GET THE FACTS: How states have tried to fight mail-order abortion

Since its fast-tracked approval in 2000 during the Bill Clinton administration, the abortion pill (mifepristone) has been fraught with controversy. Over the years, the drug's safety protocols (REMS) have been weakened or removed, leaving more women and preborn children vulnerable to a predatory, profit-driven abortion industry.

The Biden-Harris administration removed a requirement for in-person distribution of the abortion pill in 2021 (making it permanent in 2023), despite the existence of unenforced federal Comstock laws preventing this action. Since that time, multiple lawsuits and "cease and desist" orders have been issued by states seeking to enforce their own laws restricting abortion as abortion pills flood their states, unchecked.

The Live Action News articles below discuss these cases.

Lawsuits:

Texas and Florida add persuasive arguments to abortion pill lawsuit

On August 28, 2025, Live Action News reported that Texas and Florida filed to intervene in Missouri's lawsuit against the FDA regarding the abortion pill. As noted in the article, the states alleged:

• "States have the sovereign power to enact and enforce regulations on abortion."

• "The FDA’s actions seek to enable the violation of state laws restricting abortion."

• Telehealth was a "boon for sex traffickers" and  mailing abortion pills to men has "facilitated the death[s] of multiple preborn children." 

• States "have been forced to divert resources to address the explosion of abortion drugs mailed to their residents by abortionists operating under...'shield laws.'"

• "... The FDA’s actions have inflicted concrete economic injury on states as the payers and insurers of residents’ medical expenses."

Abortion pill risks 'undercounted,' court document claims

On August 31, 2025, Live Action News noted:

 In a motion to intervene in the... lawsuit, State of Missouri v. FDA, challenging the expansion of the abortion pill mifepristone (200mg), the states of Texas and Florida claim that "inadequate adverse event reporting" has led to the undercounting of "true rates of risks associated with chemical abortion drugs," meaning that the risks are "therefore... unknown."

But then:

In September of 2025, the States of Florida and Texas were denied their motion to join the existing abortion pill lawsuit and in December of that same year, the two states filed re-filed their lawsuit in the Northern District of Texas, Wichita Falls Division.

Florida and Texas re-file lawsuit challenging abortion pill

On December 13, 2025, Live Action News reported:

The States of Texas and Florida have filed a new lawsuit against the U.S. Food and Drug Administration (FDA), asserting that "the FDA’s approval and deregulation of abortion drugs have placed women and girls in harm’s way."

"The lawsuit, filed Tuesday in federal court in Wichita Falls, Texas, by Florida Attorney General James Uthmeier and Texas Attorney General Ken Paxton," CBS News reported, "alleges that decisions by the U.S. Food and Drug Administration dating back to 2000 were 'arbitrary, capricious' and an 'abuse of discretion' and should be rejected."

'Destructive of state sovereignty': Louisiana sues to block mail-order abortion pill expansion

A December 21, 2025, article from Live Action News states:

The State of Louisiana and coerced abortion victim Rosalie Markezich have filed a motion for a preliminary injunction against the U.S. Food and Drug Administration's (FDA) enforcement of the 2023 REMS safety protocols, which removed in-person dispensing requirements for the abortion pill mifepristone (200mg). 

The lawsuit contends that the 2023 REMS "unlawfully remov[ed] the in-person dispensing requirement for the sole purpose of allowing out-of-state doctors to facilitate illegal mail order abortions in pro-life states like Louisiana." 

The lawsuit seeks injunctive relief for a period of for 705 days (just under two years).

21 states join Louisiana's lawsuit challenging the FDA's abortion pill changes

Live Action News reported on February 17, 2026:

Twenty-one (21) states have filed an amicus brief in support of Louisiana’s lawsuit seeking injunctive relief from the erosion of the U.S. Food and Drug Administration's (FDA) 2023 changes to the abortion pill's safety measures...

[Those states] claim that because of the Biden FDA's changes to the REMS, their state sovereignty over their own abortion laws is being thwarted by the refusal to return to the previous in-person requirement.

60 lawmakers file brief supporting Louisiana's FDA abortion pill challenge

On February 18, 2026, Live Action News noted that "60 lawmakers have filed an amicus brief in support of the State of Louisiana's challenge to the FDA's eroding safety regulations for the abortion pill. The move follows a separate filing of amici by 21 separate states."

The article details that "The lawmakers are calling out the FDA for violating the Comstock Act when it (under the Biden administration) eroded safeguards on mifepristone, allowing it to be sent by mail or obtained by telehealth," and that their brief also asserts that a "federal agency action that rewrites, contradicts, or ignores a federal statute violates the separation of powers."

