2026年5月14日 / 美国东部时间下午6:13 / 哥伦比亚广播公司新闻
华盛顿讯 美国最高法院周四维持了堕胎药米非司酮的邮寄渠道，暂时搁置了下级法院作出的禁止堕胎服务提供者通过远程医疗开具该常用药物并邮寄给患者的裁决。
最高法院未署名的这项裁决确保全美患者将继续广泛使用米非司酮，同时路易斯安那州针对美国食品药品监督管理局放宽该药物获取政策提起的诉讼将继续推进。
保守派大法官塞缪尔·阿利托和克拉伦斯·托马斯投下了反对票。
该命令出台前，联邦上诉法院本月早些时候恢复了一项FDA规定，要求米非司酮必须当面配药。生产该药物的两家制药公司——丹科实验室和GenBioPro曾警告称，该裁决给患者、堕胎服务提供者和药店造成了混乱，并请求最高法院推翻下级法院的裁决，继续允许患者通过邮寄方式获取该药。
但路易斯安那州官员敦促最高法院维持更严格的米非司酮配药规定，FDA已于2021年取消了该当面配药要求。他们警告称，取消当面配药规定将让外州服务提供者规避该州的堕胎禁令，导致该州境内出现超过1000例药物流产。FDA此前未就最高法院是否应维持米非司酮的邮寄渠道表态。
阿利托上周发布了一项临时命令，暂停上诉法院的裁决，供最高法院审议，但该暂停令将于周四到期。全体大法官现已同意继续通过邮寄渠道广泛获取该堕胎药。
大法官们的此次干预源于路易斯安那州去年对FDA提起的诉讼，该诉讼威胁将切断全美女性——包括堕胎合法州的女性——获取米非司酮的邮寄渠道。米非司酮需与另一种药物米索前列醇联合使用，以终止早期妊娠。
支持堕胎权的研究组织古特马赫研究所的数据显示，2023年，临床医师提供的所有堕胎手术中，65%使用了药物流产。该研究所发现，去年医护人员共提供超过110万例堕胎手术，其中包括在堕胎受限州通过远程医疗为患者提供的药物流产服务。
最高法院2022年推翻“罗伊诉韦德案”后，限制堕胎的州增至半数以上，保护堕胎药获取渠道的紧迫性骤然上升。在路易斯安那州，堕胎已被全面禁止，仅存在极少数例外情况。该州还在2024年颁布法律，将米非司酮和米索前列醇列为管制物质，并将无处方持有该类药物定为刑事犯罪。
但拜登政府在新冠疫情期间暂停了当面配药规定的执法，认定该药物“无需当面配药即可安全使用”，从而降低了米非司酮的获取难度。FDA于2023年正式允许通过远程医疗开具米非司酮并通过邮寄方式配药。
路易斯安那州官员在诉讼中称，由于这些举措，米非司酮大量涌入该州，每年导致“数千例”非法堕胎，并让该州的医疗补助计划损失了数万美元。
今年4月，一家联邦地区法院暂停了路易斯安那州对FDA的诉讼，以待FDA审查米非司酮的安全性。特朗普政府曾表示，尽管常规研究通常需要至少一年时间，但FDA计划“早于该时限”完成审查。
但路易斯安那州官员对该裁决提起上诉，美国第五巡回上诉法院同意暂时暂停2023年的政策，该政策允许远程开具米非司酮并通过邮寄方式配送。
在向最高法院提起的紧急上诉中，丹科公司和GenBioPro警告称，上诉法院的裁决造成了混乱，并有可能突然取消全美通过邮寄渠道获取米非司酮的途径。
“多年来，患者和临床医师一直依赖无需门诊就诊即可配给米非司酮的方式，尤其对于来自农村地区以及因交通、育儿或工作限制难以当面就医的女性而言，”GenBioPro称，“第五巡回法院的命令将直接导致全美患者可能面临紧急医疗护理的延误或无法获取、供应链中断以及随之而来的健康风险。”
与此同时，路易斯安那州官员称，尽管“罗伊诉韦德案”终结后该州的当面堕胎手术“几乎消失”，但药物流产数量却“飙升”。除医疗补助成本外，该州还表示已花费超过1.7万美元调查向路易斯安那州邮寄米非司酮的外州服务提供者。
在周四最高法院裁决的两份反对意见中，托马斯和阿利托辩称，米非司酮生产商并未证明，如果上诉法院的裁决维持不变，他们将遭受不可挽回的损害。
托马斯援引了1873年的《康斯托克法案》，该法案禁止邮寄与堕胎相关的药物和避孕药具，他写道，制药商“无权基于其犯罪性经营活动的利润损失而申请暂停不利的法院命令”。
阿利托辩称，没有迹象表明FDA计划执行当面配药规定。他还写道，米非司酮在路易斯安那州等州的持续供应“挫败了”州官员全面禁止堕胎的努力。
“岌岌可危的是一项旨在破坏我们在‘多布斯诉杰克逊妇女健康组织案’中的裁决的阴谋……该裁决恢复了每个州决定如何在其境内规范堕胎的权利，”阿利托在提及推翻“罗伊诉韦德案”的裁决时写道。
此次紧急上诉使米非司酮的可获得性问题第二次提交至最高法院。在最高法院推翻堕胎宪法权利数月后，反堕胎组织提起诉讼，挑战FDA2000年批准米非司酮的决定以及该机构为放宽其使用条件采取的多项举措。
这些组织辩称，FDA未能充分考虑该药物的安全性和有效性。包括美国医学协会和美国妇产科医师学会在内的主要医学协会均表示，在药物流产中使用米非司酮时，严重不良事件的发生率低于0.32%。
最高法院2024年以一致意见驳回了反堕胎医生和医疗团体提出的诉讼，裁定原告不具备起诉FDA的法律权利。
Supreme Court upholds mail access to abortion pill mifepristone for now
