Louisiana judge maintains access to telehealth abortions for now, puts case on hold

A federal judge in Louisiana upheld telehealth access to abortion drugs in a decision issued Tuesday afternoon, pausing the case until the U.S. Food and Drug Administration completes a safety review of the drug mifepristone.

U.S. District Judge David C. Joseph also ordered the FDA to conduct the review “at a deliberate pace.” reports in December that the agency has instructed officials to delay that decision until after the midterm elections in November. These reports attracted piercing criticism from anti-abortion groups.

Republican Louisiana Attorney General Liz Murrill sued the FDA in October, arguing that the court should strike down a 2023 rule allowing mifepristone to be prescribed via telehealth. This medicine is part of a two-drug regimen commonly used to terminate pregnancy before 10 weeks and to treat miscarriage. Louisiana resident Rosalie Markezich, according to her then-boyfriend forced her to take pillsis also a plaintiff in this case.

Louisiana lawyers say doctors in states without abortion bans should not be able to prescribe drugs and mail them to a state where they are illegal. Lawyers also argued that prescribing via telehealth is unsafe, which is true not supported by many years of scientific dataand pointed to the story of Markezichus as one of the manifestations of injustice.

Many states have enacted laws to protect service providers in non-ban states from prosecution by out-of-state investigators. Louisiana authorities tried unsuccessfully to do so extradition and prosecution supplier in California in January for mailing abortion pills about a year later tries to extradite a New York doctor for the same reason.

On Tuesday, a judge left Louisiana with a request to reapply once the FDA’s safety review is complete, so the state can try to repeal the rule again at that point. And Joseph, an appointee of President Donald Trump during his first term, made it clear that he believed there was evidence of harm to the state.

In a statement released after the verdict, Murrill expressed optimism about the final legal outcome.

“Judge Joseph concluded that Louisiana has standing to bring this lawsuit and will likely be able to show that the 2023 (rule) is unlawful,” Murrill said in a statement. “He also concluded that Louisiana suffers irreparable harm every day that the 2023 (rule) remains in effect. Therefore, under binding Fifth Circuit precedent, all that remains to be done is to repeal the 2023 (rule) pending the outcome of this litigation. We will ask the Fifth Circuit to do so.”

Since the U.S. Supreme Court’s June 2022 Dobbs ruling, telehealth has become the primary method for obtaining abortion medications. According to research and advisory group #WeCount, in the first half of 2025, more than 27% of all abortions were performed via telehealth. The report shows that during the same period, almost 15,000 abortions were performed per month under the abortion shield regulations.

“Stopping this baseless case is certainly a better outcome than what Louisiana asked for: severe and immediate restrictions on mifepristone that would upend abortion and miscarriage care across the country,” Julia Kaye, senior staff attorney for the American Civil Liberties Union’s Reproductive Freedom Project, said in a statement. “But it is little consolation that the Trump administration now holds the baton in the ongoing attack on medication abortion, while we see the administration enact the same harmful restrictions that abortion opponents are trying to win in court.”

There is an ongoing lawsuit in Missouri similar to the one in Louisiana, which the Trump administration also asked the court to pursue pause or reject in March.

Stateline reporter Kelcie Moseley-Morris can be reached at: kmoseley@stateline.org.