SCOTUS Decides to Extend Telehealth Access to Abortion Care: FAQs on Preventive Care and Bodily Autonomy

On May 14, at 5 PM, the Supreme Court of the United States (SCOTUS) allowed the abortion pill mifepristone to remain available while it pauses lower court rulings restricting access, further intensifying debates over reproductive health care and bodily autonomy.

Here are several FAQs related to the recent SCOTUS decision.

1. What did the Recent SCOTUS Action Change About Mifepristone Access?

On May 1, the New Orleans-based United States Court of Appeals for the Fifth Circuit issued an appeal restricting access to the abortion drug mifepristone. The appeal moved to prohibit women from receiving their prescriptions by mail or from a pharmacy,¹ with Louisiana arguing that allowing women in the state to receive mifepristone via telehealth circumvents its strict abortion ban.

The 2 manufacturers of the drug, Danco Laboratories and GenBioPro, filed a request with SCOTUS to enact an administrative stay or pause the Louisiana federal court’s ruling. On May 2, Associate Justice Samuel Alito paused the appeal until May 12 at 5 PM EDT. The 2 pharmaceutical companies asked again and were granted an extension of the administrative stay until May 14 at 5 PM EDT by the same judge.

Freezing Louisiana’s order would preserve telehealth prescriptions and mail receipt of the medication until the FDA completes a safety review or is delivered to SCOTUS for a full review.¹ However, mifepristone was approved by the FDA over 2 decades ago, in September 2000, for medical termination of pregnancy through 7 weeks of gestation and extended to 10 weeks in 2016. Mifepristone is deemed safe when used as indicated and directed, and consistent with the risk evaluation and mitigation strategy (REMS) program.²

This decision is “not rooted in any kind of science or medicine. We have more than 25 years of history using this medication in the US alone….and it's extremely safe, and it works well,” Sally Rafie, PharmD, founder of the Birth Control Pharmacist, said in an interview with The American Journal of Managed Care^® (AJMC^®). “It’s really happening because of other political or religious reasons.”

Yet Louisiana claims mail-order access to mifepristone has injured its sovereignty because it undermines the state’s strict abortion ban. The state also claimed to have accrued financial costs for women who took the pill and had to be escorted to the emergency department, thus contributing to the state’s growing Medicaid bill.¹

2. How Does Telehealth Factor Into Abortion Access Now?

Mifepristone plus misoprostol is the most common combination used for a medical abortion in the US. Approximately 1 in 4 abortions are prescribed via telehealth nationally. Last year, surveys estimated that more medical abortions were obtained via telehealth for women in the most restrictive states than traveling to other states.³

Telehealth access to mifepristone prescriptions has alleviated high costs and mental and logistical burdens for women seeking care in states with strict bans. “Telehealth is really critical for some patients, whether they're in a restrictive state or not,” Rafie said.

In a post-Dobbs society, numerous states have enacted strict abortion bans that prohibit the prescription and use of medical abortions after a certain period of gestation. These rigid bans start as early as 6 weeks in some states and are prohibited in over 10 states.³

However, the removal of in-person requirements to receive mifepristone predates Dobbs v Jackson, as an act to “reduce burden” on the health care delivery system during the COVID-19 pandemic.¹ In January 2023, the FDA modified the REMS program, permanently removing the in-person requirement for mifepristone and the generic version Mifeprex (mifepristone; Danco Laboratories).

Should access to telehealth abortion care be removed, women seeking care will likely face financial challenges, especially those with limited resources. Pre-Dobbs evidence cited that of 675 patients assessed, 42% experienced catastrophic health expenditures (CHE) to access abortion care.⁴

“If a patient is in a state where there are restrictive policies, it's going to be critical for them,” Rafie said. “It might be the only way they can access this care.”

3. How Are Social Determinants of Health (SDOH) Shaping Reproductive Access Disparities?

SDOH are key indicators of an individual’s ability to access care. Should the REMS modification of 2023 be overturned, patients already disproportionately disadvantaged will be impacted the most, Rafie said.

“People who have the time and the money and the resources, they're still able to find the evidence-based care and get the care that they need,” she said. “But the people who don't have those same resources are basically out of luck; that's not what we want.”