May 14, 2026 / 6:13 PM EDT / CBS News
Washington — The Supreme Court on Thursday maintained mail access to the abortion pill mifepristone, setting aside for now a lower court order that blocked abortion providers from prescribing the widely used drug through telehealth and shipping it to patients.
The high court’s unsigned decision ensures that patients nationwide will continue to have broad access to mifepristone while litigation in a challenge to the Food and Drug Administration’s relaxed policy for obtaining the drug brought by the state of Louisiana moves forward.
Conservative Justices Samuel Alito and Clarence Thomas dissented.
The order came after a federal appellate court earlier this month reinstated a FDA rule requiring mifepristone be dispensed in-person. Two pharmaceutical companies that manufacture the drug, Danco Laboratories and GenBioPro, had warned that the ruling caused confusion and chaos for patients, abortion providers and pharmacies, and they asked the Supreme Court to block the lower court’s decision and continue allowing patients to obtain the pills through the mail.
But Louisiana officials urged the high court to maintain the more stringent rule for obtaining mifepristone, which the FDA lifted in 2021. They warned that the end of the in-person dispensing requirement allowed out-of-state providers to evade its abortion ban, leading to more than 1,000 medication abortions in the state. The FDA did not take a position before the Supreme Court as to whether it should preserve mail access to mifepristone.
Alito had issued a temporary order last week that halted the appellate court’s decision while the court considered the matter, though his pause was set to expire Thursday. The full Supreme Court has now agreed to maintain broad access to the abortion drug through the mail.
The justices’ intervention arose out of a lawsuit Louisiana filed against the FDA last year that threatened to cut off mail access to mifepristone for women nationwide, including in states where abortion is legal. Mifepristone is taken with a second drug, misoprostol, to terminate an early pregnancy.
