Louisiana Challenges Biden-Era Policy That Expanded Mail-Order Abortion Pills
A federal hearing in Louisiana could determine whether abortion pills may continue to be shipped nationwide without an in-person doctor visit, a policy implemented under President Biden’s Food and Drug Administration that pro-life advocates argue has undercut state abortion restrictions.
Magistrate Judge David Ayo is set to hear arguments from the state of Louisiana, which is challenging FDA regulations that removed the longstanding in-person dispensing requirement for the abortion drug mifepristone. Louisiana contends the rule change has enabled the widespread mailing of abortion pills into states where medication abortions are banned and is asking the court to block the policy while the case proceeds.
Erik Baptist of Alliance Defending Freedom, representing Louisiana, called the lawsuit one of the most consequential pro-life cases since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade. He argued that while Dobbs returned abortion policy to the states, the federal government effectively sidestepped that outcome by expanding access to mail-order abortion drugs.
The lawsuit, filed in November, also includes Rosalie Markezich, who alleges that her former boyfriend coerced her into taking abortion pills that he ordered online. Louisiana officials claim that the removal of the in-person requirement has resulted in hundreds of illegal medication abortions each month within the state.
States such as California and New York have enacted shield laws protecting providers who prescribe abortion pills across state lines from being extradited to states where such prescriptions violate local law. Louisiana argues that these measures, combined with the FDA’s regulatory changes, have created legal conflicts between federal policy and state abortion bans.
The Justice Department has asked the court to dismiss the case, maintaining that the FDA’s mail-order policy does not override state law and that reinstating the in-person requirement could interfere with an ongoing safety review of mifepristone. The Department of Health and Human Services has declined to comment on the pending litigation.
Senator Bill Cassidy of Louisiana has publicly urged the current administration to restore the pre-COVID in-person dispensing requirement. Meanwhile, polling cited by pro-life groups indicates that many Republican primary voters favor stricter federal oversight of mail-order abortion practices ahead of the 2026 midterm elections.
The case could shape how states enforce abortion laws in the post-Dobbs landscape and whether federal drug regulations limit states’ ability to restrict medication abortions within their borders.