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.


0

Government says anti-abortion doctors still have individual 'conscience protections'

Amid questions from the Supreme Court about who has standing to sue, Solicitor General Elizabeth Prelogar said the federal government believes individual doctors still have broad "conscience protections" if they oppose abortion and decline to provide such access in specific instances.

Prelogar reaffirmed that later in the hearing when some justices returned to the topic but noted that the government believes there are exceptions under the law.

Preolgar previously argued that the government does not believe states have standing in this case to sue.


Solicitor general argues supposed harm is 'unduly speculative'

Solicitor General Elizabeth Prelogar is arguing the supposed harm cited by the anti-abortion alliance is "unduly speculative" and hypothetical.

"Their theories rest on a long chain of remote contingencies," she said. "Only an exceptionally small number of women suffer the kind of serious complications that could trigger any need for emergency treatment. It's speculative that any of those woman would seek care from the two specific doctors who asserted conscience injuries."

Prelogar also asserted that if there were any safety consequences to a drug, the FDA could take action itself to fix it.


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.


Government defends FDA's expert judgments and warns of 'grave harm' for women

Pelogar, in her opening statement, contended the anti-abortion plaintiffs have no standing and defended the FDA's approval of the drug.

She warned that the relief sought by the Alliance for Hippocratic Medicine would both "severely disrupt the federal system for developing and approving drugs" and "inflict grave harm on women across the nation."


Most justices sound skeptical of restricting mifepristone

With the hearing wrapped, after about two hours of arguments, the Supreme Court appeared highly skeptical of the challenge to the mifepristone regulations brought by a group of anti-abortion doctors -- suggesting recent steps to ease access to the medication used by millions of American women may be allowed to stand.

At the heart of the case are steps taken by the FDA in 2016 and 2021 to roll back safety measures around the pill, which was first approved for use in 2000.

The plaintiff doctors -- who do not prescribe mifepristone, use mifepristone or otherwise perform abortions -- claim that wider availability of the drug was authorized improperly and has adversely impacted them, forcing them to care for women in emergency rooms suffering complications from the pill, often in violation of their conscience.

While conservative-leaning Justices Samuel Alito and Clarence Thomas were the most sympathetic to the legal challenges, for the most part, the court on Tuesday steered clear of openly second-guessing FDA’s scientific analysis of mifepristone.

A majority of the justices, across the ideological spectrum, expressed doubt during the arguments that the doctors had sufficiently demonstrated legal standing that they had been directly harmed by the FDA’s mifepristone rule changes.

“It makes sense for individual doctors to seek a [conscience] exemption but they already have that,” said liberal-leaning Justice Ketanji Brown Jackson. “What they are asking for here is -- in order to prevent them from ever having to do these kinds of procedures -- that everyone else should be prevented from getting access to that medication. How is that not overbroad?”

That view was echoed by conservative-leaning Justice Neil Gorsuch.

Erin Hawley, the attorney for the doctors, was repeatedly pressed to provide specific examples or testimony from a physician who had been forced to violate his or her conscience in treating a mifepristone patient but she could not do so.

Solicitor General Elizabeth Prelogar, defending the FDA on behalf of the Biden administration, warned of "profound harm" for women and for drug companies working with the FDA should the lower court's restrictions on mifepristone remain.

-ABC News' Lalee Ibssa and Devin Dwyer