Lawsuit: Louisiana suffered 'sovereign and economic harms' from FDA abortion pill changes

Live Action News reported on February 23, 2026:

... [A]bortion pill manufacturers Danco Laboratories and GenBioPro filed to intervene in [Louisiana's] case[;] 60 lawmakers filed briefs in support of Louisiana, along with AGs from 21 states.

The State contends that "although Louisiana has significantly restricted abortion, there are nearly 1,000 abortions occurring in the State every month — all through mail-order abortion.

The state argues that changes to the FDA's 2023 REMS on the abortion pill have caused "sovereign harm by facilitating illegal abortions in Louisiana" and have also "cause[d] economic harm by directly increasing Louisiana’s Medicaid costs."

Louisiana AG faces FDA and abortion pill manufacturers in court

On February 26, 2026, Live Action News reported that the state of Louisiana was seeking to block the "2023 REMS safety rule changes that allowed the abortion pill mifepristone to be dispensed through the mail and sold in pharmacies."

The state argued that mail-order dispensing of th eabortion pill "violates the Comstock Act, causes sovereign harm by facilitating illegal abortions, and causes economic harm by increasing Louisiana's Medicaid costs." 

The FDA has asked for Louisiana's lawsuit to be halted, claiming that it will "'short circuit' its ongoing review of mifepristone."

Trump DOJ seeks to halt abortion pill lawsuit filed by three states

Live Action News reported on March 10, 2026 (emphasis added):

The DOJ is asking a U.S. District Court to stay a lawsuit brought by Missouri, Kansas, and Idaho against the FDA for changing the abortion pill's safeguards.

The states claim the REMS changes violate their sovereignty, causes them financial harms, and more. The removal of the in-person requirement for dispensing the drug regimen has led to numerous serious secondary issues these states are facing. 

The DOJ claims the lawsuit will "short-circuit" the FDA's ability to conduct an orderly review of the risks of the abortion pill.

FDA admits in abortion pill lawsuit that HHS can suspend any drug if 'imminent threat to public health'

As Live Action News noted on March 10, 2026:

In the case, State of Louisiana v. Food and Drug Administration (FDA), the FDA admitted that "if the Secretary of Health and Human Services finds that a drug presents “an imminent hazard to the public health,” he may suspend the approval of the application (including a supplemental application) 'immediately.' 21 U.S.C. § 355(e)."

This could impact the abortion pill because an analysis from the Ethics and Public Policy Commission "suggested that 'the rate of serious adverse events following a chemical abortion (mifepristone) was significantly higher after the FDA’s in-person dispensing requirement was removed.' This was a result of the 2023 REMS, which Louisiana asked the court to block."

Cease and Desist:

Arkansas AG issues cease-and-desist letters related to abortion pills

As reported by Live Action News on August 23, 2025:

"Arkansas Attorney General Tim Griffin has issued cease-and-desist letters to... four businesses — Possibility Labs, Mayday Medicines, Dreamscape International, and Cloudflare — that they have been found to be in violation of state law regarding the advertising of abortion pills.

Griffin says the entities may be violating Arkansas' deceptive trade practices law for claims regarding the safety of the abortion pill."

Texas AG sends cease-and-desist letters to three groups shipping abortion pill into state

As reported by Live Action News on August 22, 2025, Texas Attorney General Ken Paxton sent cease-and-desist letters "to Plan C, Her Safe Harbor, and California doctor Remy Coeytaux, who have been named as parties shipping abortion pills into the state of Texas."

The articles additionally notes:

The parties stand accused of breaking Texas laws as well as federal Comstock laws for shipping the drugs to Texas.

The AG accuses Plan C of deceptive advertising in its claims of abortion pill safety.

The letters threaten penalties for noncompliance, including the possibility of “civil penalties for violations of the Human Life Protection Act of not less than $100,000 per violation….”

South Dakota AG tells abortion pill advertiser to 'cease and desist'

As Live Action News reported on December 11, 2025, South Dakota Attorney General Marty Jackley issued a "cease and desist" order against Mayday Health:

On December 9, Governor Larry Rhoden asked Jackley to investigate Mayday Health, stating that its promotion of the pill via mail violates state law, which prohibits distribution of the abortion pill. South Dakota law protects the majority of preborn children from abortion....

The day after Rhoden's request, Jackley sent the cease and desist letter to Mayday Health, noting that the organization's ads do not mention that distribution of the abortion pill is illegal.

North Dakota AG issues cease-and-desist order against abortion website

As Live Action News noted on January 20, 2026:

"North Dakota Attorney General Drew Wrigley... issued a cease-and-desist order against the Prairie Abortion Fund.

Wrigley has accused the Prairie Abortion Fund of violating the state's Consumer Fraud Law by promoting the unlawful sales of abortion drugs on its website. The AG explained in a press release, "Prairie Abortion Fund lends credibility and trustworthiness to unlawful websites that otherwise would look much more suspicious.”