The Supreme Court ruled to temporarily preserve access to abortion pills, saying the medication may continue to be prescribed via telehealth and mailed to patients until the case makes its way through the courts. The order, delivered Thursday, extended a block on a ruling in the U.S. Court of Appeals for the Fifth Circuit which had prohibited online prescription and mailing of mifepristone, one of two standard drugs for medication abortions. 

Litigation will return to the Fifth Circuit, where the court will decide if the regulation of by-mail abortion pills should be up to federal courts or remanded to the FDA. In the wake of the fight over reproductive healthcare rights, Illinois is working to preserve abortion access for those in and out of state.

The Rundown

The Fifth Circuit issued a May 1 decision on Louisiana’s case against the FDA. The state argued that abortion pills by mail allowed Louisiana residents to access the banned procedure and threatened the state’s sovereignty. 

Danco Laboratories and GenProBio Inc., two mifepristone manufacturers, appealed to the Supreme Court to reinstate telehealth prescription of the drug. 

“All eyes are on the courts,” said Alison Tanner, a senior litigation counsel for the National Women’s Law Center and board member of the Chicago Abortion Fund. “This is the most significant decision impacting access to abortion care since Dobbs overturned Roe v. Wade.”

What’s next?

The Supreme Court’s temporary hold will maintain the legality of telehealth abortion while the case waits to be heard, which can take months or even years. The Supreme Court also prohibited the Fifth Circuit from issuing any more injunctions on this case. Even if the Fifth Circuit rules in favor of Louisiana, the case will return to the Supreme Court before any policy changes take hold.

The case is going back to the same court that ruled in favor of Louisiana two weeks ago. Tanner emphasized that online abortion care has only been secured temporarily.

“It’s kind of already in the tea leaves what the Fifth Circuit thinks,” Tanner said.

Regardless of the decision, Tanner believes the legal battle itself creates its own set of barriers.

“The chaos is part of the strategy here,” she said. “Folks who want to restrict access to abortion care know that when people are afraid that the care that they need is illegal, they might not ultimately seek it.”

What makes telehealth important?

Telehealth is a critical part of the abortion access landscape, especially in Illinois, Tanner said.

Illinois is already an epicenter for travelling abortion seekers — over 32,000 abortions were provided to out-of-state residents last year, the highest of any state, according to a recent report from the Guttmacher Institute. 

The ease of online care for both patients and providers is what makes it so accessible, said Mary Bowman, a nurse practitioner at Chicago Women’s Health clinic and former telehealth abortion provider. 

“As a telehealth abortion provider, I would probably touch 50 charts in a day. I had over a dozen licenses working in seven states,” Bowman said.

Nearly 60% of abortions provided nationwide to residents of states with total bans were through  telehealth, said the Guttmacher report. If telehealth is banned, all of that care will need to be provided in person.

“We do not have a sufficient number of brick and mortar clinics, particularly for folks outside of the Chicago metro region,” Tanner said. “The rising demand could overwhelm the clinics we do have, causing wait times to increase for everyone.”

The increased demand for in-person care comes at a time when the number of brick and mortar clinics are declining nationwide. Four Planned Parenthood locations closed just last year in Illinois, citing financial shortfall and the unstable political landscape. This left the state with only 12 of its 102 counties with an abortion provider, according to WBEZ.

Fewer clinics means both Illinois and out-of-state residents will have to travel farther to get in-person care. Additional travel increases expenses, which could lessen access for low-income patients, according to Tanner.

“Even when you have a right to abortion care, that doesn’t mean anything if you can’t practically access it,” Tanner said.

What Illinois is doing to protect abortion access 

Reproductive health nonprofits and lawmakers have been trying to defend abortion in Illinois, despite its precarious legal status nationally.

Expenses like hotels, gas, meals and childcare can all be prohibitively expensive for some patients. The Chicago Abortion Fund is the largest of many groups that coordinate financial aid to pay for all the associated costs of abortion care.

“With a requirement that everyone needs to be seen in person, more people will need to travel and need assistance with that travel,” Tanner said. “It would be a huge spike in costs for the Chicago Abortion Fund.”

Elise Hauptman, a reproductive rights activist from the northern suburbs, said financial assistance from Planned Parenthood was essential when her close family friend needed an abortion in 2023.

“This young woman needed Planned Parenthood because of an accidental pregnancy when she was not ready mentally, emotionally or financially to become a mother,” said Hauptman, who has previously volunteered with Planned Parenthood. “She was able to continue her education and avoid the cycle of poverty. Now she is thriving on the path she was meant to take, living an independent, responsible life.”

Two bills from the Illinois State Senate seek to maintain access for people like Hauptman’s family friend. 

House Bill 4834, which passed in a Senate committee, aims to ensure the privacy of both patients and their clinicians by shielding abortion pills from the state’s Prescription Monitoring Program. The program currently tracks the prescription of controlled substances. If this bill passes in the House, it would prohibit the state from adding abortion pills to this program.

House Bill 5408, currently pending in the State Senate, would establish a new state-run Abortion Access Fund. The fund would distribute grant money to cover the cost of abortions for uninsured and underinsured people. 

Bills like these are critical to maintaining care in a constantly shifting legal landscape, Tanner said.

“Anything that can be done to increase resources for folks in need of care will be helpful to everyone,” Tanner said. “I don’t think that there is going to be a decrease of folks coming to the Chicago Abortion Fund any time soon.”

Related Stories:

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• Pritzker signs abortion access bill into law: students, faculty push for increased action to protect rights