The U.S. Supreme Court rejected a demand by anti-abortion groups and doctors to restrict access to the abortion pill, handing President Joe Biden’s administration a victory on Thursday in efforts to maintain broad access to the drug.

Two years after striking down a constitutional right to abortion, the justices voted 9-0 to overturn a lower court ruling that had ordered the U.S. Food and Drug Administration to roll back steps taken in 2016 and 2021 to make it easier to prescribe and distribute a drug called mifepristone. The decision was written by conservative Justice Brett Kavanaugh.

The pill received FDA regulatory approval in 2000, and is used in more than 60 percent of abortions in the United States.

The judges ruled that the plaintiffs who sued in Texas in 2022 lacked the legal grounds needed to pursue the case, which required them to show they had been harmed in a way that could be traced to the FDA.

The Supreme Court, which has a 6-3 conservative majority, in 2022 overturned the 1973 Roe v. Wade decision that had legalized abortion nationwide, prompting 14 states to ban the procedure or take measures to sharply restrict it.

Democrat Biden, seeking a second term in the November 5 US election, hit out at Republican officials behind such restrictions, saying they wanted to make abortion illegal across the country and that Thursday’s decision “does not change the fact that the fight for reproductive freedom continues”.

“It doesn’t change the fact that two years ago the Supreme Court overturned Roe v. Wade and women lost fundamental freedoms. It doesn’t change the fact that in many states, the right for women to get the treatment they need is threatened, if not impossible,” Biden said.

Cavanagh wrote that although the plaintiffs, led by a group called the Alliance for Hippocratic Medicine, do not prescribe or use mifepristone, they want the FDA to make it harder for other physicians to prescribe it and for women to take it.

“Under Article III of the Constitution, a plaintiff’s desire to make a drug less available to others does not establish a basis to sue,” Kavanaugh wrote, citing a constitutional provision that sets forth the authority of the judicial branch of the U.S. government.

Kavanaugh rejected the plaintiffs’ argument that the FDA’s action would force them to obtain abortions, which would violate their conscience, because federal law already protects them.

A ruling in favor of the plaintiffs would have threatened the FDA’s regulatory authority over drug safety.

The plaintiffs targeted FDA regulatory actions in 2016 and 2021, including allowing medication abortions at 10 weeks of pregnancy instead of seven and mail delivery of the drug without the woman first meeting a physician in person. The lawsuit initially sought to overturn the FDA’s approval of mifepristone, but a lower court rejected that aspect.

Biden and other Democrats have tried to make abortion rights a central issue against Republicans in the election. Biden said he would continue to urge Congress to codify abortion rights into federal law. Biden noted that some state abortion restrictions include no exceptions for rape or incest.

“Women are being turned away from emergency rooms, or forced to go to court or travel hundreds of miles to get the care their doctor recommends,” Biden said. “Doctors and nurses are being threatened with prison sentences, including life sentences, because they’re trained to provide health care. And contraception and IVF (in vitro fertilization) are under attack.”

The Supreme Court is expected to rule by the end of June on the legality of Idaho’s strict Republican-backed abortion ban, which prohibits abortion even when it is necessary to protect the health of a pregnant woman facing a medical emergency.

In the 14 states that have banned abortion with limited exceptions, medical providers cannot prescribe or dispense mifepristone under state law. Patients in those states can continue to take the legal risk of ordering the pills online from providers in other states or they can travel out of state to obtain the pills legally.

The Battle Over Mifepristone

Erin Hawley, an attorney for the Alliance Defending Freedom, a conservative Christian legal group representing the plaintiffs, expressed disappointment in the verdict, but said the decision was based not on the merits of the legal arguments but on “legal technicalities.”

The plaintiffs argued that the FDA acted contrary to its jurisdiction to ensure the safety of drugs when it relaxed restrictions on mifepristone. The plaintiffs accused the FDA of violating federal law governing the actions of regulatory agencies.

Hawley said he expects the lawsuit to continue because three states — Idaho, Missouri and Kansas — have already intervened.

“We are hopeful that the federal courts will have the opportunity to hold the FDA accountable for its unlawful actions in removing these long-standing protections for women,” Hawley said.

Mifepristone is taken along with another medicine called misoprostol to induce an abortion.

The FDA said that after decades of use by millions of women in the U.S. and around the world, mifepristone has proven “extremely safe,” and studies have shown that “serious adverse events are extremely rare.”

Abortion rights supporters and Democratic lawmakers expressed mixed feelings about Thursday’s decision.

“I am both relieved and angry at this decision,” said Nancy Northup, president of the Center for Reproductive Rights. “Grateful that the Supreme Court rejected this unfair attempt to restrict access to abortion medication, but the fact remains that this frivolous case should never have gotten this far.”

Former US President Donald Trump, the Republican candidate challenging Biden, promised in April to outline how his administration would regulate abortion drugs if elected, but has yet to do so. His campaign did not directly address the issue when responding to Thursday’s court ruling.

“President Trump has been very clear. He supports states’ rights to decide on abortion, supports exceptions for abortion in cases of rape, incest and the life of the mother, and also strongly supports protecting access to contraception and IVF,” Trump campaign spokeswoman Carolyn Levitt said.

US District Judge Matthew Kasmaric broadly sided with the plaintiffs in a 2023 decision, effectively removing the pill from the market.

After the administration appealed, the New Orleans-based 5th U.S. Circuit Court of Appeals did not reach Kacsmaric but still ruled against FDA decisions in 2016 and 2021 that broadened access to the pill. The 5th Circuit’s decision was put on hold pending Supreme Court review.

In a Reuters/Ipsos poll in May, 50 percent of respondents said they support requiring a visit to a doctor in person for abortion medication, while 33 percent said they opposed the rule. About 57 percent of respondents in the poll said abortion should be legal in all or most cases, compared with 46 percent in a Reuters/Ipsos poll a decade ago, while 31 percent said abortion should be illegal in most or all cases, compared with 43 percent in a 2014 poll.