Over 100 GOP Lawmakers Urge Supreme Court to Restore In-Person Mifepristone Rules

More than 100 Republican lawmakers urged the Supreme Court to reinstate restrictions on the abortion pill mifepristone. They warned that current rules allowing the drug to be mailed without in-person oversight have led to women being coerced and in some cases allegedly forced to take it.

The amicus brief, led by Sen. Bill Cassidy, R-La., Rep. Chris Smith, R-N.J., Senate Majority Leader John Thune, R-S.D., and House Speaker Mike Johnson, R-La., supports Louisiana's legal effort to restore an in-person dispensing requirement.

Lawmakers focused on allegations that loosened federal rules have enabled coercion. They argued the Biden-era policy "increases the risk of coercion," pointing to changes in the FDA's Risk Evaluation and Mitigation Strategy that removed the in-person requirement.

The brief highlighted several cases where abortion pills were obtained online or given without consent. Plaintiff Rosalie Markezich said her boyfriend ordered mifepristone from a California doctor and coerced her into taking it. "Had she visited a doctor in person, her boyfriend would never have been able to obtain the drugs he made [her] take," the brief stated.

Other incidents included a Louisiana mother who allegedly got abortion pills online for her teenage daughter, causing a medical emergency. Another involved a man accused of giving the drugs to a pregnant woman without her knowledge.

Lawmakers said such cases are more likely when pills can be prescribed online and shipped without face-to-face screening. They argued the policy weakens safeguards, puts women at risk and removes protections against abuse.

Cassidy called for immediate restoration of those safeguards. "Chemical abortion drugs kill innocent children and put mothers' lives at risk," he said. "Safeguards protecting against coercion, such as the in-person dispensing requirement, must be reinstated immediately. The Fifth Circuit got this right, and I urge the Supreme Court to affirm that decision."

The filing follows a ruling by the 5th U.S. Circuit Court of Appeals that sided with Louisiana and reinstated the in-person requirement during ongoing litigation.

Lawmakers said the FDA overstepped its authority by allowing mail distribution of abortion drugs. They claimed the policy conflicts with the Comstock Act, which bars mailing items "designed, adapted, or intended for producing abortion."

Smith noted the drug's risks, citing claims that more than one in 10 women face complications like infection or hemorrhaging. Lawmakers also said the FDA used insufficient safety data to drop the in-person rule, weakening adverse-event reporting and relying on limited data for expanded access.

The brief argued that skipping in-person visits blocks screening for conditions like ectopic pregnancies and hinders detection of coercion or abuse.

Mifepristone makers Danco Laboratories and GenBioPro filed emergency appeals to the Supreme Court over the weekend. They warned the lower court ruling has caused "immediate confusion and upheaval" nationwide.

Danco said the decision disrupts access and forces providers, pharmacies and patients to deal with shifting rules. GenBioPro said it ends mail-order access and disrupts a long-standing system.

The companies want the justices to pause the 5th Circuit order while the case continues. The Supreme Court is now considering those requests.

"There are legitimate concerns about these drugs putting women and girls at significant risk," Thune said. "I urge the Supreme Court to reinstate the safety guardrails that were in place before the Biden administration while the Department of Health and Human Services reviews these drugs."