WASHINGTON — The Supreme Court was split on Wednesday in a battle over whether provisions of Idaho’s nearly complete abortion ban unconstitutionally conflict with a federal law aimed at providing certain standards for emergency medical care to patients, including pregnant women.
Some conservative justices in the 6-3 majority were skeptical of the Biden administration’s case that the state ban limited potentially life-saving treatment for women suffering complications during pregnancy.
Liberal members of the court appeared to support the administration’s position.
The justices are weighing an appeal by Idaho officials challenging the Biden administration’s lawsuit over emergency abortion access.
The state’s abortion law was passed in 2020, following the Supreme Court’s 1973 ruling Roe v. There is a provision stating that it would take effect if it overruled Wade.
A law of 2020 called the Protection of Life Act, entered into force Supreme Court in 2022 rolled back Roe.
State law states that anyone who performs an abortion is subject to criminal penalties, including up to five years in prison. Health professionals found in violation of the law may lose their professional licenses.
The federal government sued a federal judge in August 2022 to block state enforcement of the emergency medical care provisions required under the federal Emergency Medical Treatment and Labor Act (EMTALA).
A federal law passed in 1986 requires that patients receive appropriate emergency care. The Biden administration argues that care should include abortions in certain circumstances. The law applies to any hospital that receives federal funding under the Medicare program.
Idaho law has an exception if an abortion is necessary to preserve the life of a pregnant woman, though the scope of that exception was scrutinized during oral argument.
Idaho State Attorney Joshua Turner faced tough questioning whether the exception could apply to situations where a woman has complications that pose a serious health risk but do not lead to imminent death.
Liberal Elena Kagan said the federal law says “you don’t have to wait until a person is on the verge of death.”
“If a woman is going to lose her reproductive organs, that’s enough to trigger this duty of the hospital to stabilize the patient,” he said.
Fellow liberal Justice Sonia Sotomayor asked similar questions, offering several real-life examples of emergency situations where women have to make the call on whether doctors can grant an abortion, including a 16-week pregnancy when a patient refuses to grant an abortion. There was a risk of sepsis or bleeding where the water broke after the abortion was denied in Florida.
“Is this a case where the day before Idaho said it’s okay to have an abortion?” Sotomayor asked.
Turner argued that such medical decisions are “subjective” and that a doctor’s decision in such cases would be based on good faith rather than an objective standard.
Justice Amy Coney Barrett and Justice Brett Kavanaugh, both conservatives, suggested there may be no conflict, saying they saw the Idaho law as allowing the Biden administration to treat it as required by federal law.
At one point, Barrett said he was “shocked” by Turner’s answers to questions about what treatment was allowed because “I thought your own specialist said below that this kind of thing was covered.”
Kavanaugh similarly questioned the daylight between the two laws, wondering what the ramifications would be if “Idaho’s law authorizes abortion in every state-defined emergency.”
“What does that mean for what we decide here?” he asked Turner.
Conservative Justice Samuel Alito was most skeptical of the federal government’s argument, citing language in the federal law that at one point refers to treatment for an “unborn child” more commonly used by anti-abortion advocates.
“Isn’t that a strange wording in a law that mandates abortion?” Alito asked Attorney General Elizabeth Prelogar.
Have you seen abortion laws that use the term “unborn child”? Doesn’t that tell us something?”
Prelogar responded that this statement does not replace the requirement that women receive the treatment they need in an emergency.
Conservative justices, including Neil Gorsuch, have also questioned whether the federal government has the authority to mandate health care standards when it comes to Medicare funding.
Supreme Court in January is allowed Idaho must comply with the provisions by agreeing to hear oral arguments in the case. Other provisions of the ban are already in force and will not affect the judgment of the justices.
The decision will affect not only Idaho but other states, including Texas, which have passed similar abortion bans that abortion rights advocates say conflict with federal law.
U.S. District Court Judge B. Lynn Winmill characterized the state’s actions as putting doctors in a difficult position by blocking parts of the state law that conflicted with federal law.
“The physician believes that her EMTALA obligations require her to offer an abortion now. But she also knows that all abortions are prohibited in Idaho. So he finds himself on the horns of a dilemma. What law should he break?” he wrote.
The San Francisco-based 9th U.S. Circuit Court of Appeals briefly stayed Winmill’s ruling in September, but later allowed it to go into effect, prompting state officials to appeal to the Supreme Court.
Prelogar wrote in court filings that EMTALA requires “necessary stabilization treatment,” which can require abortion in emergency situations involving pregnant women.
“And in these limited but critically important cases, EMTALA requires the hospital to offer that care,” he said.
The state argues that only after Roe was overturned did the Biden administration say EMTALA could be interpreted to require abortion in some contexts, calling it a “nationwide abortion mandate.”
EMTALA “simply prohibits emergency rooms from turning away indigent patients with serious medical conditions,” Idaho Attorney General Raul Labrador wrote in court filings. He added that the law is not intended to override state laws governing health care.
The Idaho dispute is one of two abortion cases currently before the Supreme Court, both of which will be overturned in 2022 by Roe v. It arose after the decision to cancel Wade. In other cases, the court hears a problem This could limit access to mifepristone, the most commonly used drug for medical abortions.