The 5th Circuit U.S. Court of Appeals heard a lawsuit last Wednesday, Sept. 9, that threatens patient access to mifepristone, a pill widely used to treat miscarriages and in medication abortions in combination with misoprostol, in Texas and every state in the country.
Louisiana’s attorney, Jorge Aguiñaga, argued on behalf of the state against the U.S. Food and Drug Administration and two drug manufacturers that mifepristone should be restricted to in-person pickup by patients at a hospital or medical office, which would cut off healthcare providers’ ability to mail or send mifepristone to a pharmacy for patient pickup.
That’s especially consequential in near-total abortion ban states like Texas, where telehealth with an out-of-state provider and mail or pharmacy prescription pickup is one of the few ways Texan patients can access the medication, Yaneth Flores of the pro-abortion nonprofit Avow Texas emphasized to the Chronicle.
The ban would result in Texans having to physically travel out of state to access abortion medication, which “would affect underrepresented communities the most,” Flores added, because travel is generally more costly than telehealth at home.
The two drug manufacturers, Danco Laboratories and GenBioPro, have argued that telehealth is just as safe as in-person prescription of mifepristone, and pointed to research that an in-person drug dispensing requirement is medically unnecessary.
The restriction of the drug could lead to more medical complications – not less, advocates say. “We are already in a really dire situation. We’re seeing a maternal health crisis, maternal mortality rates increase, infant mortality rates increase, sepsis rates increase,” Flores said. “It’s very dangerous to be pregnant in the state of Texas right now.”
Wednesday’s hearing had tricky legal context. In early May, the 5th Circuit sided with Louisiana and temporarily banned telehealth, mail, and pharmacy access to mifepristone. But in mid-May, the U.S. Supreme Court rolled back that ban, maintaining the status quo of legal access to mifepristone via mail and pharmacy until litigation about the issue has concluded.
The case is now widely expected to return to the Supreme Court. And because SCOTUS had already reversed the 5th Circuit’s first ban, the panel’s three judges questioned their own authority to “stay the stay,” or attempt to reverse the higher court’s injunction against their ruling.
Aguiñaga argued the case as one of Louisiana’s state sovereignty “to regulate abortion free from federal interference.”
“Louisiana is essentially trying to re-instate a medically unnecessary requirement nationwide, and their argument in doing so essentially boils down to an argument that Louisiana can’t enforce its own criminal laws,” Caroline Sacerdote, senior staff attorney at the Center for Reproductive Rights, explained to the Chronicle.
That’s also been the question regarding the so-far failed challenges to other states’ shield laws, which legally protect doctors in New York, California, and other states in providing abortion medication to Texan patients – much to the chagrin of top Texas Republicans.
“Louisiana should not be able to export its own restrictive policies to the rest of the country,” Sacerdote added. “If Louisiana gets what it is asking for in this case, that would impact care across the country, including in states that protect abortion care.”
Flores noted that the pending litigation and SCOTUS’s temporary ban reversal has confused both patients and providers alike. Cities like Austin could better provide public health education on what the law is “that really combats the misinformation that the state is already platforming and promoting,” they added.
“Lots of folks are already really blurry on what abortion law is currently. Many folks actually do believe that if they have an emergency situation, they can get the care that they need,” Flores said. “And unfortunately, that’s just not something we can promise folks, which is unfortunate and heartbreaking.”
This article appears in September 18 • 2026.
