Local governments and leaders urge Supreme Court to defend access to abortion pill

WASHINGTON — With a coalition of 110 local governments and leaders, Public Rights Project is urging the U.S. Supreme Court to support access to the abortion drug mifepristone. In an amicus brief filed yesterday, the coalition opposes an appeals court ruling that would ban mail delivery and pharmacy availability of the drug nationwide.

The brief urges the Supreme Court to reverse the Fifth Circuit’s decision in Louisiana v. FDA, arguing that it ignored decades of scientific evidence and countless harms to families and pregnant people across the country. It also states the court is attempting to override local decisions. When the Supreme Court overturned Roe v. Wade, that put abortion policy in the hands of voters and elected officials, who have since protected abortion in 22 states and Washington, D.C.

“If this restriction stands, it will strain health systems and delay critical care for women,” said Jill Habig, founder and CEO of Public Rights Project. “At its core, this issue is about whether pregnant people have full rights in our society, and whether local communities and their elected leaders can make choices that reflect community values. We stand with the cities and counties courageously pushing back.”

On Monday, the Supreme Court paused the Fifth Circuit’s order, temporarily restoring mail and pharmacy access to mifepristone until Monday, May 11, at 5 p.m. EST.

If the decision is allowed to stand, local governments and leaders warn it will have immediate and far-reaching consequences for their communities, including:

• Increased health care costs: Communities that provide health care or emergency medical services will have to fund reproductive care for people who normally use telemedicine.
• Strain on health care systems: Requiring the drug to only be dispensed in-person will increase demand for in-person appointments, burdening public and community health systems and delaying care for all patients.
• Barriers to care for residents: Local governments, pharmacies and health care providers will be unable to facilitate safe, legal medication abortions in their own communities. 
• Impacts beyond abortion care: Mifepristone is also used in miscarriage management, meaning disruptions could affect a broader range of reproductive health care.

Louisiana sued the FDA in October 2025, aiming to stop the agency from allowing abortion providers to distribute mifepristone to patients by mail or via pharmacy.

Medication abortion accounts for nearly two-thirds of abortions in the U.S., and mifepristone has been used safely and effectively for over 25 years. Telehealth has become a critical tool for expanding access, particularly in areas without nearby providers.

If the Supreme Court fails to reverse the Fifth Circuit’s decision, local governments and leaders warn that the impacts will be felt nationwide, with the greatest burden falling on communities of color, low-income populations, rural residents and those experiencing intimate partner violence.

The full list of cities, counties and local leaders that joined is included in the brief.

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