Topline
Emergency abortions will be allowed under Idaho’s restrictive abortion law—but could still be outlawed in the future—as the Supreme Court threw out Thursday a challenge to the state’s abortion ban, sending the case back to the lower courts.
Key Facts
Moyle v. U.S. was a lawsuit brought by the federal government against Idaho’s strict abortion ban, as the Biden administration argued hospitals in the state are required under federal law to provide abortions in emergency situations—including ones that aren’t life-threatening—even if the state bans abortion.
Under the Emergency Medical Treatment and Labor Act (EMTALA), hospitals that participate in Medicare must provide stabilizing emergency care when medically necessary, even in cases when a person might be uninsured or can’t pay.
The court ruled in an unsigned opinion to dismiss the case as “improvidently granted”—meaning they shouldn’t have taken it up in the first place—and got rid of a stay that allowed Idaho to continue refusing emergency abortions while the litigation played out.
The court’s ruling is in line with a draft opinion that was accidentally posted on the court’s site Wednesday, in which justices reportedly ruled 5-4 to dismiss the case.
Justices Elena Kagan and Sonia Sotomayor issued a concurring opinion, saying “Idaho’s arguments about EMTALA do not justify, and have never justified, either emergency relief or our early consideration of this dispute,” while Justice Amy Coney Barrett, joined by Chief Justice John Roberts and Brett Kavanaugh, said they agreed with the ruling because “the shape of these cases has substantially shifted” since the court agreed to take up the dispute.
Justice Ketanji Brown Jackson was the sole dissenter, saying she agrees with lifting the stay but wouldn’t have dismissed the case entirely, writing the Supreme Court’s “intervention has already distorted this litigation process” and “The Court has made this bed so now it must lie in it—by proceeding to decide the merits of the critical pre-emption issue this case presents.”
Chief Critic
“To be clear: Today’s decision is not a victory for pregnant patients in Idaho. It is delay,” Jackson wrote in her dissent. While this Court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires. This Court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it.”
Big Number
5. That’s the number of other states whose abortion bans don’t have exceptions allowing abortions due to health circumstances that aren’t life threatening: Arkansas, Mississippi, Oklahoma, South Dakota and Wisconsin (though that state’s abortion ban is not being enforced). Since the case will keep playing out in the lower courts, it still remains to be seen how these other states could be affected by the litigation.
What To Watch For
Health experts have also watched the Idaho case because of its potential impact on other emergency healthcare that’s covered under EMTALA, believing a ruling against the federal government could open the door to states barring other kinds of care that’s politically controversial—such as providing HIV treatment or treating transgender patients. “If Idaho was allowed to do what it wants to do, then essentially that is green lighting states to go after EMTALA for any disfavored population, or treatment or condition,” Sara Rosenbaum, the founding chair of George Washington University’s Department of Health Policy, told reporters on a press call ahead of oral arguments in the case.
Tangent
Moyle v. U.S. was one of two major abortion-related cases the Supreme Court heard this term—two years after the high court overturned Roe v. Wade—along with FDA v. Alliance for Hippocratic Medicine, a case seeking to restrict abortion drug mifepristone. The court ruled in June the challengers who brought the case didn’t have standing to do so, but GOP states are expected to continue the litigation.
Key Background
The Supreme Court’s ruling to strike down Roe v. Wade in June 2022 led Idaho and more than a dozen states across the country to ban abortion, many without exceptions in place including medical emergencies. That’s led to a slew of reports about pregnant people being denied care even during medical emergencies, as physicians face the risk of punishment should they violate state bans by performing an abortion that isn’t exempted. One of the Biden administration’s efforts to fight back against the national wave of abortion bans was releasing guidance in July 2022 declaring abortions must be provided during emergencies under EMTALA, even in states where the procedure is banned. It has since opened several investigations into hospitals it believes violated the law. The federal government sued to block Idaho’s ban in August 2022, and the provision on not allowing abortions in emergencies unless life threatening has gone back and forth. A district court first blocked the law, then federal appeals judges reinstated the restrictions—and soon blocked them again—before the Supreme Court took up the case. The law was allowed to take effect while the high court considered the case.
