West Virginia can restrict the sale of the abortion pill, despite federal regulators’ approval of it as a safe and effective medication, a federal judge has ruled.

U.S. District Court Judge Robert C. Chambers determined Thursday that the near-total abortion ban signed by Republican Gov. Jim Justice in September 2022 takes precedence over approvals from the U.S. Food and Drug Administration.

“The Supreme Court has made it clear that regulating abortion is a matter of health and safety upon which States may appropriately exercise their police power,” Chambers wrote in a decision dismissing most challenges brought against the state by abortion pill manufacturer GenBioPro, Inc. in a January lawsuit filed in the state southern district’s Huntington division.

Since the U.S. Supreme Court last year overturned Roe v. Wade, the 1973 ruling that provided nationwide access to abortion, most GOP-controlled states have enacted or adopted abortion bans of some kind, restricting abortion pills by default. All have been challenged in court.

Legal experts foresee years of court battles over access to the pills, as abortion-rights proponents bring test cases to challenge state restrictions.

In West Virginia’s case, regulation of medical professionals “is arguably a field in which the states have an even stronger interest and history of exercising authority,” than the federal government, Chambers decided.

GenBioPro, Inc., the country’s only manufacturer of a generic version of the abortion pill mifepristone, had argued that the state cannot block access to a U.S. Food and Drug Administration-approved drug.

Chambers dismissed the majority of the manufacturer’s challenges, finding there is “no disputing that health, medicine, and medical licensure are traditional areas of state authority.”