A Texas judge has given new momentum to a legal battle over mifepristone, the widely used abortion pill, by allowing a lawsuit challenging it to move forward. Attorneys general from Idaho, Missouri and Kansas filed a lawsuit aimed at limiting how mifepristone is prescribed and distributed.

States Challenge Mifepristone’s Use and Distribution

The states argue the pill, which can be mailed to patients, violates their local abortion laws.

Missouri’s law bans abortions after a fetus is considered “viable,” meaning it could survive outside the womb without medical assistance. However, there are no providers in Missouri currently offering this service. Kansas allows abortions up to 22 weeks of pregnancy, while Idaho has a complete ban on abortion at any stage.

The states also claim mifepristone can lead to physical and mental complications, resulting in healthcare costs they argue the states will have to cover.

The plaintiffs are pushing for the U.S. Food and Drug Administration, FDA, to step in, requesting the agency mandate in-person visits for patients and limit the pill’s use to the first seven weeks of pregnancy, rather than the current 10-week window.

Mifepristone has become a central tool for medical professionals in the wake of the Supreme Court’s 2022 decision to overturn Roe v. Wade, which ended the federal right to abortion. The drug, used in combination with a second medication, is now involved in approximately half of all abortions in the United States.

Legal History and Challenges

The current lawsuit follows a series of legal challenges against mifepristone. In November 2022, a group of doctors sought to have the drug banned, claiming the FDA ignored safety risks when it approved mifepristone. Texas Judge Matthew Kacsmaryk initially sided with the challengers, halting the drug’s approval. However, an appeals court reversed his ruling, reinstating the pill with some restrictions.

In 2024, the U.S. Supreme Court upheld broad access to the drug, ruling the challengers lacked standing to bring the case. Despite this, attorney generals from Idaho, Missouri, and Kansas have now taken up the issue, with similar claims but without the doctors.

Jurisdictional Dispute and Legal Strategy

The defendants in the case argue the lawsuit should be dismissed because the plaintiffs filed in the wrong jurisdiction, as there is no clear connection between the states involved and the state of Texas.

The American Civil Liberties Union, ACLU, warned the court’s decision could lead to more litigation aimed at restricting access to abortion medications, further challenging women’s reproductive rights across the country.