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More than 400 state lawmakers from all 50 states are demanding an end to attacks on telehealth abortion care.
The lawmakers have signed onto an amicus brief, shared exclusively with HuffPost, that the advocacy organization State Innovation Exchange submitted Wednesday to the Fifth Circuit Court in the Louisiana v. FDA case.
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During the COVID-19 pandemic, the Biden administration loosened restrictions around the abortion pill mifepristone, including repealing the in-person dispensing requirement, to ensure people could access the medication without exposing themselves to the virus. Louisiana seeks to reinstate the in-person dispensing requirement and ban access to the medication by mail.
Abortion pills by mail, or telehealth abortion care, has revolutionized access to reproductive healthcare since the fall of Roe v. Wade in 2022 — accounting for around 30% of all abortions in 2025.
Although the case originated in Louisiana, the outcome will impact all 50 states regardless of state laws that protect or ban abortion.
“The barriers to accessing reproductive healthcare in person, combined with the often time-sensitive nature of such care, make telemedicine a clinical and practical necessity for millions of Americans seeking reproductive healthcare of all types,” the legislators write in the brief.
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The brief details how critical telehealth care is for many Americans. In rural areas, for instance, hospitals are closing left and right, and people lack access to reliable transportation. Poor and medically disenfranchised communities also heavily depend on telehealth access to abortion care, both in states where abortion is banned and where it’s protected. Reinstating the in-person dispensing requirement for mifepristone would “cause immediate and serious harms,” the brief states.
“Right now, more than ever, state legislators are on the front lines defending this care for their constituents,” Laura Hernández, director of policy for SiX’s Reproductive Freedom & Health Equity program, told HuffPost. “They’ve really moved to protect telehealth providers and shield prescribers from out-of-state prosecutions.”
A handful of states have enacted abortion shield laws to protect healthcare providers and patients from civil and criminal penalties in states where abortion is restricted. This allows physicians from pro-choice states, like New York and California, to prescribe abortion pills to patients in states with bans in place, like Texas and Louisiana.
The U.S. Food and Drug Administration approved the use of mifepristone for abortion care in 2000. It has been used safely by millions since then, including via telehealth appointments in which a patient can speak with a physician virtually and get the medication prescribed by mail.
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Despite its proven safety record, Republicans and other anti-abortion advocates have sought to undermine mifepristone through court attacks, a pressure campaign for the FDA to review the safety and effectiveness of mifepristone and calls to resurrect the Comstock Act, an 1873 law banning the mailing of items related to abortion.
“What’s really terrifying is that one state’s law and ruling in this situation could impact so many other states where abortion is still legal, where they can still get comprehensive health services,” Iowa state Rep. Megan Srinivas (D), who signed onto the brief, told HuffPost. “That is really the danger of this case.”
Srinivas is an infectious disease doctor who also does a lot of work in ****** and reproductive healthcare. Her state currently has a six-week abortion ban in place, and nearly 40% of all Iowa counties are designated as maternity care deserts. But, up until recently, people could still access telehealth abortion care from out-of-state physicians prescribing and mailing pills to their home. A new state law, enacted this month, requires in-person dispensing for mifepristone, effectively banning telemedicine for abortions, though how enforcement will work against out-of-state providers is unclear.
A ban on mifepristone by mail would also have severe consequences for people in states where abortion is protected. Colorado state Rep. Lorena Garcia told HuffPost she signed the brief because it’s still hard for many Coloradans to access care in person, even though her state is one of the most pro-choice in the country.
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“If we ban telehealth, it’s going to be really difficult for individuals to make it all the way to a doctor’s office or find a doctor that even prescribes it,” she said.
“Think about areas in our state where maybe we don’t even have a healthcare clinic, that’s an hourslong drive. What if they don’t have a car? What if their partner or their family won’t let them? There’s just a lot of challenges to forcing in-person visits,” Garcia continued. “We have to be nimble, and we have to make sure that people can access healthcare in any form that they are able to.”
Louisiana v. FDA is similar to another case that was before the Supreme Court two years ago, which was rejected on standing because the plaintiffs could not prove real harm had been perpetrated. The oral arguments in the Louisiana case are scheduled for September, and a ruling is expected next spring or summer.
Read the amicus brief in full below.
