WASHINGTON – The Supreme Court on Wednesday extended by two days a stay on a lower court ruling that sought to limit access to the abortion pill mifepristone, ensuring the drug remains widely available.
In a brief order, Justice Samuel A. Alito Jr. announced that the recess would expire at midnight Friday, giving the court more time to consider the case, though it could act by then.
The court’s failure to meet the earlier deadline suggests there may be disagreement among the justices in its first major case over access to abortion since a conservative majority struck down the constitutional right to abortion in June. It could also indicate that there may be disagreement in the case.
This is a decision by Judge Matthew J. Kacsmaryk of the Northern District of Texas, who in recent weeks invalidated the Food and Drug Administration’s approval of mifepristone, which is part of the most widely used abortion method in the United States.
The court’s order slows down what has been a tangled and fast-moving landscape for mifepristone, marked by conflicting federal district court rulings and an appeals panel ruling that further complicated the drug’s legal status.
After the Supreme Court overturned Roe v. Wade, a landmark 1973 case, in June, political and legal battles have focused on drugs used to induce abortions. In some conservative states, lawmakers have targeted the pill.
Medical abortion, a two-drug regimen, is usually used in the first 12 weeks of pregnancy. The first drug, mifepristone, blocks progesterone, the hormone that allows pregnancy to develop, and the second, misoprostol, taken a day or two later, induces contractions and helps the uterus expel its contents.
The dispute began in November in Texas, when an umbrella group of medical organizations and several anti-abortion doctors sued the FDA, challenging its approval of the pill more than two decades ago.
In their suit, the anti-abortion groups argued that the FDA did not follow proper protocols when it approved the drug in 2000. The groups said the agency also ignored the dangers of the drug in the years that followed.
The FDA, strongly opposing these claims, said the drug was properly approved more than 20 years ago and that it is very safe. He cites years of scientific studies showing that serious complications are rare and that less than 1 percent of patients require hospitalization.
The lawsuit was filed in the Amarillo Division of the U.S. District Court for the Northern District of Texas, where the cases are heard by a single federal judge, Judge Kacsmaryk, appointed by President Donald J. Trump.
judge Kacsmaryk, a longtime opponent of abortionis a former attorney at the First Liberty Institute, a religious liberty legal group that has long supported conservative causes.
This month, Judge Kacsmaryk announced a preliminary ruling that invalidated the FDA’s approval of the drug. But the judge said the agency had a week to seek emergency relief before his decision took effect.
Judge Kacsmaryk he couched his decision in the language of the anti-abortion movementreferring to the abortion provider as “abortionist” and the fetus or embryo as “unborn person” or “unborn child”. He seemed to agree with virtually every claim made by anti-abortion groups.
Less than an hour later, another federal judge, Thomas O. Rice, appointed by President Barack Obama, issued a dissenting ruling in Washington state in another lawsuit. Judge Rice blocked the FDA from restricting the availability of mifepristone in much of the country.
The Washington state lawsuit, filed by Democratic attorneys general in 17 states and the District of Columbia, is a direct challenge to the Texas case.
The Biden administration immediately appealed the decision by a federal judge in Texas, and a divided three-judge panel of the New Orleans-based U.S. Court of Appeals for the Fifth Circuit announced that mifepristone could remain legal and available until the lawsuit was settled. on the way through the courts.
The panel rejected Judge Kacsmaryk’s finding that the FDA’s approval of mifepristone was invalid. At the same time, the justices blocked more recent steps by the FDA to make the drug more readily available, including allowing pills to be sent by mail.
The next day, Judge Rice reaffirmed his decision and ordered the FDA to maintain the status quo in 18 jurisdictions, creating further confusion over the availability of the abortion pill.
Dueling orders all but guaranteed the case would reach the Supreme Court.
Seeking emergency relief, the Biden administration asked the justices to stay a lower court ruling that sought to limit access to the pill. In a statement, the government argued that the decision has far-reaching implications not only for access to abortion pills, but also for the wider pharmaceutical industry.
If the ruling were to come into effect, the government said it would “lift the regulatory regime for mifepristone”.
In their brief, the anti-abortion groups that filed the lawsuit alleged that for “nearly a quarter century” the FDA and the drug’s maker, Danco Laboratories, “have blatantly flouted laws and applicable regulations, ignored holes and red flags in their own safety data, deliberately avoided court review and have consistently placed politics above women’s health.’
The government and Danco have stressed how binding the lower courts’ orders would be if they stand.
“Without a stay, the lower courts’ unprecedented nationwide order would disrupt the regulatory regime governing a drug that the FDA has determined to be safe and effective under approved conditions and that has been used by more than five million American women over the past two decades.” Attorney General Elizabeth B. Prelogar, representing the FDA, wrote in a second report.
In its response, Danco Laboratories said the plaintiffs’ argument would “radically overhaul standing case law.”
“If this lawsuit were about any other drug, there would be no debate that a group of doctors who  do not prescribe it and  relying on the statistical possibility of encountering a patient in need of follow-up care would be found to be inadequate,” the report said.
Adam Lipták and Pam Belluck contributed reporting.