SCOTT DETROW, HOST:
A panel of judges in Louisiana has just ended telemedicine access to the abortion pill nationally - for now, at least. NPR's Selena Simmons-Duffin is here to explain what this ruling means. Hi, Selena.
SELENA SIMMONS-DUFFIN, BYLINE: Hi, Scott.
DETROW: Let's start here. What is this case about?
SIMMONS-DUFFIN: The case was brought by the state of Louisiana against the Food and Drug Administration, and their argument centered around the FDA's decision to remove an in-person requirement for patients to receive mifepristone, which is one of the medications used for abortion and the management of miscarriages. A district court judge put the case on hold in April. Louisiana appealed that decision to the 5th Circuit Court of Appeals, and a panel of judges on that court agreed with the state, which means that telemedicine access to mifepristone has just ended for the whole country effective immediately.
DETROW: And we are going to get to that real-world impact because it is big. But first, let's talk a little bit more about the opinion itself. What was the reasoning here?
SIMMONS-DUFFIN: Yeah, the opinion was written by Judge Stuart Kyle Duncan. He is a Trump appointee. He wrote that telemedicine access to mifepristone, quote, "injures Louisiana by undermining its laws protecting unborn human life and also by causing it to spend Medicaid funds on emergency care for women harmed by mifepristone. Both injuries are irreparable," unquote.
I should say that this is not the end of the case. Drug makers are expected to appeal to the Supreme Court. It's unclear whether the FDA will also ask the Supreme Court to review this decision.
DETROW: In the meantime, what does this decision mean in the real world? I mean, this seems like it'd have a really big impact.
SIMMONS-DUFFIN: Absolutely. This is a big deal. Just, first of all, to explain, in a telemedicine abortion, a patient connects with a healthcare provider online or over the phone. And then if they're eligible, that provider will mail them mifepristone and another medication called misoprostol.
In the almost four years since the Supreme Court overturned Roe v. Wade, telemedicine abortion has grown and grown, and in fact, it's a big part of the reason why the overall number of abortions hasn't gone down at all nationally despite the state bans.
Now, mifepristone has been found to be safe by FDA. It's been used by something like 7 million patients since it was approved in 2000. And doctors say the in-person requirement is not medically necessary. But now that requirement is back.
And I should say, there is a medication abortion protocol that uses only misoprostol. So doctors could pivot to providing that through telemedicine instead. It's just hard to know how this is all going to go since the ruling just came out.
DETROW: And let's talk about the political implications here. Abortion, in the past, has been a really big political issue, and the midterms are coming up.
SIMMONS-DUFFIN: Yeah, that's right. The Trump administration has been pretty understated on abortion this term. Anti abortion advocates have noticed and have been asking President Trump to be more forceful. He didn't even mention abortion during his State of the Union address this year. Here's Mary Ziegler. She's an expert in the legal history of abortion at UC Davis.
MARY ZIEGLER: This is the most consequential - potentially, in some ways - ruling we've had since Dobbs from a lower court. And that's going to require every politician to weigh in, and it doesn't really leave the Trump administration the option of doing nothing anymore.
SIMMONS-DUFFIN: She said this decision is going to send shockwaves through medicine, through politics, and we're just at the beginning of seeing how this will play out.
DETROW: That is NPR's Selena Simmons-Duffin who will be continuing to cover the story. Selena, thank you so much.
SIMMONS-DUFFIN: You're welcome. Transcript provided by NPR, Copyright NPR.
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