California where abortion is legal. They would have to make three separate appointments in person with a doctor. This is not currently required. And instead of being able to use mifepristone into the 10th week of pregnancy, patients could only use it until seven weeks. This doesn't mean medication abortion would become entirely unavailable. Clinics and physicians and telemedicine services could still prescribe a drug called misoprostol. That's usually taken with mifepristone, but it can also be taken safely and effectively on its own. And just to note that misoprostol was actually approved by the FDA in 1988, so quite a long time ago, to treat gastric ulcers. The anti-abortion groups - we just haven't seen them target that approval process yet.

INSKEEP: Yet, you say. Now, since this is all about FDA approval and whether it was proper, what does this case mean for the FDA?

VARNEY: Yeah, this is a really unusual case. You know, the FDA approved this medication more than two decades ago. More than 5 million people in the U.S. have used it safely. It's approved for use around the world. And this case has attracted a lot of attention from FDA scholars, you know, some who support abortion rights. Others do not. They actually filed an amicus brief defending the FDA's rigorous drug approval process. And they argued that if religious groups or private individuals can challenge, you know, each drug that the FDA reviews, that it really undermines the entire FDA regulatory authority, and it's going to throw the pharmaceutical industry and, really, the country's regulation of drugs just into disarray.

INSKEEP: OK, so the court now hearing a case that would go all the way into 2024, which happens to be an election year. Sarah Varney, thanks so much. Really appreciate it.

VARNEY: Oh, thank you, Steve. Transcript provided by NPR, Copyright NPR.

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Sarah Varney