The country now awaits Supreme Court action in a case that could ban telehealth abortion nationwide only four years after the Dobbs decision overturning the constitutional right to abortion.

While the Supreme Court today temporarily paused an appeals court ruling imposing an extraordinary restriction all across the United States on telehealth access to medication abortion, a constitutional showdown is in the offing.

The 5th U.S. Circuit Court of Appeals, in its ruling in State of Louisiana v. Food and Drug Administration, ordered the FDA to temporarily ban the use of telehealth medicine to prescribe mifepristone. Although Louisiana argued the use of telemedicine for abortion undermines its draconian state ban, the appeals court not only granted Louisiana’s request but also shockingly banned telehealth abortion care all over the country. Justice Samuel A. Alito Jr., in a one-sentence order, briefly paused that ban until the parties file briefs by Thursday and the entire court can take up the issue.

“The appeals court ban is an example of practicing medicine without a license,” says Annie Laurie Gaylor, FFRF co-president. “An ideologically driven court is overriding evidence-based medicine, federal authority and the rights of patients nationwide to impose a religious agenda.”

About two-thirds of abortions in the United States are via medication and about a quarter are via telemedicine. Millions of U.S. women have used mifepristone, in combination with misoprostol, to safely end pregnancies in the last 26 years, with a serious complication rate of less than 1 percent. The FDA approved mifepristone for use in 2000. In early 2023, the FDA permanently lifted restrictions preventing patients from obtaining medication abortion pills at a retail pharmacy or requiring them to visit a medical provider in person.

Three years ago, an obscure Christian nationalist federal judge in Texas presumed to ban mifepristone nationwide, a ban that the 5th Circuit upheld with modifications, limiting use of the medication to seven weeks of gestation, also banning telemedicine and mail-order shipments. The Biden administration, along with major pharmaceuticals, appealed, with the Freedom From Religion Foundation’s brief in the case noting the plaintiff anti-abortion groups lacked standing to sue. The U.S. Supreme Court agreed with FFRF on the standing question and tossed the case in 2024. FFRF warned at the time that the crusade against medication abortion was only beginning.

The stakes are enormous. Some 100,000 patients per year living in states with abortion bans have received abortion pills through the mail from physicians living in states that have passed shield laws protecting such prescriptions. FFRF honored Dr. Maggie Carpenter with its 2025 Forward Award for co-founding Abortion Coalition for Telemedicine, after the states of Texas and Louisiana prosecuted her for prescribing and mailing medication abortion to Texas. New York’s shield law has protected her, so far, from extradition.

“The same Christian nationalist movement that pushed Dobbs is now targeting medication abortion and telehealth access nationwide,” Gaylor adds. “This ruling underscores the urgent need to defend the separation of church and state, because these bans are rooted in religious ideology, not medicine or public health.”

FFRF is calling on the U.S. Supreme Court to swiftly overturn the 5th Circuit’s ruling and on state lawmakers to enact and strengthen shield laws explicitly protecting telehealth abortion care.

“This is a wake-up call,” Gaylor concludes. “Lawmakers who support reproductive freedom must act now to protect patients and providers from escalating judicial overreach.”

The Freedom From Religion Foundation is a U.S.-based nonprofit dedicated to defending the constitutional principle of separation between state and church and educating the public on matters relating to nontheism. With about 42,000 members, FFRF is the largest association of freethinkers (atheists, agnostics and humanists) in North America. For more information, visit ffrf.org.

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