Mother Jones illustration; Bryan Olin Dozier/NurPhoto/ZUMA; Soumyabrata Roy/NurPhoto/ZUMA

The last time lawyers from the Alliance Defending Freedom argued before the Supreme Court, their case was entirely hypothetical. The conservative Christian legal advocacy group—the force behind some of the most important anti-abortion and anti-LGBTQ litigation in recent history—was representing a Colorado graphic designer who claimed to be starting a wedding website business, and wanted the right to deny service to same-sex couples. The designer had never before made a wedding website, and the only evidence that a queer couple wanted her to do so, it was later revealed, appeared to be faked. None of that mattered. The court gave her a guarantee that she wouldn’t be punished—creating a new loophole in anti-discrimination laws across the country.

On Tuesday, another ADF lawsuit will be heard at the Supreme Court. And once again, the case rests on a hypothetical: That a member of a small anti-abortion doctors’ coalition might one day have to care for a patient suffering a rare and severe complication from an FDA-approved abortion pill that the American Medical Association considers as safe as Tylenol. Perhaps, the case speculates, that doctor might be forced to administer that patient an emergency abortion, violating their anti-abortion convictions.

This lawsuit—known as FDA v. Alliance for Hippocratic Medicine—aims to limit the availability of mifepristone, the first pill in the two-drug regimen commonly used in medication abortions. ADF, on behalf of the anti-abortion doctors, accuses the FDA of “betraying women and girls” when it approved mifepristone 23 years ago by overlooking potentially harmful side effects and by later making it easier to get. The case has the potential to produce the most consequential abortion ruling since 2022, when, in its Dobbs decision, the court ended the constitutional right to an abortion by upholding a Mississippi law that had been written by ADF. Since that decision, 14 states have made it illegal to provide abortion in virtually all cases, and seven more have restricted abortion to earlier in pregnancy. Now, with Tuesday’s case, the Supreme Court could broadly limit access to mifepristone—even in blue states that protect people’s right to end their pregnancy.

The lawsuit first made........

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