A Republican-appointed federal judge in Texas issued an order suspending the US government’s decades-old approval of a key drug used in medication abortion, initiating a process that could block access to the pill nationwide in a week.

But his order Friday was almost immediately contradicted by a Democratic-appointed judge in Washington state who affirmed the US Food and Drug Administration’s approval of mifepristone and blocked the government from restricting access.

The competing orders just minutes apart signal the issue is almost certainly bound for the US Supreme Court, potentially setting up another politically seismic ruling a year after the high court’s conservative majority overturned Roe v. Wade.

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