Supreme Court Hears Case on Idaho Abortion Ban and Federal Emergency Care Law

The U.S. Supreme Court heard its first test on Wednesday of state abortion bans that have been enacted since the court upended the Roe v. Wade constitutional right to abortion.

While the current case involves an Idaho abortion ban, the court’s ruling could have implications beyond that state. Idaho lawmakers have banned abortion except when a mother’s life is at risk. The Biden administration says the state law conflicts with a federal law requiring emergency room doctors to stabilize patients, no matter what, even if that means an abortion.

How the court will rule is uncertain. The justices could make a major ruling — or they could rule narrowly on how Idaho’s state law interacts with the federal law, the Emergency Medical Treatment and Active Labor Act (EMTALA).

A look at the key points in Wednesday’s arguments:

– Attorneys for both sides warned that the justices’ ruling could affect women and doctors far beyond Idaho, changing how emergency rooms treat patients in many other states.

– Solicitor General Elizabeth Prelogar, arguing for the Biden administration, cautioned that other states could pass laws limiting how emergency rooms offer other services, which could mean trouble for more patients when they go to a hospital.

– Medical “what-ifs” peppered the arguments, sometimes turning personal: What if a woman’s water breaks early in her pregnancy, exposing her to serious infection risk at a point when the fetus can’t survive outside the womb? What if continuing the pregnancy would subject a pregnant person to organ failure, or cause permanent infertility?

– Justice Amy Coney Barrett, one of the conservatives who voted to overturn Roe v. Wade, pressed Turner on when a prosecutor might bring charges against a doctor for providing an abortion.

– Justice Sonia Sotomayor, part of the court’s liberal minority, asked Turner to consider how the federal law requires hospitals to treat patients for more common medical emergencies, like the diabetes that she has had since childhood.

– Conservative Justice Samuel Alito was particularly alarmed by Idaho’s argument that emergency rooms could be forced to provide abortions if a pregnant patient in mental distress demanded one.

– Congress passed its federal law mandating that emergency rooms stabilize or treat patients in 1986, after reports that private hospitals were offloading patients – many of them without health insurance and in bad condition – on public hospitals.

It’s unclear exactly where the Supreme Court will land, but the court had earlier allowed Idaho’s abortion ban to be fully enforced while litigation continues. That means at least five members of the court voted to put on hold a lower court’s ruling that the federal law overrides Idaho’s abortion ban in medical emergencies.

So the Biden administration was facing a tough road in persuading the court to uphold that ruling. Six conservative justices all have cast votes to limit abortion access, including five who voted less than two years ago to overturn Roe v. Wade. Justices Neil Gorsuch, Clarence Thomas and Alito seemed most likely to side with Idaho on Wednesday. The liberal justices, Ketanji Brown Jackson, Kagan and Sotomayor were most favorable to the administration. The outcome likely turns on the votes of the other three members of the court — Chief Justice John Roberts and Barrett and Kavanaugh. Barrett and Kavanaugh voted to overturn Roe.

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