The Supreme Court on Thursday preserved broad access to the abortion pill mifepristone without an in-person doctor visit, keeping on hold a lower court order that would have restricted the drug’s availability as litigation over FDA safety regulations continues.

The decision means patients can continue to obtain a prescription for the medication via telehealth and pick it up at a pharmacy or have it delivered by mail. More than one in four women who get an abortion today obtain the medicine via telehealth, according to the ACLU. 

Justices Clarence Thomas and Samuel Alito dissented from the decision.

The court did not elaborate on its decision, but the action matches the approach it took two years ago in a similar case brought by a group of anti-abortion doctors.

In 2021, the FDA discontinued an in-person dispensation requirement for the medicine, citing data from 15 studies involving more than 55,000 patients the agency said showed that eased access was safe. 

Louisiana, which brought the case, alleges government regulators acted arbitrarily without proper consideration of health risks.  

The state had asked the justices to affirm — at least temporarily — an appeals court ruling which concluded the Biden administration did not lawfully develop the new mifepristone guidelines and that they should be put on hold. 

Drugmakers Danco Labs and GenBioPro, backed by 20 states, insist the guidelines were properly studied by FDA and safely implemented over the past five years with little complaint or challenge. 

No federal court has ever second-guessed FDA-approved drug regulations, they pointed out. 

“We are pleased that a safe and effective drug Americans depend on will continue to be available while this litigation proceeds,” Abby Long, a Danco spokesperson, said in a statement. “Danco also is confident that a review of all recent, reliable data by FDA will continue to show that [mifepristone] is very safe and effective.”

Louisiana Attorney General Liz Murrill said in a statement, “It’s shocking that the Supreme Court would block this common-sense return to medically ethical practices and oversight. DOJ did not defend Big Pharma, which is profiting from the illegal and unethical distribution of abortion pills. We will keep fighting.”