The Supreme Court Allows Idaho to Block Emergency Abortions

Late on Friday, the Supreme Court ruled that Idaho can enforce its total abortion ban even when it’s necessary to save a pregnant person’s life, lifting a lower court’s injunction from 2022 that blocked this part of the law. Now, the state can criminalize doctors for offering abortion care during medical emergencies, at least until the Supreme Court hears the case against Idaho’s abortion law in full in April.

The lower court ruling from August 2022 came after the Biden administration filed a lawsuit against Idaho’s abortion law for violating the federal Emergency Medical Treatment and Labor Act (EMTALA). EMTALA, passed in 1986, requires doctors to provide stabilizing, emergency care to patients, including those experiencing pregnancy-related complications. Currently, Idaho’s ironically named “Defense of Life Act” makes it a crime to “perform or attempt to perform an abortion” even when someone’s life would be severely endangered by continuing their pregnancy. The law ostensibly allows an exception only when the state deems that an abortion is “necessary to prevent the death of the pregnant woman”—which the Biden administration has argued is much narrower than EMTALA.

The Supreme Court’s ruling on Friday is the latest development through months of legal back-and-forth in the state. In October, a three-judge panel of the Ninth Circuit Court of Appeals briefly overturned the lower court’s injunction from 2022. But almost immediately after this, the full Ninth Circuit reversed the panel’s ruling and upheld the injunction.

The decision came just days after another blow to the Biden administration’s attempts to invoke EMTALA to try and protect pregnant people from the rigidity of state abortion bans. In Texas, on Tuesday, the Fifth Circuit Court of Appeals similarly ruled that emergency rooms in the state aren’t required to perform life-saving abortions under EMTALA. The Fifth Circuit decision was in response to Biden’s July 2022 guidance to hospitals that, under EMTALA, they’re required to provide emergency abortion care—even if doing so is at odds with state laws.

Rabia Muqaddam, senior staff attorney at the Center for Reproductive Rights, said the Fifth Circuit’s ruling in Texas “shows a complete disregard for the lives of pregnant people.” She continued, “It suggests that everyone who goes to an emergency room in Texas is entitled to stabilizing care under EMTALA—unless they happen to be a pregnant person who needs an emergency abortion to be stabilized.”

In a statement responding to the Supreme Court’s decision on Friday night, President Biden maintained that his administration “will continue to defend a woman’s ability to access emergency care under federal law.”

Idaho has one of the most aggressively anti-abortion legal landscapes in the country. Last spring, Idaho Republicans passed a law making it a crime to help a minor travel across state lines for an abortion without their parents’ consent, though the law was blocked by a federal judge in November. Over the summer, Northwest Public Broadcasting obtained a letter from a group of Idaho Republicans sent to hospitals in the state, questioning the accuracy of abortion data that they’ve reported to the government as required by state law and threatening doctors with criminal charges for failing to report abortions.

In June, Idaho ended its maternal mortality review committee, even as the U.S. maintains the highest maternal mortality rate among wealthy nations, and states with more abortion restrictions have disproportionately high maternal mortality rates. At least one hospital in a rural area with limited access to health care shuttered its entire labor and delivery department in March, following a mass exodus of OB/GYNs who feared that continuing to do their jobs in Idaho could land them in prison. Now that the state can render criminal charges against doctors for providing emergency, stabilizing abortion care, these bleak figures are likely to get worse.