The Supreme Court on Jan. 5 granted Idaho the authority to enforce its strict abortion ban while legal clashes play out over a federal law mandating emergency care.
In response to emergency requests from Idaho state officials, the nation’s highest court temporarily suspended a federal judge’s ruling that found that parts of the ban conflicted with the federal Emergency Medical Treatment and Labor Act (EMTALA) of 1986.
“The applications for stay ... are granted,” the Supreme Court stated in its ruling. “The preliminary injunction issued on August 24, 2022, by the United States District Court for the District of Idaho ... is stayed.”
The high court stated that it would hear oral arguments on the matter in April.
US Law Turns Hospitals ‘Into Abortion Clinics’
EMTALA, the federal law at the center of the case, stipulates that emergency room care must be provided to anyone, regardless of their ability to pay.The Biden administration cited that law in a 2022 federal guidance for health care providers regarding abortion. The guidance told hospitals that they were obligated to provide “stabilizing” care under EMTALA to patients experiencing an emergency condition, extending this to include abortion.
It applies to hospitals receiving federal funding through the Medicare program.
In November 2023, lawyers from Alliance Defending Freedom (ADF), acting on behalf of the Idaho attorney general’s office, filed an emergency application for a stay pending appeal with the Supreme Court. Their motion asked for an immediate injunction against the 9th Circuit’s ruling, arguing that EMTALA preempts Idaho’s abortion ban, the Defense of Life Act.
“Hospitals—especially emergency rooms—are centers for preserving life. The government has no business transforming them into abortion clinics,” ADF Senior Counsel Erin Hawley said in a statement.
“Emergency room physicians can, and do, treat ectopic pregnancies and other life-threatening conditions. But elective abortion is not life-saving care—it ends the life of the unborn child—and the government has no authority to override Idaho’s law barring these procedures.
District Court’s Block of Ban
Idaho’s abortion ban has been partially blocked from being enforced to the extent that it conflicts with EMTALA since U.S. District Court Judge Lynn Winmill issued an injunction in July 2022 after the Biden administration sued.Judge Winmill, in making his ruling, noted that the state’s actions put doctors in an ethical bind.
The dilemma, as described in the ruling, revolves around doctors grappling with the obligation to provide emergency care under EMTALA and the state’s blanket prohibition of abortions in Idaho.
“The doctor believes her EMTALA obligations require her to offer that abortion right now. But she also knows that all abortions are banned in Idaho. She thus finds herself on the horns of a dilemma. Which law should she violate?” Judge Winmill wrote.
Idaho challenged this ruling, arguing that the two laws weren’t conflicting and emphasizing that the federal law didn’t expressly mandate doctors to perform abortions in specific circumstances.
The Biden administration, represented by Solicitor General Elizabeth Prelogar, disagreed, asserting in court filings that the Idaho law “criminalizes care required by federal law.”
Appeals Court’s Suspension of Block
The 9th U.S. Circuit Court of Appeals briefly suspended Judge Winmill’s ruling in September 2023 but later allowed its reinstatement, prompting Idaho to appeal to the Supreme Court in November 2023.Idaho aimed to expedite resolution, seeking an injunction to limit the full enforcement of its abortion ban. An appeal is pending at the 9th Circuit.
In a win for Texas, the 5th Circuit unanimously declined “to expand the scope” of EMTALA to include enforcing abortions. The state’s attorney general, Ken Paxton, argued that the Biden administration’s rule would force doctors to perform elective abortions against state law.
“The question before the court is whether EMTALA, according to HHS’s Guidance, mandates physicians to provide abortions when that is the necessary stabilizing treatment for an emergency medical condition. It does not,” wrote 5th U.S. Circuit Court of Appeals Judge Kurt Engelhardt in the opinion.
“EMTALA does not mandate any specific type of medical treatment, let alone abortion.”
ADF lawyers are also litigating the Texas case.
Idaho’s abortion law was enacted in 2020 with a provision stating that it would take effect if the Supreme Court overturned Roe v. Wade. Following the Supreme Court’s decision in July 2022, which effectively overturned Roe, Idaho’s law came into force.
The Defense of Life Act imposes criminal penalties, including up to five years in prison, for anyone performing an abortion, with health care professionals risking the loss of their licenses if found in violation. An exception is granted if the abortion is deemed necessary to protect the life of the pregnant woman.