Washington — The Supreme Court on Thursday allowed Idaho to perform abortions during certain medical emergencies. That reinstated a lower court order that barred the state from enforcing the near-total ban when an abortion is necessary to protect the mother’s health while the lawsuit is pending.
The dispute pitted Idaho’s measure, issued after the reversal of Roe v. Wadeagainst a federal law that requires Medicare-funded hospitals to offer abortions when necessary to stabilize a patient’s medical emergency.
The majority rejected Idaho’s appeal of a decision by the U.S. Court of Appeals for the 9th Circuit that upheld the order. The Supreme Court in January allowed Idaho to enforce its ban in certain medical situations while it considered the case, but its ruling now vacates that order.
The justices were split 6-3 in agreeing to lift the stay. Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented.
The court did not address the underlying question of whether the federal law, the Emergency Medical Treatment and Labor Act, or EMTALA, trumps Idaho’s near-total ban in certain circumstances. Instead, the ruling indicates that the Supreme Court believes it intervened too early in the dispute. The case is likely to return to the Supreme Court after further proceedings.
Still, the ruling is a victory for the Biden administration, although likely a temporary one. The government has argued that EMTALA requires hospitals in states with the strictest restrictions to offer abortions in certain medical emergencies when necessary to prevent harm to the mother’s health.
President Biden said in a statement that the order ensures women in Idaho have access to emergency medical care while additional proceedings take place in the lower courts.
“No woman should be denied care, forced to wait until she is near death, or forced to flee her home state just to get the health care she needs. This should never happen in America,” Biden said. “Physicians should be able to practice medicine. Patients should be able to get the care they need.”
The decision’s release came after Bloomberg reported that a copy of the opinion was accidentally posted on the Supreme Court’s website on Wednesday. The outlet published the ruling, which showed the court would allow emergency abortions in Idaho. The Supreme Court a document recognized was uploaded “accidentally and briefly,” but said the opinion in the Idaho cases would be issued “in due course.”
The Idaho Abortion Dispute
The case before the Supreme Court is the first since Roe was overturned in which the justices examined a state law restricting access to abortion. It was also the second case involving the proceedings pending before the Supreme Court during the current term. In that other lawsuit, the judges a challenge rejected for procedural reasons to a commonly used abortion pill, thus maintaining access to it.
The case concerned whether the Biden administration could require Medicare-participating hospitals in states with strict abortion bans to offer abortions in certain emergency situations. The Justice Department argued that under EMTALA, the necessary stabilizing treatment required by law can sometimes be an abortion.
Two months after the reversal of Roe, in August 2022, the Biden administration sued the state of Idaho because of the abortion ban. The law has exceptions in cases of rape or incest, or to prevent the death of the mother. Doctors who perform abortions in violation of the law can be charged with a crime and face a prison sentence of up to five years.
But the Justice Department argued that EMTALA overrides state bans in cases where they conflict.
A federal judge sided with the Biden administration and allowed doctors to perform abortions in certain emergency situations. The U.S. Court of Appeals for the 9th Circuit declined to stay that order while the lawsuits continued, prompting the state and its Republican legislative leaders to seek the Supreme Court’s intervention.
The Supreme Court agreed to consider whether EMTALA preempts state laws like Idaho’s, which ban most abortions, but allows the state to fully enforce the ban. It took up the case before the 9th Circuit had ruled on the merits.
In a concurring opinion supported in full by Justice Sonia Sotomayor and in part by Justice Ketanji Brown Jackson, Justice Elena Kagan said the court’s decision “will prevent Idaho from enforcing its abortion ban when the termination of a pregnancy is necessary to prevent serious harm to women.” She said the Idaho law violates EMTALA’s promise to ensure patients receive stabilizing treatment, including abortion care, and that the court was right to reinstate the lower court’s order.
“This will allow Idaho women to regain access to all the necessary medical treatments that EMTALA guarantees,” Kagan wrote.
Justice Amy Coney Barrett also wrote a concurring opinion, which was joined by Chief Justice John Roberts and Justice Brett Kavanaugh. She lamented that the “shape of these cases” has changed in the months since the Supreme Court agreed to intervene in the disputes, convincing her that they are “no longer suitable for early resolution.”
“We should not jump ahead of the lower courts, especially on such an important issue,” Barrett wrote.
The legal battle showed the fallout from the Supreme Court’s June 2022 decision that struck down the constitutional right to abortion, after which laws restricting abortion access went into effect in 22 states. In seven of those states, including Idaho, abortion laws do not include a health exception, according to the Justice Department.
Scores of doctors warned the Supreme Court that state abortion bans have left them confused and concerned that they could face charges for performing abortions in medical emergencies, and have asked their state lawmakers for clarification on the limited exceptions.
In Idaho, a health care system that filed a friend-of-the-court brief said many gynecologists have left the state due to confusion and fear as they tried to navigate the new abortion care landscape. It also says it has transferred pregnant patients with urgent medical conditions to neighboring states because of concerns about the consequences of delaying care and uncertainty about whether an abortion can be performed without violating Idaho law.
To date, no medical providers in the state have been charged or prosecuted for violating Idaho’s ban.
