Supreme Court Allows Emergency Abortions in Idaho for Now

The Supreme Court said Thursday it would dismiss a case over emergency abortions in Idaho, temporarily clearing the way for women in the state to have abortions when their health is at risk.

The unsigned, one-sentence decision said the case was “imprudently granted,” meaning a majority of the justices had changed their minds about whether the case needed to be heard now. It reinstated a lower court ruling that had blocked Idaho’s near-total ban on abortion and allowed emergency abortions in hospitals if necessary to protect the mother’s health while the case worked its way through the courts.

The decision, which did not rule on the substance of the case, closely mirrored a version that appeared briefly on the court's website the day before and reported by Bloomberg. A court spokeswoman acknowledged Wednesday that the publishing unit had “inadvertently and briefly uploaded a document” and said a ruling in the case would appear in due course.

Chief Justice John G. Roberts Jr. announced the court’s decision from the gallery, as is customary for unsigned opinions.

Justice Ketanji Brown Jackson, who disagreed in part with the court's decision and said the justices should address the case on its merits, read his dissent from the bench. Such a move is rare and signals a deep disagreement.

The consolidated cases, Moyle v. United States and Idaho v. United States, focus on whether a federal law aimed at ensuring emergency care for any patient replaces Idaho's abortion ban, one of the nation's strictest. The state bans the procedure with few exceptions unless the woman's life is in danger.

The decision was essentially made by a vote of 6 to 3, with three conservative justices siding with the liberal wing, albeit with different writings and reasons, stating that they would dismiss the case.

The dispute was the first time the Court wrestled with the issue of state-level abortion restrictions, many of which quickly took effect after the Court struck down a constitutional right to the procedure two years ago.

The ruling handed a temporary victory to the Biden administration, which had turned to federal law as one of the few, if limited, ways to challenge state bans on abortion and preserve access after the court overturned Roe against Wade.

It was also a second victory, albeit quietly, for abortion rights in recent weeks. This month, the court rejected a challenge to the long-standing approval of a commonly used abortion pill, saying that a group of anti-abortion medical organizations and doctors bringing the case lacked standing to sue. Although the decision preserved the pill's availability, the court did not rule on the merits of the case.

However, just as happened with the abortion pill, the case over emergency abortions, and the underlying issue between state and federal law, will continue in the lower courts.

Supporters of abortion rights have highlighted this possibility, while welcoming the outcome.

“We are relieved for the moment, but hardly celebrating,” said Nancy Northup, president and CEO of the Center for Reproductive Rights, adding: “Women with serious pregnancy complications and the hospital staff who care for them have need clarity right now. “

Idaho Attorney General Raúl Labrador said in a news conference that he was not discouraged. “We firmly believe that we will ultimately win this case,” he said, adding that he expects the lawsuit or a parallel case in Texas to reach the courts again.

The decision, coming hours before the first presidential debate, underscored the stakes of the upcoming election, where abortion remains a priority for both campaigns. Abortion access is widely popular, and the issue has galvanized voters eager to overturn anti-abortion referendums at the ballot box.

In a statement, President Biden celebrated the court’s decision.

“Today's order from the Supreme Court ensures that women in Idaho can access the emergency medical care they need as this case returns to the lower courts,” Biden said. “No woman should be denied care, forced to wait until she is near death or forced to flee her home state just to receive the health care she needs.”

Idaho had asked judges to intervene after an 11-member panel of the U.S. Court of Appeals for the Ninth Circuit temporarily blocked the law. By agreeing to hear the case, the judges had temporarily reinstated the ban.

Under Idaho law, abortion is illegal except in cases of incest, rape, certain cases of nonviable pregnancies, or when it is “necessary to prevent the death of the pregnant woman.” Doctors who perform abortions could face criminal penalties, prison time, and loss of their medical licenses.

The Biden administration had argued that the ban conflicted with federal law and that federal law should prevail over it. Idaho argued that the Biden administration had improperly interpreted federal law in an attempt to circumvent state bans, effectively turning hospitals into legal abortion sites.

The liberal justices, along with Justices Amy Coney Barrett and Brett M. Kavanaugh and Chief Justice John G. Roberts Jr., wrote or joined in concurring opinions. The court’s remaining conservatives, Justices Samuel A. Alito Jr., Clarence Thomas, and Neil M. Gorsuch, dissented.

In his partial concurrence and partial dissent, Judge Jackson wrote that he would decide the case on the merits and that the federal law in question, known as the Emergency Medical Treatment and Labor Act, trumps Idaho's strict ban.

Justice Elena Kagan, in a concurring opinion, said the practical outcome of the court's decision would avoid heartbreaking consequences.

Federal law, he wrote, “unequivocally requires” that hospitals receiving Medicare funding provide any treatment necessary to stabilize a patient, including pregnant women.

Judge Jackson agreed. When the court allowed Idaho's abortion ban to temporarily take effect, a “months-long catastrophe” ensued that could have been avoided, she wrote. Instead, she noted, “Idaho doctors were forced to stand back and watch while their patients suffered, or to arrange for their patients to be airlifted.”

The dismissal of the case, he warned, was cause for concern, a path that simply allowed the court “to avoid questions it does not wish to decide.”

“There is simply no good reason not to resolve this conflict now,” he wrote.

Although Justice Alito sided with Justice Jackson that the court should hear the case on its merits, he came to the opposite conclusion. Idaho’s abortion ban applied to emergency room care, he wrote.

In contrast, he added, federal law requires hospitals receiving Medicare funding to “treat, not abort, an 'unborn child. '”

He expressed regret that the court had not had the desire to address a polarizing issue.

“This question is as ripe for a decision as it will ever be,” Justice Alito wrote. “Apparently, the court has simply lost the will to decide the easy but emotional and highly politicized issue that the case presents.”

Judge Barrett, along with Chief Justice Roberts and Justice Kavanaugh, appeared to have found a middle ground.

For now, he wrote, the case should be heard in lower courts, where a fuller picture of the facts could emerge.

The parameters of Idaho law had “changed significantly — twice” since the lawsuit began, he added, and the parties' positions had “made the scope of the dispute unclear at best.”

Eileen Sullivan contributed to the writing of the report.

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