Medication was used in 65% of all clinician-provided abortions in 2023, according to the Guttmacher Institute, a research organization that supports abortion rights. More than 1.1 million abortions were provided by health care workers last year, a figure that includes medication abortions provided by telehealth to patients in states where abortion is restricted, Guttmacher found.
Preserving access to the abortion pill garnered newfound urgency after the Supreme Court overturned Roe v. Wade in 2022, after which more than half of the states imposed limits on the procedure. In Louisiana, abortion is banned, with narrow exceptions. The state also enacted a law in 2024 that designates mifepristone and misoprostol as controlled substances and criminalizes possession without a prescription.
But the Biden administration made mifepristone easier to obtain when it suspended enforcement of the in-person dispensing rule during the COVID-19 pandemic, finding that the drug “may be safely used without in-person dispensing.” The FDA formally allowed mifepristone to be prescribed through telehealth and dispensed through the mail in 2023.
In its lawsuit, Louisiana officials said because of those actions, mifepristone is flooding into the state, causing “thousands” of unlawful abortions each year and costing the state tens of thousands of dollars through its Medicaid program.
A federal district court had paused Louisiana’s case against the FDA in April while the agency reviews mifepristone’s safety. The Trump administration has said that while studies typically take at least a year to conduct, the FDA’s plan is to complete the review “sooner than that timeframe.”
But Louisiana officials appealed that decision, and the U.S. Court of Appeals for the 5th Circuit agreed to temporarily block the 2023 policy allowing mifepristone to be prescribed remotely and sent through the mail.
In emergency appeals to the Supreme Court, Danco and GenBioPro, warned that the appellate court’s decision caused chaos and threatened to abruptly eliminate nationwide access to mifepristone by mail.
“Patients and clinicians have, for years, relied on dispensing mifepristone without an in-clinic visit, particularly for women from rural areas and those for whom transportation, childcare, or occupational constraints make it difficult to see providers in person,” GenBioPro said. “As a direct result of the Fifth Circuit’s order, patients nationwide may face delay or denial of access to time-sensitive medical care, supply-chain disruptions, and attendant health risks.”
Louisiana officials, meanwhile, said that while in-person abortions have “virtually vanished” in the state following the end of Roe, medication abortions have “skyrocketed.” Beyond the Medicaid costs, the state said it has also spent more than $17,000 investigating out-of-state providers who shipped mifepristone into Louisiana.
In a pair of dissents to Thursday’s Supreme Court decision, Thomas and Alito argued the makers of mifepristone did not show that they will suffer irreparable injury if the appellate court ruling is left in place.
Thomas pointed to the Comstock Act, an 1873 law that banned the mailing of abortion-related drugs and contraceptives, writing that the drugmakers “are not entitled to a stay of an adverse court order based on lost profits from their criminal enterprise.”
Alito argued there is no indication the FDA is planning to enforce the in-person dispensing rule. He also wrote that the continued availability of mifepristone in states like Louisiana had “thwarted” state officials’ efforts to largely ban abortion.
“What is at stake is the perpetration of a scheme to undermine our decision in Dobbs v. Jackson Women’s Health Organization, … which restored the right of each State to decide how to regulate abortions within its borders,” Alito wrote, referring to the ruling that overturned Roe v. Wade.
The emergency appeals landed the issue of mifepristone’s availability before the Supreme Court for a second time. Months after the high court rolled back the constitutional right to abortion, anti-abortion rights groups filed a lawsuit challenging the FDA’s 2000 approval of mifepristone and several steps the agency took that eased the conditions for its use.
The groups argued that the FDA has failed to adequately consider the drug’s safety and effectiveness. Major medical associations, including the American Medical Association and the American College of Obstetricians and Gynecologists, have said that major adverse events occur in less than 0.32% of patients when mifepristone is used in medication abortions.
The Supreme Court in 2024 unanimously rejected the challenge from the anti-abortion rights doctors and medical groups, ruling that the plaintiffs did not have the legal right to sue the FDA.
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