Washington — The Supreme Court on Thursday allowed abortions to be performed during certain medical emergencies in Idaho, reinstating a lower court order that blocked the state from enforcing its near-total ban when an abortion is needed to preserve the health of the mother while legal proceedings continue.
The dispute pitted Idaho’s measure, enacted after the reversal of Roe v. Wade, against a federal law that requires Medicare-funded hospitals to offer abortions when needed to stabilize a patient’s emergency medical condition.
The majority dismissed Idaho’s appeal of a decision from the U.S. Court of Appeals for the 9th Circuit that kept the injunction in place. The Supreme Court in January allowed Idaho to enforce its ban in certain medical situations while it considered the case, but its ruling now dissolves that order.
The justices split 6-3 in agreeing to lift its 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 decision indicates the Supreme Court believes it intervened in the dispute too soon. The case is likely to return to the high court after more 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 most stringent restrictions to offer abortions in certain medical emergencies when necessary to prevent harms to the mother’s health.
The decision’s release came after Bloomberg reported that a copy of the opinion was posted on the Supreme Court’s website inadvertently Wednesday. The outlet published the ruling, which showed that the court was set to allow emergency abortions in Idaho. The Supreme Court acknowledged a document was “inadvertently and briefly” uploaded, but said the opinion in the cases out of Idaho would be issued “in due course.”
The Idaho abortion dispute
The case before the Supreme Court is the first since it overturned Roe in which the justices examined a state law restricting access to abortion. It also was the second case involving the procedure that was before the high court in its current term. In that other court battle, the justices rejected a challenge to a widely used abortion pill on procedural grounds, preserving access to it.
This case involved whether the Biden administration could require Medicare-participating hospitals in states with stringent abortion bans to offer pregnancy terminations in certain emergency situations. The Justice Department argued that under EMTALA, the necessary stabilizing treatment required by the law may sometimes be an abortion.
Two months after Roe’s reversal, in August 2022, the Biden administration sued the state of Idaho over its abortion ban. The law includes exeptions in cases of rape or incest, or to prevent the death of the mother. Physicians who perform abortions in violation of the law may be charged with a felony and face up to five years in prison.
But the Justice Department argued that EMTALA overrides state bans in instances where they conflict.
A federal judge sided with the Biden administration and allowed physicians to perform abortions in certain emergency situations. The U.S. Court of Appeals for the 9th Circuit declined to pause that order while litigation continued, prompting the state and its Republican legislative leaders to seek the Supreme Court’s intervention.
The high court agreed to consider whether EMTALA preempts state laws like Idaho’s that prohibit most abortions, but allowed the state to continue enforcing its ban in full. It took up the case before the 9th Circuit had ruled on the merits.
The legal battle demonstrated the fallout from the Supreme Court’s June 2022 decision unwinding the constitutional right to abortion, after which laws curtailing access to abortion took effect in 22 states. In seven of those states, including Idaho, abortion laws do not contain a health exception, according to the Justice Department.
Numerous doctors warned the Supreme Court that state abortion bans have left them confused and concerned that they could face felony charges for providing abortions in medical emergencies and have sought clarifications to the narrow exceptions from their state legislatures.
In Idaho, one health care system that filed a friend-of-the-court brief said many OB-GYNs have left the state because of confusion and fear as they attempted to navigate the new landscape for abortion care. It also said it’s been transferring pregnant patients with emergency medical conditions to neighboring states amid concerns about the ramifications of delaying care and uncertainty about whether an abortion could be performed without violating the Idaho law.
No medical worker in the state has been charged or prosecuted for violating Idaho’s ban so far.