Supreme Court Allows Emergency Abortions In Idaho, Sidestepping Broader EMTALA Questions

Dive Brief:

• The U.S. Supreme Court ruled 6-3 on Thursday to allow Idaho doctors to perform abortions to stabilize a patient’s life and health. 
• However, the court declined to take up the fundamental legal question underlying the case: whether a federal law mandating hospitals provide medical services during emergencies supersedes near-total state abortion bans.
• It is the court’s first ruling on statewide abortion restrictions since Roe v. Wade was overturned in 2022, ending the constitutional right to abortion in the United States. 

Dive Insight:

At the center of the dispute is Idaho’s near-total abortion ban, which allows for exceptions only when the patient’s life is in danger and includes criminal penalties for providers, according to the Supreme Court filings.

The state’s abortion ban was enacted in 2020. However, it only went into effect in 2022 when the Supreme Court axed Roe.

The Biden administration sued after the ban went into effect, arguing it conflicts with the decades-old Emergency Medical Treatment and Labor Act, which states Medicare-funded hospitals must provide medical services when required to stabilize a patient’s life or health.

A federal judge agreed with the Biden administration, and the U.S. Court of Appeals for the 9th Circuit declined to pause that order while the lawsuit continued upon Idaho’s appeal. However, the Supreme Court allowed the ban to remain in place earlier this winter while it heard arguments.

Now, the high court has agreed that EMTALA has precedence in this particular instance.

“By their terms, the two laws differ,” Justice Elena Kagan wrote in the court’s majority opinion.

In a situation when a woman continuing a pregnancy could put her health in grave danger, “federal law requires a hospital to offer an abortion, whereas Idaho law prohibits that emergency care,” Kagan wrote.

The majority opinion was made up of the court’s liberal judges — Kagan, Ketanji Brown Jackson and Sonia Sotomayor — and three of their conservative colleagues — Chief Justice John Roberts and Justices Brett Kavanaugh and Amy Coney Barrett.

Conservative justices Samuel Alito, Neil Gorsuch and Clarence Thomas dissented.

The decision is not a straight win for advocates of abortion access, as the court declined to extend its ruling to other states with similar laws on their books.

In a concurring opinion, Jackson was aggrieved at the court’s decision to punt the broader question. “There is simply no good reason not to resolve this conflict now,” she wrote.

Laws on the books of up to 22 states could have been impacted if the court had extended a full ruling finding EMTALA supersedes state bans, according to abortion opponents.

“Today’s decision is not a victory for pregnant patients in Idaho. It is delay,” Jackson wrote. “While this Court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires.”

In his dissenting opinion, Alito said the court “has simply lost the will to decide the easy but emotional and highly politicized question that the case presents.”

Earlier this month, the Supreme Court rejected a challenge to the government’s approval of a commonly used abortion medication in another win for abortion supporters. The court did not rule on the merit of the case, instead finding that plaintiffs lacked standing to sue.