Fifth Circuit reinstates in-person requirement for mifepristone, blocking mail-order access nationwide

The Fifth Circuit Court of Appeals rules on May 1, 2026, reinstating a nationwide requirement that mifepristone be obtained in person from a healthcare provider, effectively reversing the FDA's 2023 rule that allowed mail-order dispensing via telehealth. The ruling comes in a Louisiana lawsuit challenging the FDA's modification of the mifepristone REMS. Because the FDA rule applies federally, the Fifth Circuit's order blocks mail-order mifepristone in all 50 states — including states where abortion is legal — pending further court proceedings. Mifepristone manufacturers Danco Laboratories and GenBioPro ask Justice Samuel Alito to pause the ruling on an emergency basis. The ruling sets up a potential Supreme Court conflict between state abortion laws and federal drug approval authority.