Fears of Another Supreme Court Assault on Abortion Rights Grow After Idaho Ruling

Reproductive rights advocates on Wednesday applauded a federal court ruling in Idaho allowing doctors to provide abortion care in cases of medical emergencies, but legal experts warned the decision could mark the beginning of the next fight over abortion rights at the U.S. Supreme Court.

Judge B. Lynn Winmill of Idaho's Federal District Court ruled that the state's near-total ban on abortion care violates the Emergency Medical Treatment and Labor Act of 1986 (EMTALA), siding with the U.S. Department of Justice.

"The justices could easily be deciding an EMTALA-related case in September, before the new term even begins."

The DOJ sued Idaho over the ban, arguing that doctors are required under EMTALA to provide stabilizing medical treatment to anyone who comes to an emergency department, and that includes pregnant patients who need abortions to treat medical emergencies.

Idaho's ban demands that doctors do "the opposite" of what they are trained and obligated to do, said Winmill: "effectively identify problems and treat them promptly so patients are stabilized before they develop a life-threatening emergency."

The ruling still allowed Idaho's ban on nearly all abortion care to go forward, but enforcement of the ban on emergency care will be blocked by Winmill's preliminary injunction as the DOJ's lawsuit proceeds.

"Thanks to this ruling, Idaho hospital emergency departments cannot deny abortions to patients experiencing a medical emergency," said Planned Parenthood Action Fund, while the group's president, Alexis McGill Johnson, tweeted, "We applaud this ruling."

The decision was handed down a day after a federal judge in Texas ruled against the Biden administration's directive that doctors in states banning abortion follow EMTALA and provide emergency care to pregnant people, leading legal observers including Slate's Mark Joseph Stern to warn that the Supreme Court will likely take up the issue in the coming months.

If the cases proceed to circuit courts in Texas and Idaho, Stern said, they will likely also hand down conflicting rulings.

As journalist Chris Geidner wrote at Law Dork:

It is not clear yet what is going to happen next, but, if Idaho appeals, that case would go to the reliably liberal U.S. Court of Appeals for the 9th Circuit, which would likely affirm Winmill's ruling. If the Justice Department appeals the ruling out of Texas, that case would go to the U.S. Court of Appeals for the 5th Circuit, which is a step beyond conservative depending on the panel and would almost certainly affirm Hendrix's ruling.

At that point, either or both could make a request to the Supreme Court--perhaps even on the shadow docket, if the appeal to the circuit courts are actually seeking a stay of the district court's ruling during an appeal. If that happens, the justices could easily be deciding an EMTALA-related case in September, before the new term even begins.

Responding to the ruling in Idaho, U.S. Attorney General Merrick Garland said the DOJ "will continue to use every tool at its disposal to defend the reproductive rights protected by federal law" and that it is "considering appropriate next steps" regarding the ruling in Texas.

Steven Mazie, who covers the Supreme Court for The Economist, suggested the cases could hinge on "what counts as a medical emergency."

"I can't believe in a matter of months we've gone from losing the constitutional right to abortion to debating whether doctors can provide lifesaving care to patients," said Kate Smith, senior director of news content for Planned Parenthood.