Supreme Court Temporarily Allows Emergency Abortions in Idaho

The Supreme Court in Washington on June 25, 2024. Madalina Vasiliu/The Epoch Times

The Supreme Court on June 27 decided to dismiss Idaho’s appeal against a lower court ruling that granted an exception to its strict abortion law for abortions deemed to be medical emergencies.

The decision allows emergency abortions to proceed in Idaho, while a challenge to the state’s abortion law moves through the lower courts.

President Joe Biden praised the ruling.

“Today’s Supreme Court order ensures that women in Idaho can access the emergency medical care they need while this case returns to the lower courts. No woman should be denied care, made to wait until she’s near death, or forced to flee her home state just to receive the health care she needs,” he said in a written statement.

“This should never happen in America. Yet, this is exactly what is happening in states across the country since the Supreme Court overturned Roe v. Wade.”

The release of the judicial opinion came after the court’s website staff inadvertently published a version of the document on June 26 and then took it down.

The Supreme Court’s new opinion is unsigned and marked “per curiam,” which means “for the court,” but does not identify the opinion’s author. The opinion also states that the decision to grant the petition and hear the case was “improvidently granted,” which means the justices decided that they had made a mistake in agreeing to hear the case.

The opinion itself consists of a single sentence and does not provide reasons why it was issued. It is possible the opinion was labeled per curiam and kept to a mere two dozen words in length because there was significant disagreement among the justices on the reasoning underlying the decision.

The ruling means that the case will return to the lower courts where the litigants will be free to continue arguing about its merits.

The new opinion was handed down two years after the Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization that the U.S. Constitution doesn’t confer a right to abortion and returned its regulation to the states. The ruling overturned Roe v. Wade (1973).

A version of the Dobbs opinion was leaked weeks before that decision was published. An investigation by the court failed to identify the source of the leak. The leak was followed by raucous protests at the homes of the court’s conservative justices. One man was arrested for attempting to assassinate Justice Brett Kavanaugh.

History of Case

Idaho’s Defense of Life Act forbids abortions except when “necessary to prevent the death of the pregnant woman” or during the first trimester when the pregnancy was caused by rape or incest. Performing an abortion can lead to five years in prison and result in the revocation of a medical doctor’s license.

The case was about whether the state law conflicts with the federal Emergency Medical Treatment and Labor Act (EMTALA), which forbids “patient dumping,” the practice of hospitals refusing emergency treatment to people who can’t afford to pay for medical services.

The Biden administration says the state law runs afoul of EMTALA, which requires that emergency room patients in hospitals that accept Medicare be provided stabilizing care. The administration argued stabilizing care includes abortions. The government also said that state abortion restrictions such as Idaho’s have confused patients and health care professionals and delayed critical care for pregnant women.

At the same time, Idaho argued that federal law and the state law aren’t in conflict. Idaho said the federal government was trying to stretch the reach of the federal law to override the state’s abortion law, as part of an effort to create a federal right to abortion despite the Supreme Court’s ruling in Dobbs.

The court heard oral arguments on April 24 in Moyle v. United States, which was consolidated with Idaho v. United States. Lead applicant-petitioner Mike Moyle is the Republican speaker of Idaho’s House of Representatives. The conservative advocacy group Alliance Defending Freedom is on Idaho’s legal team.

Representing the Biden administration, U.S. Solicitor General Elizabeth Prelogar said Idaho’s law was forcing women to leave the state for medical treatment.

“The doctors can’t provide the care” because they fear that a prosecutor is “looking over their shoulder” and may “second-guess” them, Ms. Prelogar said.

Idaho Deputy Solicitor General Joshua N. Turner said EMTALA and the Idaho statute don’t conflict.

“If ER doctors can perform whatever treatment they determine is appropriate, then doctors can ignore not only state abortion laws, but also state regulations on opioid use and informed consent requirements,” the attorney said.

EMTALA was passed by Congress in 1986 with the goal of ensuring public access to emergency services regardless of a patient’s ability to pay.

The federal government took the position that Idaho’s Defense of Life Act was preempted by EMTALA. Federal preemption means that a state law that conflicts with federal law is invalid.

