The Supreme Court, with its conservative majority of 6-3, revisited the legal landscape it established with its June 2022 decision overturning the landmark Roe v. Wade ruling that had legalized abortion nationwide. Idaho’s so-called “abortion trigger” law, enacted in 2020, automatically took effect upon Roe’s reversal. The state law prohibits nearly all abortions unless necessary to prevent the mother’s death, and doctors who violate it face two to five years in prison and the loss of their medical license.
The Biden administration, which sued Idaho over its abortion law, contends that the termination of a pregnancy is the only care that can prevent serious harm to the health of some pregnant women facing emergency complications, Idaho is one of several states that have implemented a near-total abortion ban in recent years, with no exception to protect the health of pregnant patients.
At the heart of the case is the Emergency Medical Treatment and Labor Act (EMTALA), which mandates hospitals receiving federal Medicare funding to “stabilize” patients with emergency medical conditions. Hospitals that violate EMTALA face potential lawsuits, civil fines, and the loss of Medicare funding. The crux of the legal debate revolves around whether Idaho’s abortion ban should yield to EMTALA when a doctor determines that the necessary “stabilizing care” is an abortion that falls outside Idaho’s narrow exception for preventing the mother’s death.
Solicitor General Elizabeth Prelogar, representing the Biden administration, asserted that EMTALA takes precedence over state abortion bans in instances of conflict. She emphasized that the administration’s position does not require religiously affiliated hospitals with emergency rooms to perform abortions or compel individual doctors who oppose abortion to perform the procedure. “Our position is that EMTALA does not override either set of conscience protections,” Prelogar clarified.
Joshua Turner, Idaho’s lawyer, argued that EMTALA does not compel doctors to disregard the scope of their licenses and offer medical treatments that violate state law. “Nothing in EMTALA requires doctors to ignore the scope of their license and offer medical treatments that violate state law,” Turner said. He implored the justices to dismiss the administration’s broad interpretation of EMTALA.
The Supreme Court’s three liberal justices posed sharp questions to Turner, highlighting that EMTALA mandates the provision of stabilizing care for emergency medical conditions and supersedes the authority of hospitals or states in these specific healthcare situations.
Following Roe’s demise, the Biden administration issued guidance stating that EMTALA prevails over state abortion bans in cases of conflict, and subsequently filed a lawsuit challenging Idaho’s ban. Medical experts stressed that conditions posing risks to a woman’s life and health, ranging from gestational hypertension to excessive bleeding, may necessitate an abortion to stabilize her or avert seizures, vital organ damage or failure, or the loss of the uterus.
The Supreme Court has allowed Idaho to enforce its law while simultaneously agreeing to determine its legality. Before the arguments, hundreds of protesters gathered outside the court building, mostly abortion rights advocates but also some abortion opponents.
