Health Care

Supreme Court rejects Idaho ban on emergency abortions in a limited ruling

At present, when federal and state laws on emergency care clash, federal law takes precedence.

The U.S. Supreme Court ruled on Thursday to permit — for now — abortions to be performed in Idaho when pregnant women are facing medical emergencies, as the justices dispensed with the contentious issue without actually deciding the case on its merits.

The 6-3 ruling, with three of the six conservative justices dissenting, effectively reinstated a lower court’s decision that Idaho’s Republican-backed near-total abortion ban must yield to a 1986 U.S. law known as the Emergency Medical Treatment and Labor Act (EMTALA) when the two statutes conflict.

President Joe Biden’s administration had sued Idaho, arguing that EMTALA takes precedence over state law. EMTALA ensures that patients can receive emergency care at hospitals that receive funding under the federal Medicare program. Idaho is among six states with abortion bans that offer no exceptions to protect the health of pregnant women.

The court’s decision lifted a block, or stay, that the justices had placed on the lower court’s ruling in January. But the Supreme Court did not resolve the underlying legal dispute, opting instead to dismiss the case as “improvidently granted.”

Liberal Justice Ketanji Brown Jackson in a separate opinion agreed with the court’s decision to lift its stay, but said she would not have dismissed the case, calling the legal situation a “fragile detente.”

“This court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it,” Jackson wrote. “And for as long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas and elsewhere will be paying the price.”

Following the 2022 abortion ruling that overturned the 1973 Roe v. Wade precedent that had recognized a constitutional right to abortion and legalized the procedure nationwide, a series of states, including Idaho, enacted Republican-backed laws imposing bans on abortion.

Candidates widely diverge on abortion issue

Biden, seeking re-election this year, has sought to make abortion rights a centrepiece of his campaign, as Democrats try to use the issue to political advantage against Republicans in races across the country.

“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,” Biden said in a statement. “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. 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,” Biden added.

WATCH | Idaho abortion ruling offers partial victory for abortion rights activists, U.S. Supreme Court litigator says: 

Elizabeth Wydra of the Constitutional Accountability Center says the ruling from the U.S. Supreme Court on Thursday about emergency abortions in Idaho can be seen as a ‘little bit of a reprieve’ for abortion rights activists and people in Idaho. ‘But it’s definitely not a victory, it’s more of a delay.’

Donald Trump, again likely to be the Republican candidate challenging Biden in the Nov. 5 election, has offered shifting statements on reproductive rights heading into an unprecedented June debate on Thursday, in which the subject of abortion rights could be addressed.

Trump as president appointed three of the six justices who were in the majority in the 2022 abortion ruling, and he has been on the defensive on the abortion issue during this year’s campaign. Trump has said in states with abortion bans he backs exceptions for rape, incest and to protect the life of the mother, and also that he supports the availability of in-vitro fertilization (IVF).

In another case, the Supreme Court in a unanimous decision on June 13 rejected a bid by anti-abortion groups and doctors to restrict access to the abortion pill mifepristone, finding that the plaintiffs lacked the necessary legal standing to pursue the litigation targeting the U.S. Food and Drug Administration.

The justices also did not decide the underlying legal issues in that case, ruling that the anti-abortion groups and doctors who brought the challenge lacked the necessary legal standing to bring the case.

Idaho’s so-called abortion “trigger” law, adopted in 2020, automatically took effect upon Roe’s reversal two years later. The state law banned nearly all abortions unless needed to prevent a mother’s death, threatening doctors who violate it with two to five years in prison and loss of their medical licence.

Medical experts have said conditions that could threaten the woman’s life and health — from gestational hypertension to excessive bleeding — could require an abortion to stabilize her or avoid seizures, vital organ damage and failure, or the loss of the uterus.

Court decision released early again

EMTALA requires hospitals that receive funding under the federal Medicare program to “stabilize” patients with emergency medical conditions. Hospitals that violate EMTALA can face lawsuits by injured patients, civil fines and potentially the loss of Medicare funding.

Following Roe’s demise, Biden’s administration issued federal guidance stating that EMTALA takes precedence over state abortion bans in the relatively rare instances in which the two conflict, and filed the lawsuit challenging Idaho’s ban.

Boise-based U.S. District Judge B. Lynn Winmill in 2022 blocked enforcement of Idaho’s law in cases of abortions that are needed to avoid putting the woman’s health in “serious jeopardy” or risking “serious impairment to bodily functions.”

A version of the Idaho ruling was inadvertently posted to the court’s website on Wednesday in the second instance in the past two years of the disclosure of a major abortion decision before its formal issuance. It also happened in May 2022 with the momentous Dobbs v. Jackson Women’s Health Organization case that upended abortion rights across the U.S.

WATCH | Flurry of new abortion laws, legal challenges brings real-life consequences: 

Elizabeth Wydra of the Constitutional Accountability Center says doctors and patients are often unclear on what is and isn’t allowed since a landmark 2022 ruling that saw the U.S. Supreme Court overturn Roe v. Wade, which had established the right to abortion.

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