Federal appeals court to consider Louisiana’s arguments for banning telehealth abortion

By Sofia Resnick, Stateline
September 4, 2026

Next week, the U.S. 5th Circuit Court of Appeals will consider Louisiana’s arguments for tightening federal policy around a common abortion and miscarriage drug. The primary target of Louisiana v. Food and Drug Administration and similar lawsuits against mifepristone is to end a Biden-era policy allowing abortion pills to be prescribed without an in-person visit with a provider. 

Medication abortion has become the most common form of abortion since Roe v. Wade was overturned in 2022, and telehealth prescriptions have continued to rise. The Biden administration loosened telehealth regulations in response to the COVID-19 pandemic. 

According to the Guttmacher Institute, a research think tank that supports abortion access, about 91,000 abortions were provided last year via telehealth prescription of abortion medication sent by mail to states with bans, including more than 9,300 in Louisiana.

Unpacking the fight over telehealth access to abortion medication

The FDA’s policy that mailing abortion pills is safe is unlikely to change in the next few months. The Trump administration has asked courts to delay the cases until it finishes a highly anticipated safety review about mifepristone. Numerous studies have concluded the medicine, which also is used to manage miscarriage treatment, is safe to prescribe through telehealth.

The case is one of three federal lawsuits — the others are being considered in Missouri and Texas — that could affect telehealth access to mifepristone nationwide.

“What this is doing is shutting down access to people in states that have committed to continuing to make abortion legal, and it will impact people in all 50 states,” said Melissa Grant, co-founder of carafem, which operates telehealth or physical health centers in 21 states where abortion remains legal.  

Earlier this year, the 5th Circuit ruled in favor of Louisiana’s motion to temporarily reinstate an old rule that patients could only receive mifepristone in person. The Supreme Court blocked that ruling, allowing telehealth abortion to continue as the case progresses. Whatever the appeals court rules this time, it will likely go back to the Supreme Court for a final ruling on Louisiana’s motion to reverse the policy until the case is decided on the merits.

Two years ago, the U.S. Supreme Court dismissed a lawsuit seeking to restrict mifepristone, brought by Alliance for Hippocratic Medicine, ruling the doctor-plaintiffs did not have proper standing to sue.

But Gabriella McIntyre, legal counsel of Alliance Defending Freedom, which is helping to defend Louisiana and one of its residents, a co-plaintiff who says her then-boyfriend coerced her into taking abortion pills, believes her team can persuade the 5th Circuit on Wednesday that Louisiana has proper standing.

The state is arguing in part that the 2023 FDA rule violated the 2022 Dobbs v. Jackson Women’s Health Organization decision by allowing for telehealth abortion and abortion by mail in states that banned abortion, like Louisiana. The FDA has so far argued Louisiana doesn’t have standing to sue and that it needs more time to review the drug’s safety. Two mifepristone drugmakers have intervened on the FDA’s side.

“If Louisiana wins this case, we’re going to see for the first time what it looks like under an actual Dobbs regime, where pro-life states get to enforce their laws protecting the unborn,” McIntyre said.

Abortion law expert Mary Ziegler said she expects the conservative 5th Circuit to side with Louisiana and that its justification will likely serve as a roadmap for the U.S. Supreme Court. 

“The 5th Circuit, they’re going to be writing almost like a proposed first draft for the U.S. Supreme Court,” Ziegler said. “Maybe the court has questions about standing again so, ‘We want to focus the hearing and the opinions on standing because we think that’s the hurdle that we have to overcome to get the five votes at the Supreme Court.’ Or do they talk about everything, and just sort of let the chips fall where they may?”

The Trump administration has reversed several Biden-era reproductive health policies, but not the 2023 rule, citing an ongoing review expected to be released after the November midterm elections. But recently confirmed Attorney General Todd Blanche recently promised faith leaders he will focus on restricting abortion pill access. 

Oral arguments will be livestreamed through the court system at 9 a.m. CDT on Wednesday.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.  

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