Sorting out 3 major mifepristone court cases

A trio of federal court cases seek to restrict the availability of the abortion drug mifepristone. One lawsuit is set for a hearing in Louisiana on Wednesday, another suit was postponed until after the midterms, and a third has been kicked between federal judges in different states. 

The U.S. Senate confirmed Attorney General Todd Blanche last month, and he’s expected to focus on mifepristone as part of his job. Blanche told faith leaders in July that he would lead the Department of Justice in a way that ensures the Dobbs v. Jackson Women’s Health Organization decision overturning the right to abortion “becomes permanent in every single state.”

And still to come is the U.S. Food and Drug Administration’s review of mifepristone, a drug backed by mounds of scientific evidence pointing to its safety and efficacy. 

These legal challenges have been languishing in the courts for months, all with similar goals that can make sorting out developments confusing. 

Here’s a breakdown of the three major mifepristone lawsuits: 

Idaho, Missouri and Kansas v. FDA 

The lawsuit by three Republican attorneys general has its roots in one filed by conservative powerhouse firm Alliance Defending Freedom in November 2022 on behalf of the Alliance for Hippocratic Medicine, a group of anti-abortion doctors, against the FDA, the U.S. Department of Health and Human Services and the agencies’ top leaders over mifepristone’s safety and whether it should have been approved by the federal drug authority. 

The conservative group filed the case in a federal district court in Texas overseen by a judge with a history of anti-abortion rulings. The doctors asked him to reinstate an in-person dispensation requirement and limit mifepristone’s use from 10 weeks’ gestation to seven weeks, among other regulations that were on the drug before changes in 2016. The anti-abortion group also requested that the judge revoke the FDA’s 2000 approval of mifepristone entirely, alleging that the drug was unsafe and had a high rate of complications. 

U.S. District Judge Matthew J. Kacsmaryk granted the request, but the U.S. Supreme Court ruled in 2024 that the plaintiffs lacked standing. Republican attorneys general in Idaho, Missouri and Kansas intervened in the case, and Kacsmaryk moved the case to a Missouri court last year. 

Texas and Florida v. FDA 

Republican attorneys general Ken Paxton of Texas and James Uthmeier of Florida filed a federal lawsuit in a Wichita Falls, Texas, district court last year seeking to revoke federal approval of mifepristone entirely. The prosecutors relied on the Comstock Act of 1873, a dormant law that banned the mailing of anything deemed morally obscene such as abortion-related materials, to argue that mifepristone’s FDA approval should be nullified.  

This week, U.S. Chief District Judge Reed O’Connor paused the case’s proceedings until at least Dec. 1, Stateline reported. O’Connor, an appointee of former President George W. Bush, granted the FDA’s request that the lawsuit should be halted until the agency completes its current safety review of mifepristone. The states of Texas and Florida agreed to the delay.

Louisiana v. FDA 

In October, Louisiana Republican Attorney General Liz Murrill and a woman who said her ex-boyfriend coerced her into taking abortion medication sued the FDA, the Department of Health and Human Services and related officials in federal court, asking a Louisiana judge to require providers to give patients mifepristone only in person. Their request would effectively gut access to telehealth medication abortion, which has become the most common way to terminate early pregnancies since the Dobbs decision. 

A panel on the 5th U.S. Circuit Court of Appeals ruled in favor of the plaintiffs in May, Stateline reported, but the case was quickly blocked and appealed to the Supreme Court, which indefinitely halted the ruling. Drug manufacturers have intervened in the lawsuit. The full bench on the 5th Circuit is set to hear arguments in the case Wednesday in New Orleans. 

Stay tuned for a full primer from Stateline reporter Sofia Resnick in Tuesday’s edition of Reproductive Rights Today. 

Next on our Stories From The States podcast: Colorado ranchers join fight against fossil fuel companies 

In Colorado, officials in the city of Boulder and Boulder County have filed a lawsuit against Suncor Energy and Exxon Mobil. They are seeking monetary damages for costs incurred responding to wildfires, repairing transportation infrastructure, restoring watersheds and other devastation caused by climate change.

The officials are not seeking to regulate emissions or fossil fuel production, but they want the companies to help pay for harms Boulder contends were caused by their industry.

Some counties, however, have filed court records in support of Suncor and Exxon Mobil. When Deirdre Macnab learned hers was one of them, she rallied her fellow ranchers in support of Boulder’s cause.