Interested Parties Memo: Louisiana v. FDA Amicus Briefs

TO: Interested Parties FROM: American Civil Liberties Union DATE: February 24, 2026 SUBJECT: Urging Federal Court to Reject Abortion Opponents’ Efforts to Make it Harder for People to Get Medication Abortion, Preeminent Medical Associations, Former FDA Commissioners, Advocates for Domestic Violence Survivors and People with Disabilities, Reproductive Freedom Organizations, and Other Experts File Suite of Amicus Briefs On Feb. 24, a federal court in Louisiana will hear arguments in a lawsuit, Louisiana v. U.S. Food and Drug Administration (FDA), that threatens to imminently limit nationwide access to mifepristone, a safe and effective medication used in nearly two-thirds of U.S. abortions, as well as for miscarriage care. In a suite of amicus briefs filed in advance of the hearing, a range of experts — including the American College of Obstetricians and Gynecologists and other premier medication associations; nine former FDA Commissioners; the National Domestic Violence Hotline; disability rights advocates; and more than 100 organizations supporting people in need of abortion care — urged the court to deny this attempt to make it harder for people around the country to get medication abortion and miscarriage care. The lawsuit, filed by Louisiana’s attorney general and an individual plaintiff, seeks to end patients’ access to mifepristone through telemedicine — the method by which more than 1 in 4 people who have abortions obtain care today — by reinstating a medically unnecessary and extremely burdensome requirement that all patients travel in person to a health center for the sole purpose of being handed the medication, rather than filling their prescription by mail or at a local pharmacy. The court could rule any time after the Feb. 24 hearing, when it is scheduled to hear both Louisiana’s request for immediate restrictions and the Trump administration’s request to pause the case while it continues a sham FDA review that lays the groundwork for additional nationwide restrictions. The amicus briefs outline how this lawsuit — one of three pending cases brought by anti-abortion state politicians seeking nationwide restrictions on mifepristone — threatens to upend how essential reproductive health care is currently delivered to patients across the country. The briefs describe the wealth of peer-reviewed research over more than 25 years confirming mifepristone’s safety and efficacy, including when prescribed through telemedicine. The briefs also explain how mail and pharmacy access is a lifeline for patients who might otherwise struggle to access abortion and miscarriage care, including survivors of domestic violence, people with disabilities, and those living in rural areas or health care deserts. For some patients, being able to safely get their prescription at home, instead of being forced to travel long distances just to pick up a pill, can be the difference between getting the timely care that they need on the one hand, and, on the other, being forced to continue a pregnancy and have a child, or being forced to endure untreated miscarriage complications. Below are excerpts from key amicus briefs urging the court to deny Louisiana’s request to limit access to mifepristone nationwide: Expert Medical Associations, including the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the Society for Maternal-Fetal Medicine: “Mifepristone—whether dispensed in person or not—is extremely safe. More than two decades, hundreds of medical studies, and vast amounts of data have confirmed mifepristone’s safety and efficacy for abortion care and miscarriage management.” “Preserving access to mifepristone and expanding access to telehealth are both crucial steps to support vulnerable populations who face structural barriers to abortion care, including patients of color, patients of lower incomes, patients who are disabled, and/or patients who are living in rural areas or health care deserts. Telehealth allows such patients to avoid significant costs associated with travel to obtain care (such as transportation, gas, and lodging), childcare expenses, and lost wages—burdens that deter and delay abortion access. Telehealth also reduces delays in obtaining care because it enables patients to avoid long wait times at physical clinics—a particularly urgent concern since Dobbs v. Jackson Women’s Health Organization, as state abortion bans have increased demand for abortion care in many states where abortion remains lawful.” The National Domestic Violence Hotline and Legal Voice: “Restricting access to mifepristone will cause irreparable harm to the many Americans who face IPV [intimate partner violence], need abortions to protect their own health and safety, and face unique barriers to access this time-sensitive care because of the nature of abusive relationships. Abusive partners often exert control and maintain power within the relationship by undermining survivors’ autonomy to make reproductive decisions, limiting access to health care, and forcing pregnancy. Being forced to carry a pregnancy to term for lack of access to abortion care exposes survivors of IPV to a higher likelihood of further violence, poses significant health risks, and increases the chance of being trapped in violent relationships. The consequences of such entrapment range from heightened abuse during pregnancy to death. As difficult as it is for all survivors of IPV to escape abusive relationships and exercise their reproductive autonomy, IPV survivors of color—who already experience disproportionately high rates of unintended pregnancy and increased health risks—face systemic inequities that make doing so even more difficult.” “Reducing abortion access harms survivors. Research has shown a significant increase in IPV rates in areas with limited access to abortion, including Louisiana. Removing telemedicine options is especially harmful to survivors. The availability of telehealth, the ability to fill prescriptions at local pharmacies, and the ability to receive medication by mail are essential to survivors of IPV because these options reduce both the cost of abortion care and the barriers of having to pay for and arrange transportation, childcare, and time off work outside the surveillance of an abuser. Indeed, in-home medication abortion is often a survivor’s only option for abortion care because the survivor must obtain care without the abuser finding out. Having a variety of options for accessing that care—in one’s home via telehealth or from a local provider—helps survivors maintain safety and privacy.” Disability Rights Education and Defense Fund and Other Disability Justice Advocates: “Granting Plaintiffs’ requested relief would deepen the already substantial barriers disabled people face in accessing health care: physical inaccessibility, transportation limitations, financial strain, and entrenched medical bias. For many disabled people, telemedicine access to mifepristone is not mere