Supreme Court dismisses Idaho emergency abortion care case

June 27, 2024

The Supreme Court will allow Idaho doctors to resume performing abortions in medical emergencies, at least while the case works its way through lower courts.

The court ruled 6-3 to dismiss the case as improvidently granted, which means doctors in Idaho will be able to perform emergency abortions despite state-level restrictions while the case is being litigated. Conservative Justices Clarence Thomas, Samuel Alito and Neil Gorsuch dissented.

The ruling marks a temporary victory for the Biden administration which has struggled to protect access to abortion since the Supreme Court overturned Roe v. Wade two years ago. But dismissing the appeal from Idaho won’t resolve the legal questions and will merely send the case back to the appeals court instead of rushing it through to the highest level.

Bloomberg first reported on the decision, citing an earlier draft of the ruling that the Court accidentally posted online for a brief time on Wednesday.

The ruling reinstates a lower court decision that had allowed emergency abortion care while the case continues. The Supreme Court had paused that ruling months earlier before hearing arguments in the matter in April.

The case centered on the Emergency Medical Treatment and Labor Act (EMTALA), which requires federally funded hospitals to provide stabilizing care to emergency room patients no matter their ability to pay. Abortion is the standard of care to stabilize many pregnancy-related conditions, and hospitals have long provided the procedure when necessary.

The Biden administration invoked EMTALA in the wake of the Supreme Court decision that overturned Roe v. Wade. The administration said state laws or mandates that employ a more restrictive definition of an emergency medical condition are preempted by the federal statute.    

The Department of Justice argued that stabilizing treatment can be an abortion if it’s deemed medically necessary. 

But EMTALA doesn’t specifically mention abortion and doesn’t outline which procedures should be provided. Idaho argued that state law supersedes the federal requirement, and states can create a carveout for abortion if the patient’s life is not at risk. 

Idaho permits an abortion when “necessary to prevent the death of the pregnant woman,” but not if the patient’s health or reproductive future is at risk from a catastrophic health consequence, like the loss of her uterus. It imposes penalties of up to five years in prison on doctors who perform the procedure.

Health providers say state laws contain too much uncertainty and don’t protect them if they need to perform an abortion. As a result, stories about pregnant patients in medical distress being turned away from hospitals or being told to wait in a parking lot until their life is in danger are becoming common. 

“Everyone is practicing confused and afraid and it’s hurting patients,” said Jessica Kroll, president of the Idaho chapter of the American College of Emergency Physicians.  

Kroll said if an EMTALA violation is enforced, it’s at the hospital level rather than the individual physician level. Facilities that violate EMTALA can be fined or stripped of their Medicare and Medicaid funding. 

Idaho’s abortion law criminalizes individual physicians, she said.