A protester at a Planned Parenthood Great Northwest rally in Boise, Idaho, holds up a sign about the EMTALA case on April 21, 2024. (Photo by Otto Kitsinger/Idaho Capital Sun)
Quality Journalism for Critical Times
As expected after the court said it inadvertently uploaded the opinion prematurely on Wednesday, the U.S. Supreme Court issued a decision Thursday remanding a case about emergency abortions in Idaho back to the U.S. Court of Appeals for the Ninth Circuit for now.
The decision was 6-3, with conservative Justices Samuel Alito, Neil Gorsuch, and Clarence Thomas dissenting. It was issued “per curiam,” meaning there is no lead author of the overall opinion.
The justices affirming the decision wrote that they determined the court took the case too early in the process. The court granted the request to hear the case in January before the Ninth Circuit could hold its own hearing on an injunction that blocked enforcement of the law against emergency room physicians who might need to perform an abortion to prevent a pregnant patient from experiencing significant health effects from infection or other conditions.
U.S. Supreme Court nominee Amy Coney Barrett at hearings of the U.S. Committee on the Judiciary. Credit: Screenshot/Judiciary Committee website
The government argued Idaho could not enforce its criminal abortion ban in emergency rooms because it would violate a federal law known as the Emergency Medical Treatment and Labor Act, or EMTALA, which requires Medicare-funded hospitals to treat patients who come to an emergency room regardless of their ability to pay.
When justices agreed to hear the case, the court dropped the injunction, leaving doctors in Idaho open to prosecution under its criminal abortion ban, which carries penalties of jail time, fines, and loss of a medical license. Idaho’s civil law allows immediate and extended family members to sue the doctors for up to $20,000 over an abortion procedure.
Idaho’s ban contains only an exception to save the pregnant patient’s life, not to prevent detrimental health outcomes, including the loss of future fertility, which is a risk with severe infection or bleeding.
Without further clarity written into the law, doctors have said they can’t confidently assess when to safely intervene to save someone’s life. Rather than take the chance, high-risk obstetric specialists have airlifted patients to a facility out of state that can freely perform the procedure before it’s too late. In 2023, the state’s largest hospital system said at their facilities such transfers happened once, but occurred six times between January and April, when the injunction was lifted.
‘No longer appropriate for easy resolution’
Justice Amy Coney Barrett, who is typically conservative in her rulings, said the court’s decisions to hear the case and drop the injunction were premised on the belief that Idaho would suffer “irreparable harm” under the injunction and that the cases were ready for the court’s immediate determination. She wrote that the briefings and oral argument in April shed more light on the case and made it clear that conscience objections were covered under EMTALA and other concerns about an interpretation that would include emergency mental health concerns did not apply.
“I am now convinced that these cases are no longer appropriate for early resolution,” Barrett wrote.
Dr. Caitlin Gustafson, president of a group of Idaho physicians who have spoken out against the ban and submitted a brief to the court in the case, said the decision is not the end of her coalition’s work.
“We are relieved by the Supreme Court’s decision,” Gustafson said. “However, this ruling addresses only a small part of the ever-increasing barriers across the health care landscape. The coalition remains committed to advocating for comprehensive policy updates to fill the gaps in health care access created by Idaho’s restrictive laws, which jeopardize patient safety. We will not relent until private health care decisions are once again at the discretion of patients and their physicians, free from political interference.”
Ahead of the decision, more than 6,000 doctors from around the country also appealed to the court to protect ER physicians, along with medical professionals in Idaho and advocacy organizations.
The case now returns to the Ninth Circuit to resume the process, but it could ultimately return to the Supreme Court at a later date.
Pro-choice reaction
Pro-choice forces expressed relief that the court allowed continued enforcement of the federal law but also skepticism about where the court eventually would land.
Rep. Anna Eskamani rallies against anti-abortion legislation.
Sept. 21, 2021. Credit: Danielle J. Brown
“Some celebrated this decision as a victory for reproductive rights. I want to be clear — this is not a victory. This is a delay,” Florida state Rep. Anna Eskamani of Orange County said in a written statement.
“Justice [Ketanji Brown] Jackson stated this clearly in her opinion: ‘Today’s decision is not a victory for pregnant patients in Idaho. It is delay. While this court dawdles, pregnant people in emergencies remain in a precarious position, as their doctors are left uncertain about the law,’” Eskamani continued.
“We can expect another EMTALA case to come before the Supreme Court, which means we must continue to fight for reproductive freedom in this nation and state — no court is guaranteed to protect us or restore our rights. I encourage every Floridian to learn more about the Yes on Four campaign and help codify reproductive freedom here in the Sunshine State this November,” she concluded.
Proposed constitutional Amendment 4 would bar government interference in abortion care up to the point of viability.
The progressive group Indivisible released a statement suggesting the court was putting off a decision until this year’s elections are over.
“Nothing says, ‘This MAGA Supreme Court is playing politics with our rights and health,’ like SCOTUS recklessly and needlessly endangering women’s lives, and then punting on issuing a major ruling in an election-year. The MAGA Justices should be ashamed of themselves,” chief campaigns officer Sarah Dohl said.
“In the six months the Supreme Court deliberated on this case, at least six pregnant patients in Idaho had to be airlifted to out-of-state hospitals for emergency care — according to just one hospital’s reports. Countless other pregnant patients, terrified and in crisis, were denied necessary care due to Idaho’s extreme law,” Dohl added.
Reproductive Freedom for All President and CEO Mini Timmaraju released another written statement:
“The court could have upheld this basic right, but they refused to. Instead, the conservative majority kicked the case back to a lower court, punting so that they didn’t need to weigh in before an election where attacks on abortion access are already top of mind for voters.
“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. Let this serve as a reminder of what’s at stake this November. 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.”
Michael Moline in Tallahassee contributed to this story.
The post U.S. Supreme Court sends Idaho abortion case back down to lower courts appeared first on Florida Phoenix.