convenience but a critical safeguard. Disabled people experience heightened rates of reproductive coercion and intimate partner violence, in part because reliance on others for daily assistance can compromise privacy and autonomy. Eliminating remote access would strip away a vital layer of safety and control.” Telehealth Abortion Providers, Sharing Stories From Their Patients, In Their Own Words: “[Patients’] accounts illustrate that without timely access, abortion care may be out of reach for many, and especially for those already navigating complicated demands of work, caregiving, and economic precarity. Telehealth addresses these constraints directly, allowing patients to obtain care quickly, safely, and privately, without sacrificing employment, income, or responsibilities to the families they already support.” “Amici’s patients described the telehealth services they received as ‘lifesaving’” care that provided meaningful intervention and support during moments when they felt scared or vulnerable[:] ‘I would have died if this pregnancy went through. My 3 other kids would be without a mother. Thank you for being there and not judging me.’ ‘You saved my life. I was scared and alone and I didn’t know what to do and I’m grateful to have these services. Without care I’m not sure what would have happened.’” “Beginning with the initial consultation, continuing through real-time support during the process, and extending into comprehensive follow-up care, many patients describe their telehealth abortion experiences as high-quality, trustworthy, and affirming, Patients shared: ‘During a very personal and challenging time, [Telehealth Provider] provided not only expert care but genuine compassion and support. From the first patient intake to the final follow-up, everyone made me feel seen, heard, and safe. The level of professionalism and attention to detail was unmatched. I’m incredibly grateful for their care and would recommend them without hesitation to anyone in need of top-tier medical support. They are so private & easy to work with! I loved it.’ [...] ‘[Telehealth Provider] offered care that felt personal, compassionate, and judgment-free. In a vulnerable moment, they made me feel safe, seen, and supported. Grateful beyond words.’” 100+ Reproductive Health, Rights, and Justice Organizations, including the ACLU Foundation: “Telehealth, which is an increasingly common method of healthcare delivery in general, is now a standard method of care for medication abortion, both in the United States and around the world. ... [T]elehealth care is individually tailored to each patient’s circumstances, with in-person testing or examination ordered when appropriate based on individualized patient screening. Rigorous studies from the past several years resoundingly reinforce that patients can be screened and counseled for medication abortion via telehealth as safely and effectively as in-person screening and dispensing.” “Abortion access saves lives, reduces maternal and infant mortality, narrows racial health disparities, and protects survivors of violence. Telehealth is the mechanism through which millions of patients access that care. Restricting it would not protect anyone; it would cause the gravest harm to those who can least afford it.” Medical Students for Choice: “[R]einstating the in-person dispensing requirement would have a profound impact on medical training and the future of the medical profession nationwide. Future medical professionals rely on learning the best, evidence-based practices to care for patients now and in the future. ... Louisiana’s attempt to impose its political preferences on the medical profession and patients nationwide would erect obstacles in the paths of medical students and undermine medical schools’ ability to provide future medical professionals with evidence-based, patient-centered education. Reinstating the in-person dispensing requirement risks creating gaps in medical education and diminishing the quality of medical care in this country for generations to come.” “Restrictive abortion laws have exacerbated maternal care deserts, including by impacting the choices of where medical students are able and willing to complete their education and training, and later work and reside. ... [S]tates with restrictive abortion laws are experiencing a ‘medical brain drain,’ in which many future physicians are choosing to study, and then practice, out-of-state. Even existing maternal healthcare providers are moving out of states with restrictive abortion laws in part due to fears of legal consequences for providing at times life-saving care, which has detrimental effects on maternal healthcare including for women who want to continue their pregnancies.” Nine Former FDA Commissioners: “If [Louisiana’s] position were adopted, it would upend FDA’s rigorous, well-established system for drug approvals, which relies on voluntary reporting by prescribing physicians for almost all drugs. … The orderly system that Congress and FDA have established would screech to a halt if litigants could weaponize the limitations of [FDA’s adverse-events] data to support successful challenges to drug approvals.” 19 States and the District of Columbia that Protect Access to Abortion Care: “If granted, [Louisiana’s] requested relief would increase costs to amici’s health systems, harm amici’s residents, and undermine amici’s sovereign policy decisions [to protect abortion access]. ... [M]any [amici States] have experienced a steep rise in demand at clinics from out-of-state patients after Dobbs. While providers have endeavored to meet the increased demand, the influx has stretched clinics past their already-strained capacity and has dramatically increased wait times for patients from both within and outside of their States. Eliminating access to medication abortion via telemedicine would deprive amici States of a critical tool in expanding capacity to meet this demand.” “[Removing the in-person dispensing requirement has] been critical to extending access for amici’s residents in rural and underserved communities where barriers to abortion and other forms of healthcare are most acute. The availability of abortion care by telehealth has reduced the impact of many practical and cost barriers that can make it difficult for many people to obtain an abortion—including childcare needs, missed work and resulting lost income, lack of insurance coverage, and travel costs and logistics, all of which increase with distance traveled.” Former Department of Justice Officials: “Adopting [Louisiana’s] erroneous interpretation of the Comstock laws would risk a profound destabilization of medical care. ... [I]t necessarily would affect in-person abortion and a broad range of other kinds of healthcare ... [including because] many abortion-inducing drugs and devices are used for non-abortion-related care. For instance, mifepristone is regularly used to treat miscarriages, and misoprostol is frequently used during labor and delivery.”