FFRF welcomes Supreme Court’s EMTALA ruling allowing life-saving abortion care . . . for now

The Freedom From Religion Foundation welcomes as a temporary reprieve today’s Supreme Court decision to allow hospitals in Idaho to resume performing emergency abortion care under the federal Emergency Medical Treatment and Labor Act (EMTALA).

In a surprise ruling preceded by an inadvertently leaked opinion temporarily posted on the Supreme Court’s website Wednesday, the divided decision vacates the court’s own action interfering in a lower court order that upheld access to emergency abortion care in Idaho while litigation continues. The Washington Post called it “at least a temporary victory for the Biden administration.”

Earlier this year, the high court took the extraordinary action of issuing a stay of the ruling enjoining Idaho from enforcing its extreme abortion ban even when abortion is medically necessary. The stay meant the state could enforce its abortion ban even during medical emergencies while the Biden administration’s lawsuit against Idaho is pending. The high court then took a second extraordinary action by announcing it would hear the case before the appeals court review was final.

Six justices voted to lift the stay, and five voted to return the case to the lower courts, for now. A concurrence was authored by Justice Elena Kagin, joined by Justice Sonia Sotormayor, with Justice Ketanji Brown Jackson partially joining. Justice Amy Coney Barrett authored her own concurrence, joined by Chief Justice John Roberts and Justice Brett Kavanaugh. Jackson authored a third concurrence and partial dissent in which she agreed with the majority’s decision to lift the stay but disagreed with the majority’s vote to refrain from reaching the merits. Three justices dissented, arguing that the court should have reached the merits and ruled in favor of Idaho: Clarence Thomas, Samuel Alito and Neil Gorsuch.

The two consolidated cases, Moyle v. United States and Idaho v. United States, concern the rights of pregnant persons under EMTALA. Passed in 1986, EMTALA requires hospitals to stabilize patients experiencing a medical emergency and is in conflict with Idaho’s interpretation of its draconian limits on abortion care. Under the state’s current abortion ban, abortion is illegal except when absolutely necessary to save a patient’s life.

In her concurrence, Justice Kagan explained, “Idaho’s arguments about EMTALA do not justify, and have never justified, either emergency relief or our early consideration of this dispute. With this court’s writ of certiorari dismissed, the lower courts can proceed with this litigation in the regular course. And with this court’s stay dissolved, the district court’s preliminary injunction will again take effect. That will prevent Idaho from enforcing its abortion ban when termination of a pregnancy is needed to prevent serious harms to a woman’s health.”

After the Biden administration sued Idaho in August 2022 to enforce EMTALA, a district court ruled in its favor, issuing a preliminary injunction. A three-judge panel from the 9th U.S. Circuit Court of Appeals stayed the injunction, which was put back in place by the full 9th Circuit. Idaho’s anti-abortion attorney general then filed an emergency stay with the Supreme Court.

FFRF maintains that extreme abortion bans like Idaho’s are religiously motivated and enshrine a single extreme ideology into law: the idea that life begins at conception, a belief that not even all religious Americans share, including many Christians. These restrictive laws force doctors to wait for women to be at death’s door before they can perform a life- saving abortion. In some tragic circumstances, doctors are essentially forced to wait until it’s too late to prevent serious bodily harm or even death to the patient.

FFRF signed onto a friend-of-the-court brief filed by the National Women’s Law Center. The brief urged the Supreme Court to reject Idaho’s dangerous and legally dubious claim that states may refuse to comply with EMTALA when it comes to abortion, even in cases where abortion is the only way to prevent a patient from suffering grave harm — and potentially death.

The brief further pointed out: “In the wake of Dobbs, health care professionals in abortion-ban states fear that providing medically necessary emergency obstetric care (including care required by EMTALA) may invite criminal prosecution, among other severe consequences,” and that “this fear is driving providers out of already underserved areas.”

Since the Idaho abortion restriction was passed in 2020, obstetric care is in crisis in the state, with physicians fleeing and two major maternity and labor wards closing in 2023, forcing some pregnant Idahoans to travel out of state for pregnancy-related care and causing disproportionate hardship for underserved groups, including citizens who are low-income, teenaged or Black, Indigenous People of Color.

The court’s decision today punts on the core issues of the case. As Jackson explained in her dissent from the court’s decision to avoid ruling on the merits, “Today’s decision is not a victory for pregnant patients in Idaho. It is a delay. 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.”

The case will wind its way through the lower courts until it very likely finds its way back to the same Supreme Court that voted there is no federal right to abortion in the 2022 Dobbs decision that overturned Roe v. Wade.

“Today, the Supreme Court decided that Idaho, for the present, is not allowed to watch pregnant patients die in ER rooms for lack of abortion care, such a small favor to ask,” comments FFRF Co-President Annie Laurie Gaylor. “The decision provides a sigh of relief for now, but the threat to patients with pregnancy complications remains.”

The Freedom From Religion Foundation is a national nonprofit organization with 40,000 members and several chapters across the country. Our purposes are to protect the constitutional principle of separation between state and church, and to educate the public on matters relating to nontheism.

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