The Supreme Court on Thursday unanimously preserved access to a medication that was used in nearly two-thirds of all abortions in the U.S. last year, in the court’s first abortion decision since conservative justices overturned Roe v. Wade two years ago.

The nine justices ruled that abortion opponents lacked the legal right to sue over the federal Food and Drug Administration’s approval of the medication, mifepristone, and the FDA’s subsequent actions to ease access to it. The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal.

Justice Brett Kavanaugh, who was part of the majority to overturn Roe, wrote for the court on Thursday that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.”

The decision could lessen the intensity of the abortion issue in the November elections, with Democrats already energized and voting against restrictions on reproductive rights. But the high court is separately considering another abortion case, about whether a federal law on emergency treatment at hospitals overrides state abortion bans in rare emergency cases in which a pregnant patient’s health is at serious risk.

More than 6 million people have used mifepristone since 2000. Mifepristone blocks the hormone progesterone and primes the uterus to respond to the contraction-causing effect of a second drug, misoprostol. The two-drug regimen has been used to end a pregnancy through 10 weeks gestation.

Health care providers have said that if mifepristone is no longer available or is too hard to obtain, they would switch to using only misoprostol, which is somewhat less effective in ending pregnancies.

President Joe Biden’s administration and drug manufacturers had warned that siding with abortion opponents in this case could undermine the FDA’s drug approval process beyond the abortion context by inviting judges to second-guess the agency’s scientific judgments. The Democratic administration and New York-based Danco Laboratories, which makes mifepristone, argued that the drug is among the safest the FDA has ever approved.

The decision “safeguards access to a drug that has decades of safe and effective use,” Danco spokeswoman Abigail Long said in a statement.

The plaintiffs in the mifepristone case, anti-abortion doctors and their organizations, argued in court papers that the FDA’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and “jeopardize women’s health across the nation.”

Kavanaugh acknowledged what he described as the opponents’ “sincere legal, moral, ideological, and policy objections to elective abortion and to FDA’s relaxed regulation of mifepristone.”

Federal laws already protect doctors from having to perform abortions, or give any other treatment that goes against their beliefs, Kavanaugh wrote. “The plaintiffs have not identified any instances where a doctor was required, notwithstanding conscience objections, to perform an abortion or to provide other abortion-related treatment that violated the doctor’s conscience since mifepristone’s 2000 approval,” he wrote.

In the end, Kavanaugh wrote, the anti-abortion doctors went to the wrong forum and should instead direct their energies to persuading lawmakers and regulators to make changes.

Those comments pointed to the stakes of the 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone.

The mifepristone case began five months after the Supreme Court overturned Roe. Abortion opponents initially won a sweeping ruling nearly a year ago from U.S. District Judge Matthew Kacsmaryk, a Trump nominee in Texas, which would have revoked the drug’s approval entirely. The 5th U.S. Circuit Court of Appeals left intact the FDA’s initial approval of mifepristone. But it would reverse changes regulators made in 2016 and 2021 that eased some conditions for administering the drug.

The Supreme Court put the appeals court’s modified ruling on hold, then agreed to hear the case, though Justices Samuel Alito, the author of the decision overturning Roe, and Clarence Thomas would have allowed some restrictions to take effect while the case proceeded. But they, too, joined the court’s opinion Thursday.

Two years after a leaked draft of a U.S. Supreme Court opinion signaled that the nation’s abortion landscape was about to shift dramatically, the issue is still consuming the nation’s courts, legislatures and political campaigns — and changing the course of lives.

On Wednesday, a ban on abortion after the first six weeks of pregnancy, often before women realize they’re pregnant, took effect in Florida, echoing laws in two other states. In Arizona, meanwhile, lawmakers voted to repeal a total ban on abortion dating back to 1864, decades before Arizona became a state — and the governor signed it a day later. Also this week, the Kansas Legislature increased funding for anti-abortion centers, while advocates in South Dakota submitted the required number of signatures for a ballot measure to enshrine abortion rights in the state constitution.

The status of abortion in states across the country has changed constantly, with lawmakers passing measures and courts ruling on challenges to them. Currently, 14 states are enforcing bans on abortion at all stages of pregnancy, with limited exceptions. Most Democratic-led states, meanwhile, have taken steps to preserve or expand access.

“Some of it’s exactly what we knew would happen,” said David Cohen, a professor at the Thomas R. Kline School of Law at Drexel University who studies abortion policy, “and others have been big surprises that have put, frankly, the anti-abortion movement on their heels.”

Although more than 20 states have begun enforcing abortion bans of varying degrees since the Supreme Court overturned Roe v. Wade in June 2022, studies have found that the number of monthly abortions nationally is about the same — or higher — than it was before the ruling. Asked to weigh in on the emotional debate, voters have supported the position favored by abortion rights advocates on all seven statewide ballot measures since then.

The Supreme Court’s decision in the Dobbs v. Jackson Women’s Health Organization case was released officially on June 24, 2022, upending nearly 50 years of abortion being legal nationwide. But the world caught a glimpse of it about six weeks earlier, on May 2, after a news outlet published a leaked draft.

“With the Dobbs decision, the will of the people is now able to be adhered to,” said Stephen Billy, vice president of state affairs for Susan B. Anthony Pro-Life America. He said abortion rights supporters have sought to create uncertainty about laws he says are clear — especially with assertions that the bans bar abortion in medical emergencies: “They’ve tried to sow political division just to advance their policy agenda,” he said.