U.S. District Judge B. Lynn Winmill ruled in August 2022 that the Idaho law partly conflicts with EMTALA. The judge restrained Idaho from enforcing its state law “as applied to medical care required by” EMTALA.

In September 2023, a three-judge panel of the U.S. Court of Appeals for the Ninth Circuit reversed the District Court’s decision, finding that EMTALA and the state statute didn’t conflict, but two months later, the court reinstated the District Court’s injunction.

The full circuit was preparing to rehear the case, but on Jan. 5, the Supreme Court stepped in and granted Idaho’s request to lift the injunction, pending the outcome of the case at the high court.

Concurrences and a Dissent

Justice Elena Kagan concurred with the per curiam opinion because “Idaho’s arguments about EMTALA do not justify, and have never justified, either emergency relief or our early consideration of this dispute.”

The opinion reinstated the lower court’s injunction against the Idaho law and this will prevent the state from enforcing its abortion ban “when the termination of a pregnancy is needed to prevent serious harms to a woman’s health,” the justice wrote.

EMTALA requires hospitals to provide abortions that are prohibited by Idaho’s law, she added.

Justice Amy Coney Barrett filed an opinion concurring with the decision to dismiss the case, which was joined by Chief Justice John Roberts and Justice Kavanaugh.

Although the Supreme Court put the injunction on hold based on the belief that it would cause Idaho irreparable harm, Justice Barrett said the briefing process and oral argument made her change her mind about the nature of the case.

“I am now convinced that these cases are no longer appropriate for early resolution,” she wrote.

“The parties’ positions are still evolving,” Justice Barrett wrote, adding that because the terms of the dispute have been narrowed, Idaho’s ability to enforce its law “remains almost entirely intact” even with the injunction in place.

Justice Ketanji Brown Jackson issued an opinion concurring in part and dissenting in part from the per curiam opinion.

The Supreme Court’s lifting of the injunction almost a half a year ago forced Idaho physicians “to step back and watch as their patients suffered, or [arranged] for their patients to be airlifted out of Idaho,” Justice Jackson wrote.

“This months-long catastrophe was completely unnecessary” and “directly violated federal law, which in our system of government is supreme,” she wrote.

“To the extent that Idaho law conflicts with EMTALA, the State’s law must give way.”

Justice Jackson also wrote that she concurred with the decision to lift the stay, “which should not have been entered in the first place,” but would not have dismissed “these cases as improvidently granted” because the “fundamentals” of the dispute between Idaho and the federal government still remain.

Justice Samuel Alito filed a dissenting opinion. Justice Clarence Thomas joined the opinion but Justice Neil Gorsuch joined only in part.

Justice Alito emphasized that when a pregnant woman shows up at a hospital, EMTALA requires that both “the woman” and “her unborn child” must be stabilized, which means the federal government’s theory that the federal law preempts the Idaho law is “plainly unsound.”

The “novel” argument that EMTALA requires hospitals to perform abortions on request when the “health” of a pregnant woman is in jeopardy, grows out of President Biden’s Executive Order 14076 of July 8, 2022, in which he instructed federal officials to find ways to limit the reach of the Dobbs ruling that was handed down days prior, the justice wrote.

The Supreme Court’s “about-face is baffling,” Justice Alito wrote. “Nothing legally relevant has occurred since January 5” when the justices lifted the injunction.

The issue of whether EMTALA sometimes requires hospitals to perform abortions “is a straightforward question of statutory interpretation” that has been “exhaustively briefed and argued,” the justice wrote.

At a press conference following the new ruling, Idaho Attorney General Raul Labrador said he remains optimistic about the case.

The ruling said that Idaho “will be able to enforce its law to save lives in the vast majority of circumstances while the case proceeds,” the Republican official said.

Mr. Labrador said his office won “concessions” from the federal government that EMTALA “will rarely override Idaho’s law” and this “caused the Supreme Court to ask the Ninth Circuit for review in light of the federal government’s changing position.”

“The Ninth Circuit’s decision should be easy,” he said.

The issue will “definitely” return in some form to the Supreme Court in the future, Mr. Labrador said.

Texas currently has a similar case before the U.S. Court of Appeals for the Fifth Circuit, in which that court sided with Texas, he said.