SCOTT SIMON, HOST:
A panel of judges in Louisiana has ended telemedicine access to the abortion pill mifepristone. Yesterday's ruling applies nationally and goes into effect immediately. It's likely to be appealed to the U.S. Supreme Court. Already, one company that makes the drug has filed for an emergency stay. NPR's Selena Simmons-Duffin joins us. Selena, thanks for being with us.
SELENA SIMMONS-DUFFIN, BYLINE: Good morning, Scott.
SIMON: And first, what was the Louisiana case about?
SIMMONS-DUFFIN: The case was brought by the state against the Food and Drug Administration. Their argument centered around the FDA's decision to remove an in-person requirement for patients receiving mifepristone, one of the medications used for abortion and the management of miscarriages. For decades, patients had to physically go to a clinic or a doctor's office and get the medicine. FDA changed that in 2023 so patients could have the doctor's visit online or over the phone and then receive the medication in the mail.
Louisiana has an abortion ban. They argued that FDA allowing mifepristone through the mail undermined their ban. A district court judge put the case on hold in April. Louisiana appealed that decision to the 5th Circuit Court of Appeals, and a panel of judges on that court agreed with the state, which means that telemedicine access to mifepristone has just ended for the whole country, effective immediately.
SIMON: What does this ruling mean across the country?
SIMMONS-DUFFIN: Yeah. You know, this is a really big deal. First of all, a decision from a panel of judges in New Orleans changed how Americans all over the country can access an FDA-approved medication. That's unprecedented. In terms of abortion access, this severely restricts access in states with abortion bans, but it also affects people in states like California, Maryland, Massachusetts, who have come to rely on telemedicine too. In the almost four years since the Supreme Court overturned Roe v. Wade, telemedicine abortion has grown. It's a big part of the reason why the overall number of abortions hasn't gone down at all nationally, despite the state bans.
Mifepristone has been found to be safe by FDA. It's been used by something like 7 million patients since it was approved in 2000. And doctors say the in-person requirement is not medically necessary, but now that requirement is back. There is a medication abortion protocol that uses only misoprostol, which is another medication. So doctors could pivot to providing that through telemedicine instead. It's just really hard to know how this is going to go. It's just happened so quickly.
SIMON: Selena, I gather you've talked to many people who've used telemedicine to get mifepristone. What have you learned?
SIMMONS-DUFFIN: You know, one significant thing is that telemedicine has become key for access in remote and rural areas all over the country. I talked to a woman named Julia (ph). We're not using her last name because she fears professional repercussions for sharing her story. In 2024, she lived in a remote part of California in the Sierra Nevadas.
JULIA: I was pregnant - was not planned. Did not want to keep it.
SIMMONS-DUFFIN: It was winter, and she was in an area where roads were often unsafe. There were possible landslides. There were no OB-GYNs nearby, so she used Planned Parenthood remotely and received the medication in the mail along with instructions.
JULIA: It was very, very clear, easy to understand. I never, like, was unsure of what to expect.
SIMMONS-DUFFIN: She says she's really grateful she had that option.
SIMON: And, Selena, we have to ask in - coming up to the midterm elections, are there political implications?
SIMMONS-DUFFIN: Oh, yes. Democrats have come out swinging after the appeals court decision. Washington Senator Patty Murray called it, quote, "infuriating and infantilizing." Many Republicans celebrated this decision. The Trump administration did not respond to my request for comment by airtime. President Trump has been pretty understated on abortion this term, and anti-abortion advocates have noticed and called for him to be more forceful. Here's Mary Ziegler. She's an expert in the legal history of abortion at UC Davis.
MARY ZIEGLER: This is the most consequential - potentially, in some ways - ruling we've had since Dobbs from a lower court. And that's going to require every politician to weigh in, and it doesn't really leave the Trump administration the option of doing nothing anymore.
SIMMONS-DUFFIN: She says this decision is going to send shockwaves through medicine, through politics, and we're just at the beginning.
SIMON: NPR's Selena Simmons-Duffin. Thanks so much.
SIMMONS-DUFFIN: You're welcome. Transcript provided by NPR, Copyright NPR.
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