Supreme Court rules allows abortions in medical emergencies, for now, in Idaho case



Abortions in Idaho will now be allowed in medical emergencies, over a dissent from Supreme Court Justices Samuel Alito, Clarence Thomas and Neil Gorsuch. That’s a result of Thursday’s decision to dismiss a key abortion appeal and to restore a lower court injunction that was previously blocked. But the crucial issue in the case isn’t going away, and the court could further weaken reproductive rights in a future case.  

The appeal in Moyle v. United States was a clash between Idaho’s ban and federal law that requires emergency medical care. The court dismissed the case as “improvidently granted,” meaning the court realized it shouldn’t have taken it up in the first place but only recognized that after accepting review. So it’s a non-decision, really. That’s different from what happened in the mifepristone case, where the court unanimously rejected the anti-abortion challenge on standing grounds. But in both cases, the court didn’t reach the merits of the issue, leaving further threats to reproductive rights looming.

Earlier in the litigation, the trial court’s injunction allowed abortions during emergencies. The Supreme Court took the case, bypassing the appeals court and blocking the injunction. Justice Elena Kagan, joined by Justice Sonia Sotomayor and partly by Justice Ketanji Brown Jackson, wrote that the court was correct to both dismiss the case and restore the injunction, noting the disastrous health effects for women in Idaho since the court stayed the injunction, which allowed the state to enforce its ban even when terminating a pregnancy was necessary to prevent grave harm to the pregnant person.

Jackson wrote separately because she didn’t think the case should be dismissed — she thought Idaho should lose now. She said the outcome “is not a victory for pregnant patients in Idaho. It is delay” and that “while this court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires.”

Justice Amy Coney Barrett also wrote separately, joined by Chief Justice John Roberts and Justice Brett Kavanaugh, who agreed on the bottom line with Kagan’s opinion but left open how they would rule on the merits of the issue should it come back to the court.

Alito’s dissent, joined by Thomas and partly by Gorsuch, said the court should have decided the case now, but in the state’s favor, in an opinion that was ultimately dismissive of the real health concerns for women presented by the case.

The federal law is the Emergency Medical Treatment and Labor Act. It requires hospitals participating in Medicare to provide necessary stabilizing treatment for patients with emergency medical conditions. The Biden administration argued that the law takes precedence over Idaho’s law when termination of a pregnancy is required to stabilize an emergency medical condition that would otherwise threaten serious harm to a pregnant woman’s health.

“This case concerns whether a State can prevent pregnant women from receiving the essential emergency medical treatment that federal law guarantees to all Americans,” the federal government wrote to the justices.

The dispute follows the Supreme Court’s 2022 decision to overturn Roe v. Wade with the Dobbs ruling, which prompted Idaho’s law to take effect.

“Even after Dobbs,” the government explained in a high court brief, “States that have adopted more restrictive abortion laws have usually included exceptions permitting termination of a pregnancy to avoid serious harm to the pregnant woman’s health. But a handful of States, including Idaho, have prohibited such care even in the emergency circumstances where EMTALA requires it.”

The decision follows the high court’s June 13 ruling rejecting an anti-abortion challenge to the widely used mifepristone pill, with a unanimous court finding that the plaintiffs lacked legal standing to bring that lawsuit.

The court on Wednesday posted a document to its website that appeared to be the ruling in this case, but the court quickly took it down and said it had been published inadvertently. It was unclear at the time whether it was the final decision or a draft. The decision and separate opinions released Thursday appear to be the one inadvertently released Wednesday.

This is a developing story. Please check back for updates.

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