Louisiana escalates abortion pill challenge

(The Center Square) − Louisiana Attorney General Liz Murrill said Wednesday the state will ask the 5th U.S. Circuit Court of Appeals to vacate the Food and Drug Administration’s 2023 mifepristone rules after a federal judge concluded Louisiana has standing to sue.Murrill’s response came after U.S. District Judge David Joseph declined, for now, to block the 2023 Risk Evaluation and Mitigation Strategy, or REMS, that removed the in-person dispensing requirement for mifepristone and allowed certified pharmacies to dispense the drug, including by mail. Instead, Joseph stayed the case and denied Louisiana’s request for preliminary relief without prejudice while the FDA completes its ongoing review of the drug’s safety rules.“Judge Joseph concluded that Louisiana has standing to sue and is likely to succeed in showing that the 2023 REMS is unlawful,” Murrill said in a statement. “He also concluded that Louisiana suffers irreparable harm every day that the 2023 REMS remains in effect. Accordingly, under binding 5th Circuit precedent, the only thing left to do is vacate the 2023 REMS pending the outcome of this litigation. We will ask the 5th Circuit to do so.”Joseph’s ruling stopped short of giving Louisiana that immediate victory, but it handed the state several findings Murrill can now use in her appeal.In his opinion, the judge said Louisiana had shown likely success on its challenge to the 2023 REMS, relying in part on earlier 5th Circuit criticism of the FDA’s handling of mifepristone safeguards. He also wrote that Louisiana had shown irreparable harm because the rule allegedly interferes with the state’s ability to enforce its own abortion laws and has imposed financial costs through Medicaid-covered emergency care.At the same time, Joseph said the public interest currently favors allowing the FDA to finish the safety review it has already begun rather than changing national policy through litigation before that process is complete. The FDA agreed in 2025 to conduct a comprehensive review of mifepristone’s REMS after pressure from a coalition of Republican attorneys general, including concerns about prior approvals and recent safety data.The ruling lands amid a broader Republican push against mail-order abortion pills. Last month, U.S. Sen. Bill Cassidy, R-La., and four Senate Republicans launched an investigation into mifepristone manufacturers Danco Laboratories, GenBioPro and Evita Solutions, demanding records on their compliance with FDA safeguards, supply chains and business practices.Cassidy and his colleagues argued the manufacturers have not been sufficiently transparent and raised questions about whether current REMS requirements are being followed.Louisiana’s lawsuit specifically targets the FDA’s January 2023 REMS changes, which formalized earlier pandemic-era loosening of the rules and allowed mifepristone to be dispensed without an in-person visit.The state argues that framework has helped out-of-state providers send abortion pills into Louisiana, where abortion is broadly prohibited. Drugmakers Danco and GenBioPro intervened in the case to defend the FDA rule and keep the medication available by mail.Supporters of the lawsuit said the decision validated concerns about the Biden-era FDA framework. Tony Perkins, former Louisiana lawmaker and president of the Family Research Council, said the ruling shows states are being “irreparably harmed and undermined by the ongoing existence of dangerous abortion drug trafficking enabled by President Biden’s FDA.”Abortion-rights advocates stressed that the judge did not immediately curb telehealth access but warned the case still threatens future access. Nourbese Flint, president of All* Above All, said the ruling “pauses an immediate threat to access” but leaves abortion care “subject to political interference or ongoing legal uncertainty.”