In abortion pill hearing, Supreme Court sounds skeptical of challenge to mifepristone access

It's the first major abortion rights case since Roe was overruled.

A high-stakes hearing played out before the U.S. Supreme Court on Tuesday in a case that could reshape abortion access nationwide.

The justices considered a challenge to the Food and Drug Administration’s regulation of mifepristone, the first pill taken in a two-drug regimen for a medication abortion, which is the most common method of abortion in the country.

It is the first major reproductive rights case before the high court since Roe v. Wade was overturned in 2022. A decision is expected by the end of June.


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Justices ask how often abortion complication requires surgery

Erin Hawley, the attorney for Alliance Defending Freedom representing the plaintiffs, said they are "harmed" without an injunction of mifepristone because it may require them to treat people experiencing abortion complications and "take an unborn life."

Justice Ketanji Brown Jackson asked Hawley asked how often would it be that the plaintiffs have to complete the procedure "in the way that you are describing?"

Hawley said plaintiffs have treated people experiencing abortion complications "dozens of times" and even said treatment may require "scraping out a uterus". However, she did not provide specific numbers.


Kagan presses attorney for anti-abortion group on which specific doctor is injured

Justice Elena Kagan, continuing the court's interest in the plaintiff's standing to bring this case, pressed attorney Erin Hawley on her "conscience harm" argument.

"You need a person. You need a person to be able to come in and meet the court's regular standing requirements," Kagan. "So, who's your person?"

Hawley pointed to one doctor, Dr. Christina Francis, whose partner had to perform a dilation and curettage (or a D&C) due to a life-threatening emergency for a woman who had taken abortion medication. Kagan asked if the doctor stated her objection at that time, which Hawley said they did not.

"The way people with conscience objections do this is they make those objections known," Kagan said. "That may be harder, that may be easier in a particular context but most hospitals have mechanisms in place, routines in place to ensure the doctors who are allowed to do this in advance and are allowed to it at the moment."


Justices wonder why nationwide injunction of mifepristone is needed

Justice Ketanji Brown Jackson asked Erin Hawley, the attorney for Alliance Defending Freedom -- the group representing the plaintiffs -- if a nationwide reversal of the FDA's approval of mifepristone is needed and if the court can simply rule that doctors do not need to prescribe the pill if they have conscience objections.

"Do we have to entertain your argument that no one in the world can have this drug in order to protect your client?" the justice asked.

Hawley argued that given the "emergency nature," it is "impracticable" to not have a broader ban or block on access to the pill.

Justice Neil Gorsuch echoed Jackson's question and asked if it is enough for the court to rule on behalf of the plaintiffs not being required to prescribe the pill and why the court has to consider a universal injunction.


What Americans think of the abortion pill

Two-thirds of Americans (66%) said mifepristone should remain on the market in an ABC News/Washington Post poll conducted last year.

Plus, 72% of Americans said at the time that access to the drug should remain the same.

Overall, 78% of Americans said the decision whether to have an abortion should be left to a woman and her doctor rather than regulated by law. That view was shared by 58% of Republicans.

The poll (conducted 10 months after the fall of Roe) also found half of Americans thought the Supreme Court justices base their rulings mainly on their personal political opinions, not on the law. Before the abortion ruling, the public was divided 46%-45% on whether the justices' rulings were based mainly on the law or on their own political preferences.


Justices ask if anyone has standing to sue FDA over mifepristone

Justice Clarence Thomas asked Solicitor General Elizabeth Prelogar if there is anyone who would have have a legal right to sue in this case -- which quickly emerged as the first major topic of the court's questioning of the federal government. The FDA has claimed the current plaintiffs do not have standing, with Prelogar suggesting at the hearing that their relationship to people who use mifepristone is too speculative and remote.

Prelogar said there may be an instance where a "competing drug manufacturer might sue and claim that FDA approval of a drug creates a competitive harm or injury or injury in that sense."

Chief Justice John Roberts asked if there is a number of adverse events or a number of patients who go to the emergency room in which the arguments would change. Facing such questions, Prelogar responded by reiterating her view that these possibilities appeared to be too theoretical and detached from specific decision-making and the history of patients who have used mifepristone.