The U.S. Supreme Court ruled Idaho’s abortion ban goes against federal mandates and can not be enforced in emergency cases for now. The opinion does not rule on the merit of the case but sends the case back to lower courts.
On Thursday, the high court released its official opinion, a day after it got posted online seemingly by accident. The decision reinstates a lower court order allowing emergency abortions under the Emergency Medical Treatment and Active Labor Act or EMTALA which mandates physicians treat patients in an emergency.
In 2023, a federal court injunction prevented Idaho's ban from applying to emergency abortions. The Supreme Court lifted the hold in January while the case continued.
This 6-3 ruling vacates the previous stay and sends the case back to the Ninth Circuit which will decide on the outcome. Justice Elena Kagan concurred with the decision.
“EMTALA requires hospitals to provide abortions that Idaho’s law prohibits. When that is so, Idaho’s law is preempted,” Kagan wrote in the opinion.
The court decided to vacate its stay and dismiss the writ of certiorari before judgment as improvidently granted, which means they believe the court shouldn’t have taken on the appeal of that case.
“That will prevent Idaho from enforcing its abortion ban when the termination of a pregnancy is needed to prevent serious harms to a woman’s health,” Kagan said.
The case can now proceed to the Court of Appeals, where the District Court can take into account further evidence or argument to make a final judgment.
“Doing so will again give Idaho women access to all the needed medical treatments that EMTALA guarantees,” Kagan said.
Justices Samuel Alito, Neil Gorsuch and Clarence Thomas dissented.
Timeline of Idaho’s ban on emergency abortion
In 2023, Idaho's ban applying to emergency abortions was put on hold by a federal court. But in 2024, the injunction was lifted and Idaho hospitals saw an increase in patients being airlifted out-of-state for emergency abortions. A recent study by the Idaho Coalition for Safe Healthcare also showed Idaho lost 22% of its OBGYNs since its abortion bans went into effect.
In April, the Court heard arguments in the case, which centered around conflicting definitions of “stabilizing care” and the boundaries of state rights.
Defendants of Idaho law argued EMTALA doesn’t require emergency rooms to become “abortion enclaves in violation of state law” and said states had the right to make their own decisions on medical practices within their borders.
Shortly after Roe v. Wade was repealed in 2022, Idaho banned abortions in almost all cases, with narrow exceptions for rape, incest, and when the life of the mother is in danger. The Federal Department of Justice sued the state, arguing the law conflicted with the Emergency Medical Treatment and Labor Act.
Under EMTALA, hospitals that receive federal Medicare funds are required to provide “stabilizing care” to patients in an emergency, which in some cases, can include providing abortions. The federal government argued Idaho’s ban could not apply in emergency situations as it conflicts with doctors’ duty of care to act to preserve patients’ health.
Idaho law does not allow physicians to provide an abortion regardless of the likelihood that waiting to intervene will result in the patient suffering loss of organ function or a debilitating medical complication. Physicians say they must intervene to protect their patients’ overall health before they are at risk of dying instead of waiting for their condition to deteriorate.
But under Idaho code, anyone who provides or assists an abortion can face felony charges and up to five years in prison. Physicians are also at risk of losing their medical license.
Doctors said that left them second guessing when to intervene and fearful of being criminally prosecuted for exercising their professional medical judgment. Medical Associations, Hospitals and Physicians have sounded the alarm on the impact this has on patients in Idaho.
EMTALA came about in 1986 to prevent hospitals from “dumping” patients who could not pay for care during an emergency. This is the first abortion case in the U.S. Supreme Court has weighed in on since the repeal of Roe v. Wade.
