SCOTUS Ruling on Emergency Abortion Care Called 'Dangerous Preview for What Could Come'

Reproductive rights advocates across the United States on Thursday were "hardly celebrating" the Supreme Court's one-sentence decision in a case regarding whether emergency departments can provide abortion care to people who have urgent pregnancy complications, and the court left open the possibility that such care could ultimately be banned.

In Moyle v. United States and Idaho v. United States, Idaho officials asked the court to intervene in an earlier decision by the U.S. Court of Appeals for the Ninth Circuit, which temporarily blocked the state's near-total abortion ban after the Biden administration argued it violated the Emergency Medical Treatment and Labor Act (EMTALA).

EMTALA requires hospital emergency departments that accept Medicare to provide "necessary stabilizing treatment" to all patients, and the Biden administration argued abortion care is included in that requirement and that federal law should override Idaho's abortion ban.

But a day after a draft decision was mistakenly posted on the Supreme Court's website, the release of the ruling confirmed that the court had dismissed the case without ruling on its merits and was sending it back to the lower courts.

The decision temporarily restores Idaho medical providers' ability to provide emergency abortions, but as the Center for Reproductive Rights (CRR) said, "it still leaves millions of people in states with abortion bans vulnerable."

"Hospitals in the 14 states that completely ban abortion, as well as many others with bans and restrictions, have shown they are afraid to provide emergency abortions due to the risk of severe criminal penalties under their states' vague and confusing abortion bans," said the organization. "For patients needing abortion care in those states, they will continue to largely rely on their state's medical exceptions, which often do not work in practice."

Nancy Northrup, CRR's president and CEO, explained that the court had "kicked the can down the road on whether states with abortion bans can override the federal law requirement that hospitals must provide abortion care to patients in the throes of life-threatening pregnancy complications."

"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential healthcare, is a dangerous preview for what could come."

"The Supreme Court created this healthcare crisis by overturning Roe v. Wade and should have decided the issue," said Northrup. "Women with dire pregnancy complications and the hospital staff who care for them need clarity right now."

Two of the court's liberal members, Justices Ketanji Brown Jackson and Elena Kagan, agreed with Northrup and other advocates in a dissenting opinion that the panel should have ruled on the merits of the case.

Kagan wrote that EMTALA "unambiguously requires" hospitals to provide emergency treatment including abortion care, while Jackson said Idaho's ban on nearly all abortions created a "monthslong catastrophe" when it was in effect.

"Idaho physicians were forced to step back and watch as their patients suffered, or arrange for their patients to be airlifted out," Jackson wrote of the state's law, which bans abortions except in cases of rape, incest, certain nonviable pregnancies, and those in which a pregnant patient's life is at risk. "There is simply no good reason not to resolve this conflict now."

"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," Jackson continued.

Right-wing Justice Samuel Alito also objected to the court's refusal to rule on the case's merits, but said Idaho's ban should apply to abortion care, arguing that EMTALA requires hospitals "to treat, not abort, an 'unborn child.'"

The American Civil Liberties Union (ACLU) said Alito's dissent, joined by Justices Neil Gorsuch and Clarence Thomas, "will embolden those who are pursuing a strategy to give legal rights to embryos and fetuses that will override the rights of the pregnant person and ban not only abortion, but other forms of reproductive healthcare like fertility treatment and birth control as well."

With the official release of the ruling, said Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project, "it is now clear that the Supreme Court had the opportunity to hold once and for all that every pregnant person in this country is entitled to the emergency care they need to protect their health and lives, and it failed to do so."

"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential healthcare, is a dangerous preview for what could come," said Kolbi-Molinas. "This fight is far from over–anti-abortion politicians are trying to ban abortion in all 50 states, including in emergencies. These extremist politicians went all the way to the Supreme Court for the right to put doctors in jail for providing life- and health-saving emergency abortion care, and they will do it again, if we let them."

Since Roe v. Wade was overturned by the Supreme Court's right-wing majority in June 2022, a number of cases from states with abortion bans and restrictions have garnered national attention, with women speaking out about being denied abortion care when they were experiencing severe, sometimes life-threatening, complications or had learned their fetuses had fatal abnormalities.

Despite those cases, Indivisible co-executive director Leah Greenberg said Thursday's ruling leaves an "open question" on whether or not emergency rooms can "just let women die instead of treating them."

Mini Timmaraju, president and CEO of Reproductive Freedom for All, said the ruling should "serve as a reminder of what's at stake this November."

"While the Biden administration is fighting tooth and nail to ensure people can get the emergency abortion care they need, anti-abortion extremists will continue to do whatever they can to stop them," said Timmaraju. "We must secure reproductive freedom majorities in Congress and send President Biden back to the White House to restore the federal right to abortion and expand access for all."

Judicial reform group Stand Up America pointed to the Supreme Court Voter campaign it launched Monday, aiming to mobilize voters "on the impact the next president will have on the future of the U.S. Supreme Court."

"The Roberts court's decision to take up Idaho v. United States endangered the lives of pregnant Americans and did irreparable harm," said Stand Up America executive director Christina Harvey. "By staying the lower court's decision, the Supreme Court allowed Idaho's extreme abortion ban to take effect while it considered the case. In the meantime, for months, the lives of women in Idaho were callously put at risk, with multiple patients having to be medevacked out of the state to receive care.

"By overturning Roe, the MAGA majority on the court opened the door to extreme abortion bans like the one in Idaho," she added. "If Trump is elected again, he will appoint even more justices who could uphold future abortion bans and endanger our fundamental freedoms for decades."