SCOTUS weighs strict abortion ban in case with potential major implications
Published Date: 4/24/2024
Source: axios.com

The Supreme Court on Wednesday will consider whether a federal law requiring hospitals to provide emergency care overrides Idaho's strict abortion ban.

Why it matters: The case justices will hear focuses on a key Biden administration effort to preserve abortion access and puts a spotlight on stories of pregnant patients who have been denied abortions in medical emergencies since Roe v. Wade was overturned.


  • The court is expected to deliver rulings on this case and another on medication abortion by late June, as an election season already dominated by abortion politics heats up.

Driving the news: The Idaho case centers on a 1986 law known as the Emergency Medical Treatment and Active Labor Act, or EMTALA, that was passed to prevent hospitals from refusing emergency care to patients who couldn't pay.

  • After Roe was overturned, the federal health department issued guidance saying EMTALA offered federal protections for providers to perform abortions in emergency situations, even in states that restrict the procedure.
  • The Biden administration's Justice Department soon afterward filed a lawsuit challenging an Idaho law that only allows for abortion to save a pregnant person's life, arguing the exception was "extremely narrow" and ran afoul of EMTALA.
  • "For some pregnant women suffering tragic emergency complications, the only care that can prevent grave harm to their health is termination of the pregnancy. In those circumstances, EMTALA requires participating hospitals to offer such care — yet Idaho law forbids it," the Justice Department argued in a brief to the Supreme Court.

The other side: Idaho and anti-abortion advocates accuse the Biden administration of trying to subvert the Supreme Court ruling that sent abortion regulation back to the states.

  • "In nearly four decades since EMTALA was enacted, neither the statute nor previous federal guidance ever stated 'obligations' requiring hospitals and physicians to provide any particular procedure, much less an abortion," the brief from Idaho reads.
  • Idaho and allies also argue that EMTALA, while not mentioning abortion, provides protections for a mother and an "unborn child" equally.
  • The Justice Department argued those protections were added to the law in 1989 to make clear that hospitals had to provide emergency care for an unborn child even if the mother's health wasn't at risk.

The case could ultimately affect other states' abortion ban exceptions for the life or health of the mother. Critics say exceptions are typically worded vaguely and may force doctors to choose whether to ignore their medical judgment and refuse care — or face the risk of jail time or losing their license.

  • Anti-abortion groups argue that state laws about abortion exceptions are clear and that abortion rights advocates are sowing confusion among providers.
  • Complaints of pregnant patients being refused care at emergency rooms spiked in 2022 after Roe was overturned, an Associated Press investigation published this weekend found.
  • Leading medical groups, including the American Medical Association, told the Supreme Court that its members have "long provided abortion as necessary stabilizing treatment under EMTALA" for some patients, and the Idaho law "creates a dangerous situation for both clinicians and patients."

The bottom line: This case hasn't received the same level of attention as last month's hearing on abortion medication, but it could have major implications for access.