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Federal judge keeps alive red state lawsuit against mifepristone

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October 1, 2025
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Federal judge keeps alive red state lawsuit against mifepristone

A Texas federal judge late Tuesday declined to dismiss a lawsuit against the Food and Drug Administration seeking to sharply restrict the abortion pill mifepristone, instead transferring the case to Missouri and keeping the effort alive. 

U.S. District Judge Matthew Kacsmaryk ruled that Idaho, Missouri and Kansas — which were not the original plaintiffs — have no ties to Amarillo, Texas, where the original lawsuit was filed.  

But instead of dismissing the case outright, Kacsmaryk transferred it to the Eastern District of Missouri “in the interest of justice.” 

The red states did not file their own lawsuit but were allowed by Kacsmaryk to intervene and file a complaint in the case that was originally brought in 2022 by a group of anti-abortion activists and doctors.  

Kacsmaryk wrote that if he dismissed the case, the plaintiffs would have to start at “square one,” and sever any connection between the red states and the original plaintiffs.  

Last year, the Supreme Court dismissed the original lawsuit, ruling that private parties had no legal basis to challenge access to mifepristone. The justices found the conservative doctors in the lawsuit did not show they had personally been harmed by the government’s actions regulating mifepristone.  

The Supreme Court’s ruling on the case didn’t address the underlying regulatory or safety issues and instead decided the case only on standing.   

The states in their complaint claimed that some Food and Drug Administration’s (FDA) actions to loosen access to mifepristone allowed the pills to flood across their borders, endangering the lives of women and undermining their anti-abortion laws.  

But Kacsmaryk did not rule on any other arguments for why the case should be dismissed outright, including from the Trump administration. 

The transfer opens the door for a ruling in Missouri on the merits of this case, which could result in the reinstatement of prior restrictions on the use of mifepristone or revoking the approval of the medication altogether.  

In the suit, the states’ attorneys general requested the drug’s use to be banned after seven weeks of pregnancy instead of 10 and for federal regulators to require three in-person doctor’s office visits before people can access the drug. 

The lawsuit is also challenging the FDA’s approval of generic versions of the drug. 

GenBioPro, which makes generic mifepristone, joined the lawsuit as a defendant in April.  

In a statement, the company’s CEO Evan Masingill said they were disappointed the case wasn’t dismissed, calling it “politically motivated.”  

“Mifepristone has been approved by the FDA for a quarter century using their rigorous standards. Any attempt to roll back access to mifepristone infringes on Americans’ reproductive freedom and will jeopardize the health of millions nationwide. GenBioPro remains committed to ensuring affordable, science-based access to medication abortion for all who need it,” Masingill said.  

Mifepristone has been used by more than 7.5 million people in the U.S. for medication abortion and miscarriage care since it was approved by the FDA more than two decades ago.  

Kacsmaryk’s ruling comes as the Department of Health and Human Services recently told red states it was conducting a review of mifepristone’s safety regulations.  

The FDA has repeatedly found that mifepristone is safe and that a medication abortion regimen that includes mifepristone and a second drug, misoprostol, is a safe and effective alternative to surgical abortions.   

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