Appeals court hears challenge to Biden-era mifepristone mailing rules

On September 9, 2026, the 5th U.S. Circuit Court of Appeals heard arguments in Louisiana's challenge to Biden-era rules allowing the abortion drug mifepristone to be mailed. Louisiana argues the rules infringe on its sovereignty and strain its budget, citing 1,000 mail-order abortions monthly. The Trump administration has taken a procedural stance, refusing to defend the rules' merits while arguing Louisiana lacks standing, urging courts to wait for an ongoing FDA safety review.

5th Circuit mifepristone hearing

• ▪A three-judge panel of the 5th U.S. Circuit Court of Appeals questioned attorneys representing Louisiana, the Food and Drug Administration, and two mifepristone manufacturers and distributors on September 9, 2026.
• ▪The Louisiana lawsuit is one of three brought by anti-abortion state attorneys general challenging federal rules that permit abortion pills to be mailed to states where abortion is largely illegal.
• ▪The 5th U.S. Circuit Court of Appeals in New Orleans heard arguments on September 9, 2026, regarding Louisiana's challenge to Biden-era rules allowing the abortion drug mifepristone to be mailed.

Louisiana standing arguments

• ▪Judge Stephen Higginson of the 5th U.S. Circuit Court of Appeals expressed skepticism during the September 9, 2026, hearing regarding whether Louisiana has standing to sue.
• ▪Louisiana Solicitor General Ben Aguiñaga argued during the September 9, 2026, hearing that Louisiana experiences 1,000 abortions per month due to mifepristone mailed into the state.
• ▪Louisiana attorneys argued that mail access to mifepristone threatens the state's budget, citing two instances where women required Medicaid-funded follow-up treatment for drug complications.

State sovereignty claims

• ▪Louisiana attorneys argued that the Food and Drug Administration infringed on the state's right to ban abortion when the agency lifted the in-person dispensing requirement for mifepristone.
• ▪Louisiana argued that the Biden administration targeted the state by lifting mifepristone restrictions temporarily in 2021 and permanently in 2023, before the Supreme Court overturned Roe v. Wade in 2022.

Trump administration procedural stance

• ▪Judge Stephen Higginson of the 5th U.S. Circuit Court of Appeals expressed frustration over the Justice Department's refusal to offer an opinion on the merits of its own regulations.
• ▪Justice Department attorney Daniel Winik argued that courts should put mifepristone lawsuits on hold to allow the Food and Drug Administration to complete its ongoing safety review.
• ▪The Trump administration declined to defend the merits of the Biden-era mifepristone mailing rules, instead arguing that Louisiana lacks standing to sue.

FDA safety review timeline

• ▪A federal district court judge in Louisiana set an October 7, 2026, deadline for a status update on the Food and Drug Administration's safety review.
• ▪An administration official stated in June 2026 that the Food and Drug Administration's safety review of mifepristone is expected to take six months, with initial results potentially released earlier.

Blue state access implications

• ▪Katie Keith of Georgetown University argued that Louisiana's sovereignty arguments could trample on the rights of other states and impact medication abortion access in states where abortion is lawful.
• ▪Bella Pori of Reproductive Freedom for All criticized the Food and Drug Administration's failure to defend mifepristone's safety data, calling the ongoing safety review politically motivated.