Supreme Court to Hear Case on Idaho's Abortion Ban

Washington — The Supreme Court on Wednesday will hear arguments in a case that pits Idaho's near-total ban on abortion against a federal law that requires hospitals to provide stabilizing care to patients experiencing medical emergencies.

The dispute between the Biden administration and Idaho officials in the case known as Moyle v. United States is the second the justices will hear in the span of a month that follows the Supreme Court's decision less than two years ago overturning Roe v. Wade. The outcome of the case could determine whether the Biden administration can require hospitals in states with stringent abortion laws to offer pregnancy terminations in emergency situations.

The court fight involves the Emergency Medical Treatment and Labor Act, or EMTALA, which requires hospitals that participate in Medicare to stabilize patients facing an emergency medical condition.

The Supreme Court in early January said it would decide whether EMTALA overrides state laws that prohibit most abortions, but allowed Idaho to continue enforcing its ban in certain emergency medical situations until it issues a decision, expected by the end of June.

The battle for EMTALA

EMTALA, passed in 1986, aimed to tackle the issue of "patient dumping" by hospitals, where patients without insurance were discharged or transferred. The law set a national standard for hospitals in Medicare to provide stabilizing treatment to any patient facing an emergency condition that endangers their life or health.

The Biden administration argues that Health and Human Services, Congress, and healthcare providers have long understood that EMTALA mandates hospitals to provide abortions when necessary to protect the mother's life or prevent serious harm to her health.

While the need for stabilizing care may involve ending a pregnancy, conflicts between EMTALA and the Idaho abortion ban are uncommon, stated Solicitor General Elizabeth Prelogar in a filing.

If a situation arises later in pregnancy where the fetus can be delivered, there is no clash between federal and state laws, Prelogar explained. However, the conflict emerges when a pregnant woman faces an emergency medical condition that, without ending the pregnancy, poses a serious threat to her health but not her life. In such cases, EMTALA supersedes the Idaho ban, she argued.

"Delaying care until the woman's condition deteriorates and the doctor can say that termination is necessary to prevent her death, as Idaho law requires, stacks tragedy upon tragedy with little additional likelihood of fetal survival," Prelogar wrote.

The Biden administration has argued that the gap between what EMTALA requires and what is allowed under Idaho's law — an abortion to protect a mother's health versus an abortion to save her life — has "devastating real-world consequences."

"Many pregnancy complications do not pose a threat to the woman's life when she arrives at the emergency room — but delaying care until necessary to prevent her death could allow her condition to deteriorate, placing her at risk of acute and long-term complications," Prelogar wrote.

If Idaho prevails and the Supreme Court agrees that state abortion restrictions supersede EMTALA's stabilization requirement, Prelogar warned it would allow care under the law to vary from state-to-state, "thwarting Congress's promise of essential emergency care to all Americans."

But lawyers for Idaho's Republican legislative leader argued that EMTALA does not include a requirement for abortion care, and they accused the Biden administration of recasting the law as an abortion mandate.

"EMTALA is not [the Department of Health and Human Services'] Trojan horse for nationwide abortion rules. EMTALA nowhere mentions abortion," Republican state lawmakers said in a legal document submitted to the court. "Reading EMTALA as empowering HHS to displace state abortion laws defies the usual expectations of how Congress legislates and distorts the Constitution's separation of powers."

Under the leadership of Idaho House Speaker Mike Moyle, the GOP lawmakers argued that the Biden administration's interpretation of EMTALA represents an "intolerable federal power grab," labeling the law as a "patient-dumping statute, not an abortion-access statute."

In a separate submission from Idaho's attorney general, state attorneys, in collaboration with the conservative legal group Alliance Defending Freedom, accused the Biden administration of trying to establish a "nationwide abortion mandate" in emergency rooms that are part of the Medicare program. 

"This move would enable the federal government to compensate hospitals for disregarding state laws, granting emergency-room physicians immunity from the state-law standards of practice that regulate the treatments they are permitted to administer," stated Idaho Attorney General Raúl Labrador. "This nullification of state law is not limited in scope and extends beyond the realm of abortion."

Labrador, a Republican, clarified to CBS News chief legal correspondent Jan Crawford that Idaho's legislation and EMTALA do not clash.

"There's a lot of misinformation circulating about what the Idaho law entails, and it's crucial for people to recognize that if the life of the mother is at risk, Idaho law actually permits an abortion," he emphasized.

Labrador accuses Biden administration of fearmongering after Roe v. Wade reversal

Following the reversal of Roe v. Wade, Idaho finds itself among the 14 states that have completely outlawed abortion except for certain exceptions, as reported by the Guttmacher Institute. Additionally, seven states have banned abortion within the first 18 weeks of pregnancy.

In a legal battle, 22 states, many of which have strict abortion laws, have thrown their support behind Idaho. They argue that the Biden administration is making efforts to nullify state laws that protect the unborn.

While no physician in Idaho has faced prosecution for violating the abortion ban, the case before the Supreme Court highlights the aftermath of overturning the constitutional right to abortion. It also sheds light on the challenges faced by physicians as they navigate through narrow exceptions in state abortion laws.

Dr. Jim Souza, the chief physician executive of St. Luke's Health System in Boise, expressed concerns about the uncertainty and hesitation surrounding the legality of performing abortions within the confines of Idaho's law.