What are the current federal court cases challenging mifepristone and their statuses?
Executive summary
A constellation of federal lawsuits continues to target the Food and Drug Administration’s regulation and approval of mifepristone, but the most prominent attack—Alliance for Hippocratic Medicine (AHM)—was dismissed by the U.S. Supreme Court on standing grounds, leaving FDA rules intact for now [1] [2] [3]. Several other active federal suits brought by states, manufacturers, providers, and advocacy groups remain pending in lower courts and on appeal, and a UCLA tracker lists a dozen cases of potential effect with nine still active as of its latest update [4].
1. Alliance for Hippocratic Medicine (AHM): the headline Supreme Court decision and its immediate effect
AHM, the 2022 challenge by anti‑abortion medical groups to FDA approval and later regulatory changes for mifepristone, produced a landmark procedural victory when the U.S. Supreme Court unanimously ruled on June 13, 2024, that the challengers lacked Article III standing—meaning the Court did not decide the merits and FDA’s conditions (including telemedicine and mailing) remained in force [1] [2] [3].
2. State‑led challenges seeking to reframe the fight in other courts
States have refiled or launched separate federal suits: Missouri (joined by Idaho and Kansas) refiled claims against the FDA; Louisiana sued over remote prescribing and mail distribution; and Texas and Florida filed a suit challenging the FDA’s initial 2000 approval and later relaxations—these state actions aim to resurrect or repackage challenges the Supreme Court declined to resolve and are active in various federal courts [5] [6] [7].
3. Manufacturer litigation and preemption claims: GenBioPro v. Raynes
GenBioPro, a U.S. manufacturer of generic mifepristone, sued West Virginia prosecutors arguing certain state restrictions are preempted by federal law and the FDA’s REMS; the district court dismissed the complaint but the company appealed and the case remains pending in the Fourth Circuit as of the latest reporting [8].
4. Provider and association suits over REMS and dispensing rules
Separate lawsuits brought by physicians and health associations challenge the FDA’s REMS and other conditions that they say create unnecessary barriers; examples include Chelius v. Becerra in Hawaii and related suits such as Bryant v. Stein and other provider challenges that were active or stayed pending developments in the nationwide litigation [8].
5. Parallel federal questions: EMTALA and administrative actions
Some litigation intersects with other federal statutes—cases like Idaho v. United States and Moyle v. United States raise questions about whether EMTALA preempts state bans that lack health exceptions, and the federal government has prompted renewed FDA review activity that legal trackers flag as consequential to access debates [7] [4] [9].
6. The practical legal landscape now: status quo preserved but vulnerabilities remain
Because the Supreme Court dismissed AHM on standing grounds rather than resolving the substance, FDA’s regulatory framework for mifepristone remains operative nationwide, but multiple lower‑court and appellate matters—state suits pressing alternative standing theories, preemption appeals like GenBioPro’s, provider challenges to REMS, and new citizen petitions noted by UCLA—mean litigation could alter access in discrete jurisdictions or create new appellate paths that might reach higher courts later [1] [8] [4].
7. What reporting shows — and what it does not
Reporting and legal trackers make clear which cases exist and which remain active or on appeal, but public sources do not uniformly list each docket’s up‑to‑the‑minute procedural posture; the UCLA tracker catalogs a dozen potentially consequential cases with nine active, legal briefs and appeals remain the primary vehicles to watch, and some state attorneys general have publicly vowed to continue litigation even after the Supreme Court’s 2024 standing ruling [4] [7] [10].