Louisiana, Alabama, and Arkansas filed two lawsuits last week testing a legal argument that classifies the mailing of abortion pills across state boundaries as a "public nuisance." The filings target out-of-state medical providers and three states—New York, California, and Massachusetts—that have enacted shield laws to protect clinicians from out-of-state legal action.
The litigation follows a 2022 U.S. Supreme Court ruling that overturned Roe v. Wade, allowing states to ban or restrict abortion. In response, several states passed shield laws to protect their providers who offer telehealth services to residents of states with bans. According to the Guttmacher Institute, approximately 91,000 abortions were provided via telehealth to patients in states with total bans in 2025, an increase from 74,000 in 2024.
Public nuisance law has historically been used to address environmental pollution, blocked roads, or broad public harms like tobacco and opioid distribution. In their filings, the Republican-led states argued that circumventing their bans constitutes a nuisance aimed at thwarting public safety laws. Attorneys general from New York and Massachusetts, both Democrats, stated the lawsuits are an attempt to impose one state's laws on another and to penalize legal medical care.
The legal strategy represents a shift in how states attempt to enforce local bans beyond their own borders. By using public nuisance claims, the plaintiff states can seek broad injunctions without the standard legal requirement of proving direct harm to specific individuals. This sets a precedent for how states might challenge the conflicting laws of neighboring jurisdictions, particularly regarding the U.S. Food and Drug Administration's (FDA) 2000 approval of mifepristone, which most medical groups maintain is safe and effective.
One lawsuit was filed directly with the U.S. Supreme Court, which handles disputes between states, while a second naming nearly 30 medical practitioners and groups was filed in Louisiana federal court. A separate safety review of mifepristone by the FDA is currently underway; the agency stated in a Wednesday court filing that it expects to complete this review by March 2027. Future dates for hearings or rulings on the public nuisance lawsuits have not yet been reported.