The case before the Supreme Court is one coming out of Texas, where an appellate judge had revoked the U.S. Food and Drug Administration's approval of mifepristone more than a year ago.
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An anti-abortion rights group is suing the FDA, saying the pill could cause harmful side effects. The FDA said the drug is safe when used as indicated.
It's another hot button issue before the court with nationwide implications.
The Supreme Court justices seemed to indicate Tuesday during oral arguments that they are inclined to keep mifepristone legal. It gained FDA approval more than two decades ago, but then, more recently, the agency loosened restrictions to make it available by mail, at pharmacies and after telehealth appointments.
Justices questioned whether the anti-abortion rights group has legal standing to even bring the case.
Depending on the outcome, people across the country could lose access to mifepristone.
Supporters of abortion rights rallied outside the federal courthouse in Chicago Tuesday, calling on the Supreme Court to keep the abortion drug legal.
"This is a terrifying attack on a safe form of health care, and we will fight it, and we will make sure that we win, so that medication abortion remains an accessible option for everyone," said Anne Rumberger, with Chicago for Abortion Rights.
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In Deerfield Tuesday, outside the Walgreens headquarters, opponents of abortion rights rallied, and called on the pharmaceutical giant to stop selling mifepristone.
They also had a message for the Supreme Court.
"All of that, the pro-life petitioners, the doctors and nurses and other medical professionals who brought this case to the Supreme Court today were asking is that we go back to the restrictions that the FDA placed on abortion drugs when it first approved them in the year 2000," said Mary FioRito, former vice chancellor of the Archdiocese of Chicago.
The group is raising concerns about potential medical complications, even though the drug is widely considered safe.
"Walgreens and CVS, get out of the abortion industry. The United States Supreme Court, stop the unsafe distribution of these pills through telemedicine, through the mail and at pharmacies," said Eric Scheidler, with the Pro-Life Action League.
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But supporters of the abortion pill counter that the drug is safe, regardless of how it's distributed.
And they are sounding the alarm about the implications for women if the Supreme Court rules to restrict it.
"With this case, the Supreme Court could roll back the hands of time and limit access to essential reproductive health care, but we're gathered here today in solidarity to say, 'not on our watch,'" said Patience Roundtree, with Planned Parenthood of Illinois.
The Supreme Court only heard arguments on the case Tuesday.
A ruling is expected by the end of June, with major political implications for November.
The case could be a hard political pill for Republicans to swallow, come Election Day.
"So I do think to the extent that the Supreme Court does rule to further restrict mifepristone, which I'm not sure that it will, but if it does, I think you'll see a very clear negative backlash that in November all over this country," Democratic political strategist Joanna Klonsky said.
The evidence of that was clearly on display two years ago, when the high court overturned Roe v. Wade.
The abortion issue is a major motivator for Democrats.
"I think that's problematic for Republicans. Particularly, this race is going to come down to five states with heavy suburban areas. And, you know, Michigan, Georgia, even Arizona, Pennsylvania, and suburban women do not like the Republican position on abortion," Republican political strategist Pat Brady said.
And Brady believes that suburban women could be the votes that determine the outcome of the presidential race, and many others down ballot.
He said Republicans need to be strategic in addressing the issue of abortion.
"Don't demonize women; don't demonize this issue. That's what a lot of the elected officials on the Republican side have done. And I think it really hurts the party long-term," Brady said.
But, with abortion already a top issue for Democrats as they look to the polls in November, the Supreme Court could further foster their fervor.
"I think it'll be a jumpstart to the efforts to resist any elected official who has expressed support for these efforts to restrict abortion access and access to reproductive care," Klonsky said.