No, it was never about being ‘ left to the states’. The right-wing wants to impose its will on the entire country.
So Much for Leaving Abortion Up to the States
Louisiana’s case against the FDA is not just about one drug.
By Adam Serwer
June 14, 2026, 7:31 AM ET
The 2022 Dobbs decision, which overturned Roe v. Wade, supposedly gave states the authority to decide for themselves whether to permit abortion. What should have been apparent then, and is obvious now, is that anti-abortion activists and their allies on the high court were never going to be satisfied with that.
Since October, the state of Louisiana has been seeking to block the distribution of mifepristone, a drug used to induce abortion, through the mail—not just in Louisiana, but anywhere in the United States. The state’s lawsuit against the FDA asserts that the Comstock Act—an anti-obscenity law championed by the 19th-century book burner Anthony Comstock—bans the mailing of abortion medication, and that the federal government wrongly repealed the in-person requirement for prescribing it.
“Louisiana is complaining about reported harms in Louisiana, but they would be imposing a nationwide requirement that patients pick up the pill in person from their health-care provider, even in states that protect abortion access, even in states that explicitly, in their laws, allow for telemedicine provision of mifepristone,” Andrew Beck, an attorney with the ACLU, told me. “Louisiana is really trying to impose its own policy choices on the entire country.”
Medication abortion accounts for about two-thirds of all abortions in the United States, which have actually increased since Dobbs v. Jackson Women’s Health Organization made it possible to send mifepristone through the mail. Providers were first able to mail the drug during the pandemic, a temporary measure that was made permanent by the FDA in 2023. Even in Louisiana, which has a strict anti-abortion law with few exceptions, the number of abortions has risen, according to the state’s lawsuit. This was in part because Louisianans were able to access abortion drugs through providers based in states where the procedure is legal. Indeed—abortion medication has made it possible for women who live far from any clinic to end unwanted pregnancies. Many of those pro-abortion-rights states had passed “shield laws” that protected providers in their jurisdictions from being sued or prosecuted by authorities in anti-abortion states.
Although Louisiana v. FDA is ostensibly about a federal regulatory decision and the safety of an abortion drug, it is really about access to abortion. Louisiana even began its complaint with the declaration that “the fight for life is far from over.” The FDA has asked the court to hold off on a ruling for now, as the Trump administration has said it is conducting its own review of the drug (all medical evidence indicates that mifepristone is safe). In the meantime, two drug companies are asking the courts to allow the continued distribution of mifepristone. The Supreme Court responded to this question on May 14, overturning a lower order that halted distribution and sending the case back for review. The late Justice Antonin Scalia once predicted that overturning Roe would get the Court out of the “abortion-umpiring business.” That prediction has not aged well.
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