A revived legal challenge to the abortion pill mifepristone will be an early test for President Donald Trump’s administration and his appetite for further weighing in on reproductive health access in the US.
Three states were allowed to proceed
with a lawsuit
against the HHS and the FDA last week, resurrecting a case that the US Supreme Court unanimously rejected last year. Those states — Kansas, Idaho and Missouri — argue in part that FDA’s rules allowing for nationwide mailing of the pill, known as Mifeprex, fly in the face of state-level restrictions on abortion care.
The case gives the new administration a chance to chart its own path on mifepristone access, which was one of the few levers at former President Joe Biden’s disposal after
Roe v. Wade
was overturned.
The Supreme Court unanimously rejected a similar complaint brought by the Alliance for Hippocratic Medicine, an anti-abortion organization, for lack of standing. On Saturday, the FDA
moved to dismiss the latest complaint
, arguing that the states lack adequate venue to make their case.
Eva Temkin, a partner at Arnold & Porter who helped represent industry stakeholders filing an amicus brief in the first case, couldn’t get past the states’ decision to file the case in the Northern District of Texas.
“It seems difficult to understand how these states have a basis to sue in Texas,” she said in an interview. “It seems like these states, if they have a claim to raise, should do it in a forum with which they would have venue.”
But now it’s up to Trump and his DOJ to defend the case, with former Florida Attorney General Pam Bondi on track to lead the department. At her
confirmation hearing last week
, Bondi sidestepped a request by Sen. Cory Booker (D-NJ) to commit to defending the FDA against lawsuits involving mifepristone and the agency’s regulatory authority.
Bondi said that while she was “personally pro-life,” she would “not let my personal beliefs affect how I carry out the law.” Amanda Zablocki, a partner at Sheppard Mullin, said Bondi’s answer was not a clear position.
“That remains an open question in my mind,” Zablocki told
Endpoints News.
“It was vague enough that it gives her a lot of flexibility to come in and decide whether or not she’s going to staunchly defend.”
The FDA declined to comment on ongoing litigation. The Trump transition team did not respond to a request for comment prior to the inauguration, and the White House could not be reached on Tuesday.
One of the core features of the amended lawsuit is framing the FDA’s removal of in-person dispensing rules as a matter of states’ rights. The FDA removed the in-person requirement in 2021 and made the rule permanent in 2023. Laws in Kansas, Missouri and Idaho vary in their restrictiveness against mifepristone prescriptions.
“The FDA actions created a 50-state abortion drug mailing economy, undermining state abortion laws,” the plaintiffs wrote in their amended complaint. All three of Trump’s nominations to the Supreme Court in his first term voted in favor of overturning
Roe v. Wade
, which became a rallying cry for Democrats in political races across the country.
It’s unlikely to just be Republican attorneys general who challenge the FDA, Zablocki said. States in favor of preserving or expanding abortion access could also sue, as 12 did in 2023, arguing that mifepristone rules should be further relaxed to increase access.
“The question in my mind is, is the FDA going to look at these cases more holistically and develop a broader strategy, rather than kind of a whack-a-mole attempt at addressing each of these cases as they spring alive,” Zablocki said.
The previous mifepristone case drew condemnation from hundreds of biotech executives and investors, who signed on to an open letter condemning a 2023 decision from Judge Matthew Kacsmaryk of the Northern District of Texas, which overturned the approval of mifepristone. Both BIO and PhRMA
subsequently cheered
the case’s dismissal by the Supreme Court last year, saying it was a win for regulatory consistency that drug developers rely on.
Neither group immediately responded to a request for comment on the new lawsuit.