Last updated: 01/16/2025

On January 16, 2025, Judge Matthew Kacsmaryk ruled that the GOP-led states of Idaho, Missouri, and Kansas can proceed with their baseless case that threatens mifepristone and abortion access for more than 64.5 million people nationwide.

Kacsmaryk’s decision follows a long line of rulings where he allows anti-abortion zealots to proceed on baseless claims. Just last year, the U.S. Supreme Court ruled that the Alliance for Hippocratic Medicine (AHM) — an anti-abortion extremist group with tenuous connections to Kacsmaryk’s district—lacked standing to bring their case challenging access to mifepristone.

As a result, AHM dropped their suit at the end of 2024. Now Kacsmaryk says that the three anti-abortion attorneys general who joined the lawsuit last year can proceed with their claims challenging access to mifepristone—despite lacking any connection to the Texas district where the case is being litigated and without AHM involved.

The lawsuit seeks to either rescind approval of mifepristone, or in the alternative, restrict mifepristone access use by prohibiting:

• use after seven weeks of pregnancy (currently allowed up to 10 weeks)
• access for those under 18
• prescriptions via telemedicine, requiring three in-person visits instead
• prescriptions by nurse practitioners and non-physician health providers
• dispensing by retail pharmacies like CVS and Walgreens (limiting instead to providers’ offices/facilities only)
• generic versions of the medication

Alliance for Hippocratic Medicine v. FDA Court Case

This case was brought by anti-abortion extremists against the U.S. Food and Drug Administration (FDA) and heard by the U.S. Supreme Court in 2024.

Despite the group’s formal-sounding name, the AHM is a right-wing organization cooked up to push a national ban on medication abortion. The group has a curiously short and checkered history and you can read our deep dive on the group here.

The Case

Anti-abortion groups filed a federal lawsuit in a Texas district court challenging the FDA in its decades-old approval of mifepristone, one of the two medications typically used to provide medication abortion care.

The U.S. Supreme Court refused to protect access to mifepristone in its June ruling in 2024.

Despite decades of evidence showing that mifepristone is both safe and effective, a majority of the Court declined to validate that the FDA has broad authority to make decisions based on data and science—even regarding the access to medications like mifepristone.

Instead, the Court chose to send the case back down and issued a narrow ruling on a procedural issue, thus leaving mifepristone vulnerable to further attacks.

Why does this case matter?  

Medication abortion is the most commonly used method of abortion. Restricting mifepristone nationwide would have severe consequences on people’s ability to access critical abortion and miscarriage care.

Abortion access in our country is already in crisis after the Supreme Court overturned Roe v. Wade. If access to mifepristone is restricted, more than 64.5 million people will face increased barriers to abortion care, impacting their ability to make their own decisions about their lives, bodies, and futures.

Frequently Asked Questions

What is mifepristone?

Mifepristone is one of two pills typically used in medication abortion care.

For over 20 years, medication abortion has been a safe and effective FDA-approved option for ending an early pregnancy. It’s also used for miscarriage management.

How did this case even get in front of the Supreme Court in 2024? 

Anti-abortion groups filed this lawsuit specifically in a Texas district court with the expectation that it would be heard by Judge Matthew Kacsmaryk—a Trump-appointed judge whose nomination we opposed and who has issued many anti-immigrant, anti-LGBTQ, and anti-contraception opinions. Two of the key studies he cited in his ruling to severely restrict mifepristone have since been retracted because of unreliable findings.

Kacsmaryk also granted three anti-abortion state attorneys general (AG) requests to join the lawsuit in 2024, but the Supreme Court did not consider any of the state AGs arguments at the time.

I live in a state where abortion is legal. Will this affect me?

Yes. The case could result in significant restrictions being placed on the prescription and dispensation of mifepristone for medication abortion and miscarriage treatment, no matter where you live.

We have compiled a list of trusted partners if you need resources for accessing abortion care.

What’s the difference between medication abortion and birth control pills or emergency contraception? 

Birth control and emergency contraception (such as Plan B) prevent pregnancy, while medication abortion ends an early pregnancy and is used for miscarriage management.

Medication abortion (also known as abortion pills): Medication that is taken to end a pregnancy. The two medications typically used in the United States are mifepristone and misoprostol.

Birth control: There are many different birth control methods to prevent pregnancy. The most common include condoms, birth control pills, and IUDs.

Emergency contraception (also known as Plan B and the morning-after pill): The morning-after pill is an effective emergency form of birth control that is used to prevent pregnancy after sex.

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Alliance for Hippocratic Medicine v. FDA Legal Timeline

On October 11, 2024, three Republican attorneys general from Kansas, Missouri, and Idaho filed an amended complaint in Texas, presided over by Trump-appointed District Court Judge Matthew Kacsmaryk. Read More.

On June 13, 2024, the U.S. Supreme Court sidestepped the question of whether to further restrict mifepristone. While this is a relief, this baseless case should have never made it this far, and the fight is far from over. Read More.

On March 26, 2024, the U.S. Supreme Court heard oral arguments in this case. Read More.

On December 13, 2023, the U.S. Supreme Court agreed to hear this case. They will decide in 2024 if significant and unnecessary restrictions will be put in place on mifepristone, a safe and effective medication. Read More.

On April 21, 2023, the U.S. Supreme Court granted the Department of Justice’s request for a stay in Alliance for Hippocratic Medicine v. FDA, blocking lower courts’ dangerous rulings that would have severely restricted access to mifepristone. Mifepristone will remain available for now. This fight however, is far from over. Read More.

On April 14, 2023, the U.S. Supreme Court issued an administrative stay until Wednesday, April 19 at midnight on two lower court efforts meant to restrict access to medication abortion with mifepristone nationwide. Read More.

On April 13, 2023, the 5th Circuit Court of Appeals issued a partial stay in the federal case that could effectively ban mifepristone in all 50 states. While the court blocked large parts of Judge Kacsmaryk’s ruling meant to remove FDA approval of mifepristone, it also reinstated outdated and medically unnecessary restrictions on the safe and effective medication that were previously lifted by the FDA while litigation continues. The case is now likely to be appealed and eventually head to the U.S. Supreme Court. Read More.

Research

Behind the anti-abortion movement’s latest attempt to rig the game and attack reproductive freedom is the Alliance for Hippocratic Medicine (AHM)—a coalition of right-wing organizations cooked up to push for a national backdoor ban on medication abortion.

As Reproductive Freedom for All’s report explains, AHM isn’t a legitimate organization—they didn’t even exist until late 2021 and had no web presence until 2023.

The anti-abortion movement strategically designed and deployed AHM to carry out its baseless campaign to block access to mifepristone nationwide. Read More.