This story was originally published by the Louisiana Illuminator.
LAFAYETTE — A federal judge questioned Tuesday whether demand for abortion medication would go away even if he were to force the Trump administration to end the policy that allows the drugs to be prescribed remotely and mailed across state lines.
The case in question could determine whether people in Louisiana and other states where abortion has been outlawed can still obtain the prescription needed to end a pregnancy from an out-of-state doctor through a telehealth appointment.
U.S. District Judge David Joseph, a 2018 court appointee of President Donald Trump, is considering a request from Louisiana Attorney General Liz Murrill for a temporary injunction. She wants to end a 2023 U.S. Food and Drug Administration policy allowing mifepristone to be prescribed without an in-person doctor’s visit.
FDA Commissioner Marty Makary is asking for Louisiana’s case to be delayed so his staff can complete a review of whether mifepristone is safe.
Joseph did not provide any indication when he might rule on Louisiana’s request for an injunction, though he gave the agency’s attorney seven days to file a brief explaining how the FDA would take emergency action if it’s discovered mifepristone presents a public health risk during the ongoing review process.
Anti-abortion groups have accused Makary of slow-walking the review, while abortion rights advocates point to multiple prior studies that have found mifepristone to be safe.
Murrill filed her case against the Food and Drug Administration on behalf of Rosalie Markezich, a Louisiana woman who said her ex-boyfriend coerced her to take abortion drugs. Markezich’s attorney, Erin Hawley with Alliance Defending Freedom, argued in court Tuesday that the FDA’s mifepristone review could take an “indefinite amount of time” and that’s why the court injunction is necessary.
Joseph seemed to throw cold water on the plaintiffs’ arguments that an end to telehealth prescriptions would significantly dampen the demand or supply of mifepristone, using federal efforts to combat illegal narcotics for a comparison.
“The war on drugs has been going on for 50 years, and yet there was more cocaine produced last year than any other,” the judge said.
Noah Katzen, the FDA’s attorney, stressed multiple times in his arguments that Louisiana’s attempt at “judicial intervention” would disrupt the agency’s well-established drug review process. But he declined to provide a specific answer when Joseph pressed him for a firm timeline on when the review would be complete.
The judge also heard from lawyers from two pharmaceutical companies that make and distribute mifepristone — Danco Laboratories and GenBioPro Inc. — that called for the case to be thrown out.
Jessica Ellsworth, representing Danco, said if the court allowed Louisiana to dictate how the government conducted drug reviews, it would open the door for states to challenge any federal policy they feel harms public health.
She also challenged a claim from Benjamin Aguiñaga, Louisiana’s solicitor general, that the FDA cleared mifepristone for telehealth prescriptions in 2023 as a response to the U.S. Supreme Court overturning federal protections for abortion rights. Ellsworth argued the agency began the process for changing mifepristone’s regulations two years earlier. In his rebuttal, Aguiñaga said records show the Biden administration began the process in 2021 just days after oral arguments in the Dobbs v. Jackson Women’s Health Organization case “when it became clear where justices would land.”
Two months after the Supreme Court ruling in 2022, Louisiana declared abortion illegal in nearly all scenarios.
“We’ve closed our market to abortion,” Aguiñaga said in court.
Five other states are also suing the Food and Drug Administration over its mifepristone rules and pushing the Trump administration to further limit access or reverse the drug’s approval.
Despite the stringent abortion ban, Murrill said almost 1,000 abortions per month are administered in Louisiana through medication obtained from out of state. As of mid-2025, nearly 30% of abortions nationally were administered through medication obtained via telehealth, according to a Society of Family Planning report.
Murrill has brought criminal charges against physicians in California and New York who allegedly prescribed and mailed the pills to Louisiana, though both are protected from extradition and out-of-state prosecution by shield laws in their respective states.
