The Republican-led states of Idaho, Missouri and Kansas can proceed with a lawsuit seeking to restrict the availability of the abortion pill mifepristone in the United States, a federal judge in Texas ruled on Thursday.
U.S. District Judge Matthew Kacsmaryk in Amarillo decided that the three states can continue their case against the U.S. Food and Drug Administration in his court, where they last year joined a lawsuit originally brought by anti-abortion groups and doctors.
Those original plaintiffs dropped their case after the U.S. Supreme Court last June found they did not have the necessary legal standing to challenge the FDA’s regulation of mifepristone. The pill, given FDA regulatory approval in 2000, is used in more than 60% of U.S. abortions.
Outgoing Democratic President Joe Biden’s administration had argued that the claims by the three states should be dismissed because, with the original plaintiffs gone, they had no connection to Kacsmaryk’s court.
But Kacsmaryk disagreed, deciding that the three states could – for now – pursue the revised lawsuit, and that venue disputes could be heard later.
The three states are challenging FDA actions that have loosened restrictions on the drug since 2016, including by approving it for use in the first 10 weeks of pregnancy, up from seven weeks, and allowing it to be prescribed by telemedicine and dispensed by mail.
“Venue remains disputed here and should be properly dealt with at a phase where each party may fully argue the issue,” Kacsmaryk wrote.
Kacsmaryk was appointed by Republican President-elect Donald Trump during his first term and had previously suspended the FDA’s approval of the drug in a since-overturned ruling.
Julia Kaye, a lawyer with the American Civil Liberties Union, which is fighting abortion restrictions nationally, said that after the Supreme Court’s ruling, “this outrageous case should have been put to bed.”
“Instead, the same Texas judge who already tried to take mifepristone off the market nationwide has left the door open for extremist politicians to continue attacking medication abortion in his courtroom,” Kaye said in a statement.
Representatives for the states and U.S. Justice Department, which is defending the FDA’s approval, did not immediately respond to requests for comment.
It is not clear how Trump will handle mifepristone and the lawsuits over it after taking office on Monday. Trump said during his campaign that he would not ban the drug.
Mifepristone has been approved for use along with another drug, misoprostol, to terminate pregnancy.
In their 2022 lawsuit, the then-newly formed Texas group Alliance for Hippocratic Medicine and other abortion opponents had sought to have mifepristone pulled from the market. In April 2023, they won an order from Kacsmaryk granting the request, but the New Orleans-based 5th U.S. Circuit Court of Appeals reversed him, finding it was too late to challenge the original approval.
The 5th Circuit nonetheless found that the FDA had acted unlawfully in loosening restrictions on the drug since 2016.
On appeal, the Supreme Court found that the plaintiffs had no standing because the FDA’s actions did not harm them, without addressing the merits of their case.
Neither Kacsmaryk’s nor the 5th Circuit’s order was allowed to take effect while the FDA appealed, and mifepristone’s availability has so far remained unchanged.
The Republican-led states have argued they have standing to sue because their Medicaid health insurance programs will likely have to pay to treat patients who have suffered complications from using mifepristone.
They have also said they should be allowed to remain in Texas even without the original plaintiffs because it would be inefficient to send the case to another court after nearly more than two years of litigation.
A group of Democratic-led states is separately pursuing a case seeking to block the FDA from imposing any further restrictions on mifepristone.
