The U.S. Court of Appeals for the Ninth Circuit recently listened to arguments in a crucial case concerning emergency abortion care in Idaho. This case will determine whether doctors can perform emergency abortions without facing criminal charges in a state that has implemented a strict abortion ban. The outcome of this case will have significant implications for healthcare providers and patients in the region.
Notably, Idaho’s abortion ban includes a provision allowing for abortion in cases where the pregnant patient’s life is at risk. However, the ban does not provide exceptions for preventing other adverse health consequences, such as the possibility of losing future fertility. The federal Emergency Medical Treatment and Labor Act (EMTALA) mandates that medical professionals must offer appropriate care in emergency situations. The Biden administration has put forth the argument that this care extends to providing abortions to patients who are at risk of facing health issues, not solely those in life-threatening situations.
Given the clash between EMTALA and Idaho law, physicians have opted to airlift patients faced with such risks to a facility out of state rather than face legal consequence for what might later be considered a violation of Idaho law. The U.S. Department of Justice sued Idaho in 2022 to block it from enforcing its criminal abortion ban for emergency room physicians who perform abortions for pregnant patients risking health risks on the grounds that such action would be a violation of EMTALA.
In June, the U.S. Supreme Court released a 6-3 per curiam decision declaring that doctors in Idaho must resume performing abortions in medical emergencies. Justice Elena Kagan penned a concurring opinion in which she said EMTALA “unambiguously requires” that Medicare-funded hospitals provide whatever medical care is needed to get a medical emergency under control, including, “in rare situations,” abortions.
“And when a pregnancy goes terribly wrong, that treatment may be an abortion,” Kagan wrote. “Termination of the pregnancy (which is often of a non-viable fetus) may be the only way to prevent a woman’s death or serious injury, including kidney failure or loss of fertility.”
Justices Neil Gorsuch, Clarence Thomas, and Samuel Alito dissented and said, “no one who has any respect for statutory language can plausibly say that the government’s interpretation is unambiguously correct.”
The ruling, however, was a response to an emergency filing, and the underlying challenge to Idaho’s statute continued to work its way through the courts.
The Ninth Circuit heard oral arguments Tuesday to once again review the preliminary injunction. Attorney John Bursch, the conservative legal group Alliance Defending Freedom, argued the case on behalf of Idaho, and attorney Taylor Meehan represented the Legislature to defend the law.
U.S. Circuit Judge Consuelo Callahan, a George W. Bush appointee, raised the question of the effect the new presidential administration would have on the case, given that the incoming presidential team may not be interested in pursuing the legal challenge brought by the Biden administration.
“Is this an exercise in futility?” Callahan asked Bursch.
Bursch responded that the current administration sued Idaho because the “total abortion ban,” it claims, conflicts with the U.S. Emergency Medical Treatment and Labor Act, or EMTALA, which guarantees access to abortion care when it is necessary to stabilize emergency medical conditions that put a pregnant person’s health in serious jeopardy.
Judge Salvador Mendoza Jr., a Joe Biden appointee, asked Meehan if there had been any changes to Idaho law that would clarify the emergency situations where abortion care would be acceptable, Meehan said there were not.
Mendoza inquired about how doctors would know their actions would not violate the law and Meehan responded that the statute is not “about emergency care,” and “not about medical treatment,” but rather about “prohibit[ing] elective criminal abortions.”
When Lindsay Harrison, an attorney representing St. Luke’s Health System of Idaho, took the podium, she explained the underlying health conditions of the six patients sent out state by Idaho doctors and said that there are times when abortion is the only treatment sufficient to protect a pregnant person’s health.
Harrison answered that the underlying issue is a physician’s inability to immediately determine whether a pregnant patient’s life is at risk, and that patients are sent to states that permit abortion so that a full spectrum of options is available to meet the patient’s needs.
The Ninth Circuit’s ruling is expected some time during the next few months.
You can watch the Tuesday’s oral arguments here.