NEW ORLEANS — A panel of federal judges heard arguments on Wednesday regarding whether prescribing rules for mifepristone should be tightened. The case is before the New Orleans-based 5th U.S. Circuit Court of Appeals.

The hearing was set for 9 a.m. CDT on Wednesday. The three judges hearing the case include two nominated by Democratic presidents Barack Obama and Joe Biden and one nominated by Republican George W. Bush. Judge Dana Douglas, a President Joe Biden appointee, joined Judges Higginson and Richman on the panel. The case was brought by Louisiana Attorney General Liz Murrill and Rosalie Markezich.

Louisiana Solicitor General Benjamin Aguinaga stated that the state is impacted because some women who use the pills seek treatment for complications. He added that perhaps half of the women seeking treatment for complications have state-funded Medicaid health coverage.

Judge Stephen Higginson questioned whether the FDA's role is the reason abortion pills are flowing into Louisiana. "Those are state shield laws," Judge Stephen Higginson said. "The government has nothing to do with the shield laws." DOJ attorney Daniel Winik stated that standing issues were sufficient reason for the court to reject Louisiana’s request.

The FDA stated that its agency process should take precedence over court action. At least 3 in 5 U.S. abortions are obtained using a two-drug combination. Medication abortion accounts for two-thirds of U.S. abortions.

Currently, 13 states ban abortion at all stages of pregnancy. Four states ban abortion after about the first six weeks of pregnancy. Some states, including Mississippi and Texas, have adopted laws with civil or criminal penalties for those who prescribe abortion pills.

Louisiana and Texas have brought criminal and civil cases against some out-of-state providers. The attorneys general of Florida and Texas have filed a lawsuit challenging FDA rules. The top government lawyers of Idaho, Kansas, and Missouri have filed a separate lawsuit challenging FDA rules.

Three other three-judge panels on the 5th Circuit and two district courts have agreed that rules for prescribing mifepristone are too loose. Federal judges in Hawaii and Virginia found that current FDA rules for mifepristone prescribing are too restrictive.

The Supreme Court has blocked changes to mifepristone prescribing rules until it hears the case again. The most recent change to mifepristone prescribing rules came in 2023.

Why It Matters

The case intersects with state-level bans, as 13 states currently ban abortion at all stages of pregnancy and four states ban abortion after about the first six weeks of pregnancy. The Supreme Court unanimously rejected an effort to roll back mifepristone availability in 2024 because the anti-abortion groups lacked legal standing, but new challenges continue to test federal oversight.

Timeline

The Supreme Court unanimously rejected an effort to roll back mifepristone availability in 2024 because the anti-abortion groups lacked legal standing. A survey conducted for the Society of Family Planning estimates that between 770 and 900 women in Louisiana obtained abortions each month in 2025 using pills prescribed in other states.

What's New

Judge Stephen Higginson stated, "It looks like the Supreme Court is being constant with one principle: Let FDA do its work." The hearing scheduled in connection with this case was set for 9 a.m. CDT on Wednesday, as determined by the U.S. 5th Circuit Court of Appeals. The Supreme Court issued an emergency order in May keeping current rules allowing telehealth abortions in place.

How Sources Differ

Sources differ on the efficacy statistics for mifepristone regimens. According to the FDA label on mifepristone, the combination of mifepristone and misoprostol completes medical abortion 97.4% of the time. Other FDA labeling notes that the most common regimen for abortion pills in the U.S. is a combination of mifepristone and misoprostol, while some studies have found misoprostol’s individual effectiveness for abortion at around 80% or higher.