What Happens Next in the Mifepristone Abortion Drug Case

A federal appeals court upheld part of a Texas judge's decision. The Justice Department says it will ask the Supreme Court to intervene. Here's what's at stake.

WASHINGTON — Even though a federal appeals court ruled late Wednesday that it would allow the abortion pill mifepristone to remain on the market , she sided with a Texas federal judge in limiting distribution and access to the drug.

This ruling potentially makes it much more difficult for many many Americans to take the pill, part of a two-drug regimen that now accounts for more than half of abortions in the United States.

Here's what's to and what might happen next.

What's at stake?

The US Court of Appeals decision United for the Fifth Circuit, in New Orleans, overturned the most controversial part of the decision by Judge Matthew J. Kacsmaryk of the Northern District of Texas, who said last week that the Food and Drug Administration had improperly approved medication.

But the court left in place parts of Judge Kacsmaryk's decision that could severely restrict access to mifepristone nationwide, further complicating a case already thorny. The ruling essentially takes time back to 2016, when the F.D.A. added a series of guidelines making it easier to access the pill, including preventing patients from receiving the drug in the mail.

Experts say this would have consequences important: patients would have to miss work, pay travel expenses to get to a doctor's office, and face the stigma of going in public to have an abortion, rather than getting the pills discreetly at the house.

It could also have implications far beyond abortion, paving the way for individual medical providers to sue the F.D.A. challenge all kinds of drugs. Legal experts said the Fifth Circuit ruling could open a legal avenue for medical providers anywhere in the country to challenge government policy that may affect a patient.

Will he then?

The Justice Department said Thursday it would seek emergency assistance from the Supreme Court. He did not give a timeline for his request to the court, but it could happen at any time.

The emergency request would be given to Judge Samuel A. Alito Jr., who oversees the Fifth Circuit.

The Supreme Court may, but is not required to, review the case.

If taking the case, Judge Alito is likely to seek a response from the plaintiffs first. The plaintiffs, a group of anti-abortion organizations and doctors, claimed the pill was unsafe and argued that the agency's approval process for the drug was flawed. The timetable and deadline for responding would be set by the court.

The government could then respond to the plaintiffs. The F.D.A., pushing back against the plaintiffs' claims, countered that the drug was properly approved more than 20 years ago and was safe. Although only one judge has the power to make a decision in an emergency application, by tradition it will almost certainly go to the full court for review.

If the Supreme Court dismisses the case, the Fifth Circuit decision stands.

What about the Washington State case?

A second abortion pill case is pending in federal court in Washington state.

Less than an hour after Trump-appointed Judge Kacsmaryk issued his ruling, Judge Thomas O. Rice of the U.S. District Court for the Eastern District of Washington, an Obama nominee, ordered the F.D.A. Maintain ...

What Happens Next in the Mifepristone Abortion Drug Case

A federal appeals court upheld part of a Texas judge's decision. The Justice Department says it will ask the Supreme Court to intervene. Here's what's at stake.

WASHINGTON — Even though a federal appeals court ruled late Wednesday that it would allow the abortion pill mifepristone to remain on the market , she sided with a Texas federal judge in limiting distribution and access to the drug.

This ruling potentially makes it much more difficult for many many Americans to take the pill, part of a two-drug regimen that now accounts for more than half of abortions in the United States.

Here's what's to and what might happen next.

What's at stake?

The US Court of Appeals decision United for the Fifth Circuit, in New Orleans, overturned the most controversial part of the decision by Judge Matthew J. Kacsmaryk of the Northern District of Texas, who said last week that the Food and Drug Administration had improperly approved medication.

But the court left in place parts of Judge Kacsmaryk's decision that could severely restrict access to mifepristone nationwide, further complicating a case already thorny. The ruling essentially takes time back to 2016, when the F.D.A. added a series of guidelines making it easier to access the pill, including preventing patients from receiving the drug in the mail.

Experts say this would have consequences important: patients would have to miss work, pay travel expenses to get to a doctor's office, and face the stigma of going in public to have an abortion, rather than getting the pills discreetly at the house.

It could also have implications far beyond abortion, paving the way for individual medical providers to sue the F.D.A. challenge all kinds of drugs. Legal experts said the Fifth Circuit ruling could open a legal avenue for medical providers anywhere in the country to challenge government policy that may affect a patient.

Will he then?

The Justice Department said Thursday it would seek emergency assistance from the Supreme Court. He did not give a timeline for his request to the court, but it could happen at any time.

The emergency request would be given to Judge Samuel A. Alito Jr., who oversees the Fifth Circuit.

The Supreme Court may, but is not required to, review the case.

If taking the case, Judge Alito is likely to seek a response from the plaintiffs first. The plaintiffs, a group of anti-abortion organizations and doctors, claimed the pill was unsafe and argued that the agency's approval process for the drug was flawed. The timetable and deadline for responding would be set by the court.

The government could then respond to the plaintiffs. The F.D.A., pushing back against the plaintiffs' claims, countered that the drug was properly approved more than 20 years ago and was safe. Although only one judge has the power to make a decision in an emergency application, by tradition it will almost certainly go to the full court for review.

If the Supreme Court dismisses the case, the Fifth Circuit decision stands.

What about the Washington State case?

A second abortion pill case is pending in federal court in Washington state.

Less than an hour after Trump-appointed Judge Kacsmaryk issued his ruling, Judge Thomas O. Rice of the U.S. District Court for the Eastern District of Washington, an Obama nominee, ordered the F.D.A. Maintain ...

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