Federal judge preserves telehealth abortion access but signals Louisiana could eventually win
A Trump-appointed judge in Louisiana stayed a case challenging the FDA's 2023 rule allowing mifepristone by mail, giving the agency six months to complete its own safety review -- but warned plaintiffs are 'likely to succeed on the merits.'
U.S. District Judge David C. Joseph ruled on April 7 that telehealth abortion access will remain unchanged for now, granting the FDA's request to pause a Louisiana lawsuit while the agency completes its own safety review of mifepristone.
The ruling preserves the status quo — patients can still consult a doctor virtually and receive mifepristone by mail, as the FDA authorized in 2023. But the 37-page opinion is not a victory for abortion-rights advocates. Joseph, a Trump appointee, wrote that plaintiffs are "likely to succeed on the merits" and warned that if the FDA doesn't act quickly, his calculus will change.
"Should the agency fail to complete its review and make any necessary revisions within a reasonable time frame, the Court's analysis — and the weight accorded to these factors — will inevitably change," Joseph wrote. He ordered the FDA to report on its progress by October 7, 2026.
What Louisiana wants
Louisiana Attorney General Liz Murrill sued to undo the FDA's 2023 change to mifepristone's Risk Evaluation and Mitigation Strategy (REMS), which removed the requirement that patients pick up the drug in person. That change opened the door to telehealth prescribing and mail delivery nationwide.
The state argues the FDA didn't adequately consider safety when it loosened access. A co-plaintiff, a Louisiana woman, alleges she was coerced into taking the drug by her boyfriend. Two mifepristone manufacturers — GenBioPro and Danco Laboratories — intervened in the case to defend their products.
Joseph was sympathetic to Louisiana's arguments about harm but ultimately deferred to the FDA: "It is FDA, not this Court, that possesses the expertise to evaluate scientific evidence and make public health judgments."
Murrill has indicated she will appeal.
Why it matters
Mifepristone is used in roughly two-thirds of all U.S. abortions. By the end of 2024, about one in four abortions were accessed via telehealth — a fivefold increase in just two years. In 2025, women in states with abortion bans were more likely to obtain pills through telehealth than by traveling to another state.
The drug has been available in the U.S. for more than 25 years. The FDA's 2023 REMS revision made it dramatically more accessible, particularly in states that restrict in-person abortion services.
What happens next
The case is paused, not dismissed. The FDA has until October to complete its review. The Trump administration has separately initiated its own FDA review of mifepristone's safety — a move critics, including the ACLU, characterize as based on "discredited anti-abortion propaganda" rather than science.
If the FDA restricts access through its review, Louisiana's lawsuit becomes moot. If it doesn't, Joseph's ruling makes clear he's prepared to act. Either path could reshape abortion access nationwide.