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Supreme Court halts mifepristone restrictions until Wednesday

Ruling temporarily preserves abortion drug access status quo

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U.S. Supreme Court (Washington Blade photo by Michael Key)

The U.S. Supreme Court on Friday temporarily suspended orders from the U.S. District Court for the Northern District of Texas and the 5th U.S. Circuit Court of Appeals that would have restricted the nationwide sale and distribution of the abortion medication mifepristone.

The move by conservative Justice Samuel Alito will give the High Court until Wednesday to decide whether those restrictions will be kept in place pending the outcome of litigation over the case, Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration, which is now on appeal before the 5th Circuit.

Last week, Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas issued a stay of the FDA’s approval of mifepristone 23 years ago, effectively barring its sale and distribution nationwide.

On appeal, the 5th Circuit ruled late Wednesday night that access to the drug would be restricted, though not banned entirely, pending the outcome of the case.

But for the Supreme Court’s decision on Friday, which effectively preserves the status quo until next Wednesday, access to mifepristone would have required multiple doctors visits while telehealth consultations and mail order prescriptions would have been excluded.

Medication abortions account for more than half of all abortions performed each year in the United States. Mifepristone was first approved by the FDA in 2000, and the drug has since been proven safe and effective over more than two decades.

The Biden-Harris administration joined many legal observers in objecting to Kacsmaryk’s ruling, which these stakeholders considered an unlawful circumvention of the FDA’s Congressionally ordained power to evaluate the safety and efficacy of medications.

Kacsmaryk does not have formal training in science or medicine. Shortly after his ruling, 200 pharmaceutical industry executives issued an open letter arguing the move had cast such uncertainty around the drug approvals process that pipelines for new drug discovery would be threatened.

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U.S. Supreme Court

Supreme Court appears skeptical of arguments to restrict abortion pill access

Decision expected by June

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The Supreme Court as composed June 30, 2022 to present. Front row, left to right: Associate Justice Sonia Sotomayor, Associate Justice Clarence Thomas, Chief Justice John G. Roberts, Jr., Associate Justice Samuel A. Alito, Jr., and Associate Justice Elena Kagan. Back row, left to right: Associate Justice Amy Coney Barrett, Associate Justice Neil M. Gorsuch, Associate Justice Brett M. Kavanaugh, and Associate Justice Ketanji Brown Jackson. (Photo Credit: Fred Schilling, The Supreme Court of the U.S.)

Hearing oral arguments on Tuesday in FDA v. Alliance for Hippocratic Medicine, the U.S. Supreme Court appeared skeptical of arguments to curtail access to the abortion pill mifepristone.

A decision in the case is expected to come in June. The court’s most conservative justices, Samuel Alito and Clarence Thomas, signaled their support for the anti-abortion plaintiffs, who seek to prohibit telemedicine prescriptions and distribution of the pill by mail.

A ruling in their favor could also undermine the ability of the U.S. Food and Drug Administration to exercise its expert judgment on the safety and efficacy of medications without interference by courts ā€” which, by and large, are not qualified to adjudicate these questions.

Such concerns were relayed even by justices like Neil Gorsuch, who was appointed by former President Donald Trump, and who warned on Tuesday that the case might stand as ā€œa prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an F.D.A. rule or any other federal government action.ā€

Mifepristone was first approved in the year 2000. The drug, taken together with misoprostol, is the most commonly used method of terminating pregnancies in the U.S.

The justices’ questions also showed their skepticism toward plaintiffs’ arguments that concrete harms will result if the medication remains widely available. For instance, Gorsuch and Justice Ketanji Brown Jackson noted healthcare providers are already permitted to opt out of providing care to which they have moral objections.

Even if the Supreme Court rules in favor of the government, preserving access to mifepristone including through telemedicine and mail-order prescriptions, more than a dozen conservative states have banned the drug and implemented near-total abortion bans pursuant to the court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization.

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U.S. Supreme Court

Supreme Court declines to hear case over drag show at Texas university

Students argue First Amendment protects performance

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The U.S. Supreme Court justices on June 30, 2022. ((Photo by Fred Schilling of the U.S. Supreme Court)

The U.S. Supreme Court on Friday declined to hear a First Amendment case over a public university president’s refusal to allow an LGBTQ student group to host a drag show on campus.

The group’s application was denied without the justices providing their reasoning or issuing dissenting opinions, as is custom for such requests for emergency review.

When plaintiffs sought to organize the drag performance to raise money for suicide prevention in March 2023, West Texas A&M University President Walter Wendler cancelled the event, citing the Bible and other religious texts.

The students sued, arguing the move constituted prior restraint and viewpoint-based discrimination, in violation of the First Amendment. Wendler had called drag shows ā€œderisive, divisive and demoralizing misogyny,” adding that “a harmless drag show” was “not possible.”

The notoriously conservative Judge Matthew Kacsmaryk, who former President Donald Trump appointed to the U.S. District Court for the Northern District of Texas, ruled against the plaintiffs in September, writing that ā€œit is not clearly established that all drag shows are inherently expressive.”

Kacsmaryk further argued that the High Court’s precedent-setting opinions protecting stage performances and establishing that “speech may not be banned on the ground that it expresses ideas that offend” was inconsistent with constitutional interpretation based on ā€œtext, history and tradition.”

Plaintiffs appealed to the 5th U.S. Circuit Court of Appeals, which is by far the most conservative of the nation’s 12 appellate circuit courts. They sought emergency review by the Supreme Court because the 5th Circuit refused to fast-track their case, so arguments were scheduled to begin after the date of their drag show.

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U.S. Supreme Court

Alito renews criticism of the Supreme Court’s landmark marriage equality ruling

Obergefell decision allowed same-sex couples to marry around the country

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U.S. Supreme Court Justice Samuel Alito speaks at a conference in D.C. in December 2023 (YouTube screenshot)

Conservative U.S. Supreme Court Justice Samuel Alito on Tuesday renewed his criticism of the landmark 2015 ruling in Obergefell v. Hodges that established the nationwide constitutional right to same-sex marriage.

His remarks came in a 5-page order that was written in connection with the High Court’s decision not to hear Missouri Department of Corrections v. Jean Finney ā€” a dispute over whether a juror’s position that “homosexuality, according to the Bible, is a sin” can be the basis for striking him from an employment discrimination case that was brought by a lesbian.

The conflict, Alito argued, ā€œexemplifies the dangerā€ he foresaw in the Supreme Court’s same-sex marriage ruling, which was decided by a 5-4 majority with Alito among the justices who dissented.

Specifically, Alito raised concern in his statement that “Americans who do not hide their adherence to traditional religious beliefs about homosexual conduct will be ā€˜labeled as bigots and treated as suchā€™ by the government.'”

“The opinion of the court in [Obergefell] made it clear that the decision should not be used in that way,” the justice wrote, “but I am afraid that this admonition is not being heeded by our society.”

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