Maryland Joins States in Supreme Court Push to Maintain Postal Access to Abortion Medication

Maryland Attorney General Anthony G. Brown, along with a coalition of 22 other states and the District of Columbia, has submitted a brief to the Supreme Court of the United States, advocating for the preservation of access to mifepristone via postal mail. This legal action seeks to counter a recent ruling by the U.S. Court of Appeals for the Fifth Circuit, which could impose significant restrictions on the medication’s availability. The coalition is urging the Supreme Court to prevent this ruling from taking effect, arguing it is not supported by scientific evidence or legal precedent and could create widespread disruption to reproductive healthcare services.

The Fifth Circuit’s decision would reinstate a requirement for in-person dispensing of mifepristone, a measure that the coalition argues is medically unnecessary. Mifepristone, when used in conjunction with misoprostol, is a standard treatment for terminating pregnancies up to ten weeks gestation and is also utilized by medical professionals to manage miscarriages. Since its initial approval by the U.S. Food and Drug Administration (FDA) in 2000, an estimated 7.5 million individuals in the United States have safely used mifepristone. This medication is now central to a significant portion of abortions within the formal U.S. healthcare system, accounting for 63 percent of all such procedures, with approximately one in four of these being facilitated through telehealth services.

In 2023, following a comprehensive review of available data, the FDA removed the in-person dispensing requirement for mifepristone, concluding that it was not medically necessary. This decision was informed by extensive evidence, including data gathered during the COVID-19 pandemic, which demonstrated the safety of distributing mifepristone without requiring patients to be physically present. The FDA’s action allowed healthcare providers to offer mifepristone via telehealth and enabled patients to receive the medication through mail-order pharmacies and other approved channels, thereby expanding access for individuals who face obstacles to obtaining in-person care.

The attorneys general contend that reinstating the in-person dispensing mandate would significantly curtail telehealth access to mifepristone. This would compel patients to pursue more challenging alternatives or undertake travel to receive in-person care. In states like Maryland, where abortion services are legal and protected, telehealth has become an increasingly vital method for accessing reproductive care. Nationwide, the proportion of abortions provided through telemedicine has grown substantially, from 5 percent in 2022 to 27 percent in 2025.

Furthermore, the ruling could destabilize healthcare provision in states that protect abortion access. Following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which eliminated the federal constitutional right to abortion and delegated regulatory authority to the states, clinics in abortion-protected states have experienced increased patient volumes, including individuals traveling from states with more restrictive laws. The Fifth Circuit’s ruling, by forcing more patients to seek in-person appointments, would place additional strain on healthcare systems that are already operating under significant demand.

The coalition asserts that the Fifth Circuit’s decision infringes upon the sovereign authority of states to protect and enhance access to reproductive healthcare. In the aftermath of the Dobbs decision, numerous states have enacted executive and legislative measures to safeguard reproductive rights and expand access to medication abortion. The attorneys general argue that federal drug regulations, especially those deemed medically unnecessary, should not be used by courts to override state policy decisions or create undue barriers to care in states where abortion remains legal.

The Supreme Court has already taken preliminary action, granting an administrative stay on May 4, 2026. This temporary measure pauses the Fifth Circuit’s decision until May 11, 2026, at 5 p.m., allowing the Court time to consider emergency appeals in the case. Attorney General Brown had previously joined a multistate amicus brief in February 2026, supporting the availability of mifepristone through telehealth while the case was pending in the district court. The coalition, led by the attorneys general of New York, California, Massachusetts, and Washington, includes Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Hawaiʻi, Illinois, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Rhode Island, Vermont, Virginia, and the Governor of Pennsylvania.

Article by Mel Anara, based upon information from the Maryland Attorney General’s Office.

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