Supreme Court Allows Emergency Abortions in Idaho for Now

Three conservatives — Justices Clarence Thomas, Samuel A. Alito Jr. and Neil M. Gorsuch — issued dissenting opinions.

At issue is the nearly four-decade-old Emergency Medical Treatment and Labor Act, known as EMTALA, which requires some hospitals to stabilize or transfer patients needing emergency care.

The Biden administration sued Idaho in 2022, claiming the state’s strict abortion ban conflicted with federal law., which, according to the Justice Department, issues warrants emergency abortions if necessary to address life-threatening health problems, such as organ failure or loss of fertility, without risking death.

Abortion rights groups and medical experts see the ruling as a temporary victory that guarantees emergency care in Idaho for now but doesn’t settle the question of whether federal law overrides strict state bans, including in other states. The Biden administration has separately asked the Supreme Court to address the same issue in a Texas case, where another lower court said doctors must comply with state restrictions — and aren’t required to perform emergency abortions.

“We don’t have time to wait for this case to work its way through the legal process,” Susie Keller, CEO of the Idaho Medical Association, said in an interview Thursday. Keller said obstetricians/gynecologists are “fleeing” Idaho in the wake of the abortion ban. Citing data that shows about one in five obstetrician-gynecologists have left the state, she called on the Idaho Legislature to change the law to explicitly allow abortions when a pregnant woman’s health is at risk, even if her life is not in danger.

Idaho Attorney General Raúl R. Labrador (R) also claimed a partial victory, noting that some conservative judges adopted his state’s arguments that EMTALA did not trump the ban of the State in these circumstances. He also pointed out that Justice Amy Coney Barrett, who joined the majority, wrote in a concurring opinion that the Biden administration had offered concessions that limited the potential reach of the federal law.

“We are confident that we will ultimately win this case,” Labrador said on a call with reporters. “My office secured significant concessions from the United States that Judge Barrett described as “important” and “crucial.” »

The Idaho case was one of two cases brought before the high court this term to address abortion access nationwide, two years after the justices overruled it. Roe v. Wadewhich had guaranteed a constitutional right to abortion. In early June, the justices unanimously rejected a challenge to mifepristone, a widely used abortion drug, saying the anti-abortion doctors who brought the lawsuit lacked standing to do so.

The Supreme Court agreed to intervene in the Idaho case in January, in response to the State’s emergency request, but he allowed the abortion ban to go into effect while he heard arguments and deliberated.

The Biden administration first turned to EMTALA in late 2021 to try to ensure access to abortion in limited situations. This effort intensified after the Supreme Court struck down Roe deer the following summer.

In July 2022, the administration told hospitals that receive Medicare funds that emergency room doctors must terminate pregnancies in certain circumstances, even if state law prohibits the procedure. Hospitals that fail to comply face penalties of up to $120,000 per violation.

The White House and abortion rights advocates say the administration is implementing the emergency care law as originally intended, pointing to years-old cases that they say show a pattern of consistent application.

Idaho bans all abortions except those necessary “to prevent the death of the pregnant woman,” and imposes sentences of up to five years in prison for doctors who perform the procedure. There have been harrowing reports of hospitals denying access to women with high-risk pregnancy complications. Medical professionals have reported uncertainty and confusion over when the state’s abortion ban will be in effect, leading to delays in some procedures.

Conservatives and abortion opponents say the administration is misrepresenting EMTALA’s intent to ensure access to abortion after the pandemic ends.Roe deer.

The federal law requires hospitals to provide “any person” suffering from a medical emergency with “treatment necessary to stabilize the person’s medical condition.” The law makes no reference to abortion or any other type of care, and Republican officials say the Biden administration cannot use EMTALA to force hospitals that receive federal funds to violate a state law.

Lower courts have issued conflicting rulings on the application of the federal law. In August 2022, a district judge sided with the Biden administration and temporarily blocked the contested provision of Idaho law. The judge upheld the state’s ban on most abortions but said that because of hospitals’ obligations under a conflicting federal law, a doctor cannot be punished for performing an abortion in order to to protect the health of a patient.

Then, a three-judge panel of the U.S. Court of Appeals for the 9th Circuit allowed the state to enforce the law — before a full complement of judges from the same appeals court again blocked Idaho’s ability to punish emergency doctors while appeals continued.

In the Supreme Court’s ruling Thursday, three justices who often make up the center of the bench said it was too early for the high court to rule on the merits of the Idaho case, outlining the positions of state and the Biden administration as “still evolving.”

Barrett, joined by Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh, said the gap between what the government says EMTALA requires in terms of emergency abortion care and what Idaho says its law allows has narrowed since the justices agreed to take the case on an emergency basis.

“Idaho’s ability to enforce its law remains almost entirely intact,” Barrett wrote.

Liberal Justice Ketanji Brown Jackson wrote separately that the court should have definitively resolved the issue after its initial involvement in January allowed Idaho’s ban to temporarily take full effect.

“It is too little, too late for the Court to make a decision and simply tell the lower courts to continue as if none of this had happened,” she wrote.

Jackson warned that “storm clouds are looming” and asked rhetorically whether the court “will continue to grapple with this issue, allowing chaos to reign wherever lower courts allow states to blatantly undermine federal law, thereby facilitating the suffering of people in need of urgent medical treatment.”

The ruling, issued hours before President Biden and his presumptive Republican opponent Donald Trump meet in a prime-time presidential debate, underscores the stakes in next November’s election, advocates said. While Biden has worked to protect access to abortion, Trump imposed new restrictions on abortion funding during his four years in office and pledged to appoint judges who would overturn the decisions of justice Roe v. Wade. Trump chose three of the five justices who voted to end the nation’s abortion rights.

In a statement after the ruling, Biden said: “No woman should be denied care, made to wait until she is on the verge of death, or forced to flee her home state simply to receive the health care she needs. This should never happen in America. Yet that’s exactly what’s been happening in states across the country since the Supreme Court overturned Deer.»

Democrats also suggested Thursday that the high court was trying to avoid political pressure over abortion this year.

“The Supreme Court has decided to wait until after the election to tell Americans whether women in crisis can get the emergency medical care they need,” Sen. Elizabeth Warren (D-Mass.) said in a statement. communicated. “The Supreme Court does not have the final word on abortion, the American people do.”