Supreme Court fractures over Idaho dispute with feds on abortion exceptions

The Supreme Court splintered Wednesday during oral arguments on a closely watched case out of Idaho about the extent to which a federal law trumps the state’s ban on abortion during life-and-death emergencies.

Under the Emergency Medical Treatment and Active Labor Act (EMTALA), which was passed in 1986, emergency rooms that participate in Medicare are required to provide “necessary stabilizing treatment” to individuals in dire conditions.

The Biden administration has contended that EMTALA effectively supersedes Idaho’s abortion ban — which has a carveout for the life of the mother — in emergency situations. The Justice Department filed a complaint to that end in 2022.

The justices for the most part aligned along ideological lines, except for Chief Justice John Roberts and Amy Coney Barrett.

“If ER doctors can perform whatever treatment they determine is appropriate, then doctors can ignore not only state abortion laws, but also state regulations on opioid use and informed consent requirements,” Josh Turner, a lawyer representing Idaho argued.

All four female justices on the high court — Sonia Sotomayor, Elena Kagan, Ketanji Brown Jackson and Barrett — grilled Turner and dominated the first half-hour or so of oral arguments.

“What you are saying is that there is no federal law on the book that prohibits any state from saying even if a woman will die, you can’t perform an abortion,” Sotomayor said at one point.

Turner denied that any state in the country is banning doctors from performing abortions in the event where a woman could die without intervention.

Sotomayor, Kagan, and Jackson peppered Turner with various scenarios about women in peril and probed him on his interpretation of the law.

“You have been presented today with very quick summaries of cases and asked to provide a snap judgment about what would be appropriate in those particular cases,” Justice Samuel Alito mused to Turner at one point.

Later, Barrett chimed in and pressed Turner after he seemed to suggest standards regarding emergency scenarios would be determined on a case-by-case basis.

“I’m kind of shocked, actually, because I thought your own expert had said below that these kinds of cases were covered — and you’re now saying they’re not?” Barrett asked.

Soon the justices began sounding slightly baffled over the differences between Idaho’s abortion law and EMTALA as it pertains to emergency situations.

“Is there any other condition identified by the solicitor general where you think Idaho law would not allow a physician in his or her good faith judgment to perform an emergency abortion,” Justice Brett Kavanaugh asked.

Turner said that her team hadn’t encountered a situation in its affidavits in which Idaho’s laws prevented a physician in “his or her good faith judgment to perform an emergency abortion.”

US Solicitor General Elizabeth Prelogar, who represented the Biden administration before the high court, disputed that claim during her remarks.

“EMTALA’s promise is simple but profound,” she argued. “No one who comes to an emergency room in need of urgent treatment should be denied necessary stabilizing care.”

This case is about how that guarantee applies to pregnant women in medical crisis,” she explained. “But Idaho makes termination a felony punishable by years of imprisonment unless it’s necessary to prevent the woman’s death.”

Jackson followed up on that and point-blank asked Preloger if there was any functional difference between Idaho’s law and EMTALA.

“Idaho’s law only allows termination if it’s necessary to prevent death, and that is textually very narrow compared to what EMTALA requires,” Prelogar contended.

“Under EMTALA, you’re also supposed to be thinking about things like, is she about to lose her fertility? Is her uterus going to become incredibly scarred because of the bleeding? Is she about to undergo the possibility of cancer?”

Preloger led the Biden administration’s arguments in the landmark Dobbs v. Jackson Women’s Health Organization back in 2022.

Ultimately, the high court ruled against her and overturn roughly five decades of precedents first set in Roe v. Wade that guaranteed a national right for woman to abortion access.

The Dobbs decision open the floodgates to a myriad of abortion related questions, some of which the Supreme Court is now facing.

“Pre-Dobbs, this wasn’t much of a question,” Sotomayor claimed at one point during an exchange with Turner.

“The fact that HHS didn’t have to do it much before pre-Dobbs doesn’t make their position unprecedented.”

Back in March, the Supreme Court wrestled with another abortion case over mifepristone, a medication that facilitates terminating pregnancies at home.

Supreme Court justices are expected to rule on the consolidated case they heard Wednesday, Moyle v. United States, by June.