Women who must travel out-of-state for care were also found to incur even greater CHEs.⁴ Costs, outside of the care itself, like transportation, accommodation, and childcare, can also hinder those with limited resources from obtaining the care they need. Additionally, medically-based racism and bias play a significant role in access to care, especially for Black and Brown women.

“We have a long and deep history of medical racism in this country, which means that health care providers routinely dismiss or ignore the concerns or preferences of Black and Brown patients,” Elizabeth Ling, JD, MSW, associate director of legal services for the women’s health advocate group, If/When/How, said in an interview with AJMC.

But this bias isn’t solely limited to abortion care and access.

4. How Do State Laws Shape Reproductive Autonomy Beyond Abortion?

Recently, in Florida, a pregnant woman in labor was made to appear in court virtually for refusing a nonemergency cesarean section (C-section).⁵ Cherise Doyley, a Black mother of 3, had only had C-sections before and wanted to try for a vaginal delivery. Upon admittance, her doctors expressed concern about the risk of a uterine rupture, which was less than 2%, and encouraged an emergency C-section, which she denied persistently. After laboring for several more hours, a nursing supervisor informed her that she would be appearing virtually in court for failing to agree to a C-section.

Doyley’s experience “highlights the hypocrisy of when the state and its agents choose to use state power to interfere with someone's medical decision,” Ling said. She also claimed that the state’s wielding of power over women’s autonomy, especially in Doyley’s case, is “inhumane and alarming,” but “not surprising,” given the country’s history of medical bias and racism.

“Pregnant people know what is best for them, right? And the state making decisions about someone's body and future is always a horrifying overreach,” Ling said.

5. What Is the Broader Trajectory of Reproductive Autonomy in the US?

Rafie and Ling agree that states should not be able to govern women’s access to reproductive health or bodily autonomy. In a post-Dobbs era, decisions related to abortion access and autonomy are not made with women in mind.

If the United States Court of Appeals for the Fifth Circuit appeal is upheld, the impact will be another setback for decades of women’s rights advocacy, Rafie said. However, many organizations and providers are prepared to prescribe misoprostol-only abortion care. Studies have put its efficacy at approximately 80% or higher when used alone.⁶ It is also used in countries where mifepristone is banned.

Misoprostol offers a circumvented avenue for those seeking care, should the appeal withstand it, as it’s not formally approved by the FDA for abortion care, thus avoiding pertinent scrutiny from advocacy groups and policymakers. Regardless, the current political landscape is continuing to oppress women’s rights to essential care and revoke their bodily autonomy.

“Restrictions make it impossible for people to access the care that they need, and they only add to the stigma and atmosphere of illegality that fuels criminalization,” Ling said. “I would say what's at stake right now is, quite frankly, people's lives and their liberty.”

Tune in next week for more in-depth insights into this issue on our new YouTube series, Beyond the Clinic.

References

1. Howe A. Court extends temporary order allowing access to abortion pill by mail. SCOTUSblog. May 11, 2026. Accessed May 12, 2026. https://www.scotusblog.com/2026/05/court-extends-temporary-order-allowing-access-to-abortion-pill-by-mail/

2. Questions and answers on mifeprex. FDA. April 8, 2026. Accessed May 12, 2026. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation

3. Mulvihill G, Schoenbaum H. Court restricts abortion access across the US by blocking the mailing of Mifepristone. AP News. May 1, 2026. Accessed May 13, 2026. https://apnews.com/article/abortion-pills-mail-louisiana-ruling

4. Grossi G. Financial, psychological burden of abortion care in US raises calls for expanded insurance. AJMC. November 13, 2024. Accessed May 13, 2026. https://www.ajmc.com/view/financial-psychological-burden-of-abortion-care-in-us-raises-calls-for-expanded-insurance

5. Yurkanin A. Inside a court hearing that decided how she’d give birth. ProPublica. March 20, 2026. Accessed May 13, 2026. https://www.propublica.org/article/florida-court-hearing-c-section

6. Sherman M, Mulvihill G. Supreme Court restores access to abortion pill mifepristone through telehealth, mail and pharmacies. AP News. May 5, 2026. Accessed May 13, 2026. https://apnews.com/article/abortion-pills-mifepristone-supreme-court-louisiana