At the time Politico published the leaked draft, Amanda Zurawski was undergoing fertility treatment and was about two weeks away from learning she was finally pregnant. The Austin, Texas, woman had always supported abortion rights, and was mad that the right to abortion was on the verge of disappearing. But she didn’t expect a direct impact in her life.

That changed months later when she was denied an abortion despite a premature rupture of membranes, which can lead to dangerous internal bleeding. Days later, she was diagnosed with sepsis, a life-threatening reaction to infection. Her daughter, Willow, was ultimately aborted, but Zurawski nearly died in the process because of the delay.

Jurors in the hush money trial of Donald Trump heard a recording Thursday of him discussing with his then-lawyer and personal fixer a plan to purchase the silence of a Playboy model who has said she had an affair with the former president.

A visibly irritated Trump leaned forward at the defense table, and jurors appeared riveted as prosecutors played the September 2016 recording that attorney Michael Cohen secretly made of himself briefing his celebrity client on a plan to buy Karen McDougal’s story of an extramarital relationship.

Though the recording surfaced years ago, it is perhaps the most colorful piece of evidence presented to jurors so far to connect Trump to the hush money payments at the center of his criminal trial in Manhattan. It followed hours of testimony from a lawyer who negotiated the deal for McDougal’s silence and admitted to being stunned that his hidden-hand efforts might have contributed to Trump’s White House victory.

“What have we done?” attorney Keith Davidson texted the then-editor of the National Enquirer, which had buried stories of sexual encounters to prevent them surfacing in the final days of the bitterly contested presidential race. “Oh my god,” came the response from Dylan Howard.

“There was an understanding that our efforts may have in some way...our activities may have in some way assisted the presidential campaign of Donald Trump,” Davidson told jurors, though he acknowledged under cross-examination that he dealt directly with Cohen and never Trump.

The testimony from Davidson was designed to directly connect the hush money payments to Trump’s presidential ambitions and to bolster prosecutors’ argument that the case is about interference in the 2016 election rather than simply sex and money. Manhattan District Attorney Alvin Bragg has sought to establish that link not just to secure a conviction but also to persuade the public of the significance of the case, which may be the only one of four Trump prosecutions to reach trial this year.

“This is sort of gallows humor. It was on election night as the results were coming in,” Davidson explained. “There was sort of surprise amongst the broadcasters and others that Mr. Trump was leading in the polls, and there was a growing sense that folks were about ready to call the election.”

Davidson is seen as a vital building block for the prosecution’s case that Trump and his allies schemed to bury unflattering stories in the run-up to the 2016 presidential election. He represented both McDougal and porn actor Stormy Daniels in negotiations that resulted in the purchase of rights to their claims of sexual encounters with Trump and those stories getting squelched, a tabloid industry practice known as “catch-and-kill.”

Davidson is one of multiple key players testifying in advance of Cohen, the star prosecution witness who paid Daniels $130,000 for her silence and also recorded himself, weeks before the election, telling Trump about a plan to purchase the rights to McDougal’s story from the National Enquirer so it would never come out. The tabloid had previously bought McDougal’s story to bury it on Trump’s behalf.

At one point in the recording, Cohen revealed that he had spoken to then-Trump Organization Chief Financial Officer Allen Weisselberg about “how to set the whole thing up with funding.” To which Trump can be heard responding: “What do we got to pay for this? One-fifty?”

Trump can be heard suggesting that the payment be made with cash, prompting Cohen to object by saying “no” multiple times. Trump can then be heard saying “check” before the recording cuts off.

Trump’s lawyers sought earlier in the day to blunt the potential harm of Davidson’s testimony by getting him to acknowledge that he never had any interactions with Trump — only Cohen. In fact, Davidson said, he had never been in the same room as Trump until his testimony.

He also said he was unfamiliar with the Trump Organization’s record-keeping practices and that any impressions he had of Trump himself came through others.

The Supreme Court will consider Monday whether banning homeless people from sleeping outside when shelter space is lacking amounts to cruel and unusual punishment.

The case is considered the most significant to come before the high court in decades on homelessness, which has reached record levels in the United States.

In California and other Western states, courts have ruled that it’s unconstitutional to fine and arrest people sleeping in homeless encampments if shelter space is lacking.

A cross-section of Democratic and Republican officials contend that makes it difficult for them to manage encampments, which can have dangerous and unsanitary living conditions.

But hundreds of advocacy groups argue that allowing cities to punish people who need a place to sleep will criminalize homelessness and ultimately make the crisis worse as the cost of housing increases.

Dozens of demonstrators gathered outside the court Monday morning with silver thermal blankets and signs like “housing not handcuffs.”

The Justice Department has also weighed in. It argues people shouldn’t be punished just for sleeping outside, but only if there’s a determination they truly have nowhere else to go.

The case comes from the rural Oregon town of Grants Pass, which started fining people $295 for sleeping outside to manage homeless encampments that sprung up in the city’s public parks as the cost of housing escalated.

The measure was largely struck down by the San Francisco-based 9th Circuit Court of Appeals, which also found in 2018 that such bans violated the Eighth Amendment by punishing people for something they don’t have control over. The 9th Circuit oversees nine Western states, including California, which is home to about one-third of the nation’s homeless population.

The case comes after homelessness in the United States grew a dramatic 12%, to its highest reported level as soaring rents and a decline in coronavirus pandemic assistance combined to put housing out of reach for more Americans, according to federal data. The court is expected to decide the case by the end of June.