Louisiana judge upholds provision of access to telemedicine abortions for now and puts case on hold

A federal judge in Louisiana upheld telemedicine access to abortion drugs in a ruling 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 subsequently ordered the FDA to conduct its review with “deliberate speed.” reports in December that the agency had instructed officials to delay the election until after the November midterm elections. These reports have been well received acute criticism from anti-abortion groups.

Louisiana Attorney General Liz Murrill, a Republican, sued the FDA in October, arguing that the court should strike down a 2023 rule allowing telemedicine prescriptions for mifepristone. The drug is part of a two-drug regimen commonly used to terminate pregnancies before 10 weeks and to treat miscarriages. Rosalie Markezich, who lives in Louisiana, said her boyfriend at the time forced her to take the pillsHe is also a plaintiff in the case.

Louisiana lawyers have said doctors in states without abortion bans should not be allowed to prescribe drugs and ship them to a state where they are illegal. Lawyers also argued that prescribing the drug via telemedicine is not unthreatening, and that is the case not supported by long-term scientific dataand pointed to Markezich’s story as evidence of its harmfulness.

Many states have enacted protective laws to prevent providers in states without bans from being prosecuted by foreign investigators. Louisiana officials attempted this without success extradite and charge about a year later, a provider from California to ship abortion pills tries to extradite a New York doctor for the same reason.

On Tuesday, the judge left open Louisiana’s request to resubmit the application after the FDA’s safety review is complete, so the state could seek to overturn the rule again at that time. And Joseph, who was appointed by President Donald Trump during his first term, said he believes there is evidence of harm to the state.

In a statement following the ruling, Murrill said she was positive about the legal outcome.

“Judge Joseph concluded that Louisiana has standing to sue and is likely to successfully demonstrate that the 2023 Rule is unlawful,” Murrill said in the statement. “He also concluded that Louisiana will suffer irreparable harm every day that Rule 2023 remains in effect. Accordingly, under the Fifth Circuit’s binding precedent, the only option left is to repeal Rule 2023 pending the outcome of this litigation. We will ask the Fifth Circuit to do so.”

Since the U.S. Supreme Court’s Dobbs decision in June 2022, telemedicine has become a primary method for obtaining abortion medications. In the first half of 2025, more than 27% of all abortions were performed via telemedicine appointments, according to research and advocacy group #WeCount. According to the report, nearly 15,000 abortions per month were performed under the protective laws during the same period.

“Shelving this baseless case is certainly a better outcome than what Louisiana has demanded: strict and immediate restrictions on mifepristone that would upend abortion and miscarriage treatment 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 no consolation that the Trump administration now holds the baton in this ongoing attack on medication abortion when we see the administration enforcing the same harmful restrictions that abortion opponents are seeking to enforce in court.”

A lawsuit similar to that in Louisiana is pending in Missouri, which was also filed with the court by the Trump administration pause or dismiss in March.

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