Washington — The Supreme Court on Thursday reopened abortions in certain medical emergencies in Idaho, renewing a lower court order that prevented the state from enforcing its near-total ban when an abortion is necessary to protect the mother’s health while a court case is pending.
The dispute revolved around Idaho’s measure, which was introduced after the Overturning the Roe v. Wade decisionagainst a federal law that requires Medicare-funded hospitals to perform abortions when necessary to stabilize a patient’s emergency medical condition.
The majority rejected Idaho’s appeal of a decision by the U.S. Court of Appeals for the 9th Circuit that upheld the injunction. The Supreme Court ruled in January allows Idaho to enforce its ban in certain medical situations while it reviewed the case, but its ruling now overturns that order.
The justices voted 6-3 to lift the stay. Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented.
The court did not address the fundamental question of whether federal law, the Emergency Medical Treatment and Labor Act (EMTALA), overrides Idaho’s near-total ban under certain circumstances. Instead, the decision suggests that the Supreme Court believes it intervened too early in the dispute. The case will likely return to the high court after further arguments.
Still, the ruling is a victory for the Biden administration, albeit likely a temporary one. The administration argues that EMTALA requires hospitals in states with the strictest restrictions to provide abortions in certain medical emergencies when it is 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 further proceedings proceed in lower courts.
“No woman should be denied care, have to wait until she is near death, or be forced to leave her home state just to get the medical care she needs. That should never happen in America,” Biden said. “Doctors should be able to practice medicine. Patients should be able to get the care they need.”
The decision was released after Bloomberg reported that a copy of the ruling was accidentally posted on the Supreme Court’s website on Wednesday. The media outlet published the ruling, which indicated that the court would allow emergency abortions in Idaho. The Supreme Court a document recognized was uploaded “inadvertently and briefly,” but said the statement on the Idaho cases would be released “in due course.”
The abortion controversy in Idaho
The Case before the Supreme Court is the first case since the overturning of Roe in which the justices examined a state law restricting access to abortion. It was also the second case before the Supreme Court during its current term involving this procedure. In that other court case, the justices a challenge rejected to forego a widely used abortion pill for procedural reasons and thus preserve access to it.
That case concerned whether the Biden administration can require Medicare-funded 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 Roe’s reversal, in August 2022, the Biden administration sued the state of Idaho because of its ban on abortion. The law allows 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 up to five years in prison.
However, the Justice Department argued that EMTALA overrides state bans in cases where conflicts arise.
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 refused to stay that order while the litigation continued, prompting the state and its Republican legislative leaders to seek the Supreme Court’s intervention.
The Supreme Court agreed to examine whether EMTALA overrides state laws like Idaho’s that ban most abortions but allows the state to continue to fully enforce its ban. It took up the case before the 9th Circuit had ruled on the matter.
In a concurring opinion joined in full by Justice Sonia Sotomayor and Justice Ketanji Brown Jackson, Justice Elena Kagan said the court’s decision “will prevent Idaho from enforcing its abortion ban when terminating a pregnancy is necessary to prevent serious harm to women.” She said Idaho’s law conflicts with EMTALA’s requirement to ensure patients receive stabilizing treatment, including abortion care, and that the court acted correctly in restoring the lower court’s order.
“In this way, women in Idaho will regain access to all the necessary medical treatment guaranteed by EMTALA,” Kagan wrote.
Justice Amy Coney Barrett also wrote a concurring opinion, joined by Chief Justice John Roberts and Justice Brett Kavanaugh. She complained that the “shape of these cases” had changed in the months after the Supreme Court agreed to intervene in the disputes, convincing her that they were “no longer amenable to early resolution.”
“We should not prejudge the lower courts, especially on such an important issue,” Barrett wrote.
The litigation highlighted the fallout from the Supreme Court’s June 2022 decision to strike down the constitutional right to abortion, which led to laws restricting abortion access going into effect in 22 states. In seven of those states, including Idaho, abortion laws do not include a health-related exception, according to the Justice Department.
Numerous doctors have warned the Supreme Court that state abortion bans have left them confused and worried that they could face felony charges if they perform abortions in medical emergencies, and have asked their state legislatures for clarification on the narrow exceptions.
In Idaho, a health system that filed an amicus curiae brief said many gynecologists have left the state trying to navigate the new abortion care landscape because they are confused and scared. The system also said it has transferred pregnant patients with medical emergencies 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 healthcare worker in the state has been charged or prosecuted for violating Idaho’s ban.
