The issue of medication abortion was back before a New Orleans-based appeals court on Wednesday, in the latest iteration of a yearslong legal effort to end the provision of abortion drugs via telehealth.

Medication abortion now accounts for two-thirds of US abortions, which overall have increased since the 2022 Supreme Court decision that ended abortion rights protections nationwide. The latest case was brought against the Trump administration by Louisiana, which has argued its abortion prohibitions are being undermined by federal regulations that allow mifepristone to be sent to patients in the mail, without an in-person doctor’s visit.

Over roughly 100 minutes of arguments, the 5th US Circuit Court of Appeals wrestled with whether it could interfere with the US government’s regulatory approach to the abortion pill. The Justice Department has tried to head off the lawsuit by raising procedural issues with the case while refusing to endorse the safety of the drug.

The appeals court did not indicate how it intended to rule on Louisiana’s case; however it rules, it is expected that the Supreme Court will have the final word on the matter.

The high court issued an emergency order in May keeping the current rules allowing telehealth abortions in place for this current round of legal wrangling. Much of Wednesday’s hearing centered on what the appeals court could even do in the case in light of that order.