Last month the U.S. Supreme Court reinstated a U.S. Food and Drug Administration (FDA) rule that requires in-person visits for patients seeking medication abortion, eliminating patient access to the abortion pill mifepristone via telehealth. Last summer, a federal district court decision suspended the FDA rule during the pandemic, allowing providers to mail the pill to patients after a telehealth visit. While a recent study showed no difference in safety and efficacy, the ruling reignited political controversy around the subject of abortion and medication abortion in particular, leading the Trump Administration to request the reversal.

The lower court ruled that the in-person requirement “imposed a ‘substantial obstacle’ to abortion care that is likely unconstitutional” however, in his concurrence, Chief Justice John Roberts stated that the issue was not related to constitutionality, but whether the lower court had the authority to remove the restriction due to their own determinations related to the risks of COVID-19, when they should defer to entities with the appropriate “background, competence, and expertise to assess public health.” Justice Sonia Sotomayor and Justice Elena Kagan dissented the decision, stating that it places patients at risk, particularly minority and low-income populations, and puts “an unnecessary and undue burden on their right to abortion.”

Advocacy groups, providers, and policymakers are now requesting that the Biden Administration remove the previous Administration’s policy and FDA restriction. Meanwhile, even if the federal in-person requirement is removed, 19 states have their own in-person requirements, which will continue to prohibit the ability to provide medication abortion via telehealth.