Supreme Court allows emergency abortions in Idaho for now, punts on final decision

WASHINGTON − Abortions for gravely ill women can resume for now in Idaho after a divided Supreme Court on Thursday reversed its January decision to halt the procedures – and said it shouldn’t have gotten involved in the dispute at this stage.

In an unsigned opinion, a majority of the justices returned to the lower courts the fight over whether a federal law requires hospitals to provide emergency abortions, leaving the issue unresolved for all states.

The opinion – which was officially released the day after the court briefly published a draft by accident − came amid a razor-sharp presidential race in which abortion is a major issue.

And it was criticized from both the left and the right.

Justice Ketanji Brown Jackson, one of the three justices appointed by a Democratic president, said the decision was not a victory for pregnant patients in Idaho.

“It is a delay,” she wrote.

The Court has 'simply lost the will to decide': Alito

Justice Samuel Alito, one of the three conservative justices who wanted to uphold Idaho’s strict abortion ban, said the court “has simply lost the will to decide the easy but emotional and highly politicized question that the case presents.”

But Justice Amy Coney Barrett said the parties’ positions are still evolving so the court was wrong to consider the Biden administration’s challenge to Idaho's abortion ban.

“I am now convinced that these cases are no longer appropriate for early resolution,” Barrett wrote about Idaho's two related appeals in an opinion joined by Chief Justice John Roberts and Justice Brett Kavanaugh.

In January, the court took the unusual step of accepting the appeals without waiting for the lower courts to rule on whether Idaho’s strict abortion ban trumps a federal requirement that hospitals provide stabilizing care.

The court also allowed Idaho to fully enforce its ban while the justices considered the case.

Idaho’s law makes it a crime for doctors to perform an abortion unless a physician can demonstrate that the mother's life is in danger.

Since Idaho and other states tightened abortion restrictions after the Supreme Court overturned Roe v. Wade in 2022, doctors have said they can’t treat women who might lose organs or their reproductive ability, have uncontrollable bleeding or suffer other serious health consequences without an abortion − unless her life is clearly at risk.

The Biden administration argued the federal Emergency Medical Treatment and Labor Act (EMTALA) requires emergency rooms offer abortions if a patient’s health is in serious jeopardy.

Idaho countered that states have always been responsible for licensing doctors and setting the scope of their professional practice.

'Why are you here'?

During oral arguments in April, Barrett expressed frustration with the disagreement among the state and federal government over what type of emergency abortions would be allowed under the federal rule but blocked by the state ban.

“What’s the conflict?” Barrett asked Idaho Solicitor General Joshua Turner. “Why are you here.”

In her concurring opinion, Barrett wrote that “the parties’ litigating positions have rendered the scope of the dispute unclear, at best.”

She also said Idaho had raised a new issue about whether Congress, through EMTALA, could condition hospitals’ Medicare funding on performing procedures banned by a state.

“We should not jump ahead of the lower courts, particularly on an issue of such importance,” she wrote.

But three of her fellow conservatives said the court has all the information it needs to decide what Alito called a “straightforward question of statutory interpretation.”

“This about face is baffling,” he wrote in a dissent joined by Justices Clarence Thomas and, in part by Neil Gorsuch. “Nothing legally relevant has occurred since January 5.”

Jackson likewise argued it was wrong for the court to punt though she joined the majority in agreeing to let hospitals perform emergency abortions for now.

The need for a clear answer has only increased since January, she said, pointing out that Texas has challenged the Biden administration’s attempt to enforce EMTALA.

“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,” she wrote. “This Court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it.”

President Biden weighs in

Still, President Joe Biden said the decision would ensure that Idaho women get the emergency medical care they need while the case returns to lower federal 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,” Biden said in a statement. “This should never happen in America.”

As he headed to a debate Thursday against likely Republican nominee Donald Trump, who appointed three of the justices who overturned Roe v. Wade, Biden said his administration is committed to protecting women’s reproductive freedom.

“The stakes could not be higher and the contrast could not be clearer,” Biden said.

Biden’s campaign released on Thursday a new TV ad featuring an obstetrician who said she left Idaho because of the abortion ban.

“Physicians could be tried with a felony for saving that woman’s life too early,” Dr. Lauren Miller says in the ad.

Idaho has lost 22% of its OBGYNs since the state’s ban went into effect in August of 2022.

Duncan Harmon, a maternal fetal medicine specialist with St. Luke’s Health System in Idaho, said he’s unsure whether the Supreme Court’s decision will make doctors more interested in practicing there.

While he said Thursday's action brings some welcome relief, Harmon noted EMTALA covers only emergency room care and there are non-emergency situations in which doctors are still not able to offer abortions to protect the health of the mother.

Idaho Attorney General Raúl Labrador said Idaho will still be able to enforce its law in the vast majority of cases. He claimed as a victory the administration’s statements during oral arguments that abortion is not a required stabilizing treatment for mental health issues and that doctors who oppose abortion can claim a conscience objection.

Labrador called those “significant concessions.”

"We look forward to ending this administration’s relentless overreach into Idahoans’ right to protect and defend life," he said in a statement.

Complaints that pregnant women have been turned away from hospitals spiked after the Supreme Court decided Dobbs v. Jackson Women's Health Organization, according to an investigation by The Associated Press.

The Centers for Medicare and Medicaid Services, which enforces EMTALA, encouraged anyone who thinks they’ve been denied required treatment to reach out.

The agency said in a statement it will continue to investigate complaints and hold hospitals accountable “to the maximum extent permitted by law.”

Even when state bans include medical exceptions, the exceptions can be too vague to provide the clarity needed by patients and doctors, according to opponents of the bans.

"The Supreme Court created this health care crisis by overturning Roe v. Wade and should have decided the issue," said Nancy Northup, president and CEO of the Center for Reproductive Rights. "Women with dire pregnancy complications and the hospital staff who care for them need clarity right now.”

After the Supreme Court in January put Idaho’s law fully into effect, six patients with emergency conditions were transferred from St. Luke’s Health System to other states where they could get abortions.

Doctors in Idaho continue to operate in a risky environment, said Allison K. Hoffman, an expert on health law at the University of Pennsylvania Carey Law School.

But, at least for now, she said, they can provide abortions when necessary to stabilize an emergency medical condition.

The combined cases are Moyle v. United States and Idaho v. United States.

Contributing: Bart Jansen.

This article originally appeared on USA TODAY: Divided Supreme Court preserves emergency abortion in Idaho for now