The Supreme Court on Friday ruled for the Biden administration to preserve legal access in most of the nation to an abortion pill that is part of the most common method of ending early pregnancies.
In an unsigned order, the justices blocked rulings by a Texas judge and the 5th Circuit Court of Appeals that could have sharply restricted use of the pills or taken them off the market entirely.
The vote was 7-2, with Justices Clarence Thomas and Samuel A. Alito Jr. dissenting.
More than five million American women have used mifepristone since the Food and Drug Administration declared it was safe and effective in 2000.
The decision sends the case back to lower courts with a signal that most of the justices believe this challenge to the abortion pill will fail in the end.
The case posed the most important abortion question to reach the high court since last year’s 5-4 decision that overturned Roe vs. Wade and the constitutional right to abortion.
Though the three President Trump-appointed justices — Neil M. Gorsuch, Brett M. Kavanaugh and Amy Coney Barrett — had voted to overturn Roe last year, they joined the court’s liberals and Chief Justice John G. Roberts Jr. to stay the Texas court rulings.
Since last year’s overturning of Roe, Texas and a dozen other Republican-led states have essentially made abortion illegal and prohibited doctors from performing surgery or prescribing abortion pills.
The ruling by a Texas-based judge had threatened access to mifepristone in the rest of the nation where abortion remains legal.
The threat to the abortion pills arose in Amarillo, Texas last fall. A group of anti-abortion advocates that included doctors set up an office there and filed a lawsuit to challenge the safety of mifepristone.
The abortion pill had been used widely in Europe before the FDA approved its use in 2000. When taken in combination with misopristol, the drugs cause cramping and bleeding, but serious complications are “exceedingly rare,” the agency said.
Based on the safety record, the FDA relaxed the regulations on its use in 2016. Since then, patients need only a single visit to a healthcare provider, and they may use the medication through 10 weeks of a pregnancy, up from seven before. Soon after Biden became president, the FDA approved sending the pills through the mail.
But as widely predicted, U.S. District Judge Matthew Kacsmaryk, a Trump appointee, ruled for the anti-abortion activists and revoked the FDA’s approval of the drug.
The Justice Department immediately appealed to the 5th Circuit Court. While one appellate judge would have put Kacsmaryk’s entire decision on hold, two others agreed with part of the judge’s ruling and suspended the FDA’s regulations from 2016 and beyond.
Biden’s Solicitor General Elizabeth Prelogar sent an emergency appeal to the high court and urged the justices to block the lower court rulings.
She said the abortion pills have a safety record of more than 20 years, and no federal judge had overruled the FDA’s judgment about the safety of a drug.