Supreme Court justices are deeply divided over a critical case over whether emergency room doctors in Idaho, where abortion is all but banned, can turn away pregnant patients who need the procedure.
The court’s conservative majority appeared to disagree on some aspects of the case, which involves overlapping issues and complicated arguments involving abortion and medical care.
In a poignant moment, Trump-appointed Judge Amy Coney Barrett expressed her “shock” at the risk a doctor would have to take to perform an emergency abortion to save a life — and potentially face criminal charges.
Her vote will be crucial to the outcome of the case in the 6-3 divided conservative court.
It’s the first time the nation’s highest court is weighing the scope of a state abortion ban, after the Supreme Court overturned Roe v Wade in 2022 and returned the issue of abortion to the states.
Pro-life and pro-abortion protesters gathered outside the historic courthouse to rally supporters ahead of the closely watched arguments that could impact states with laws similar to Idaho’s.
Anti-abortion activists gather outside the Supreme Court as the justices hear a case over Idaho’s abortion ban, with limited exceptions
Abortion rights advocates also gathered outside the Supreme Court as arguments took place in the cases of Moyle v. United States and Idaho v. United States.
Oral arguments took place in the cases of Moyle v. United States and Idaho v. United States, which focused on Idaho’s abortion law, which bans nearly all abortions, with limited exceptions in cases of rape, incest, or taking the life of the save mother.
The Biden administration argued that the federal Emergency Medical Treatment and Labor Act (EMTALA) could replace state law criminalizing abortion in some circumstances.
But Idaho rejects that argument, claiming the law does not require doctors to provide specific medical treatments or require hospitals to perform abortions.
After the Supreme Court overturned Roe with the 2022 Dobbs decision that ended the constitutional right to abortion, Idaho was one of more than a dozen states that took immediate action to ban abortion, with limited exceptions.
While Idaho law has an exception for the mother’s life, it does not address the “health” of the mother, which was central to the Biden administration’s arguments and questions on Wednesday.
The Biden administration says EMTALA could be used because it requires emergency rooms to provide “necessary stabilizing treatment.”
“Today, Idaho physicians and Idaho women find themselves in an impossible position,” said Attorney General Elizabeth Prelogar.
“If a woman comes to the emergency room with a serious threat to her health, but she is not yet confronted with death, doctors must postpone treatment and allow her condition to deteriorate materially, or be transported out of state by air. she can get the emergency care she needs,” she continued.
“In Idaho, doctors must close their eyes to everything but death,” she said later.
“Whereas under EMTALA you’re supposed to think about things like, is she about to lose her fertility, is her uterus going to be incredibly scarred from the bleeding?”
One of the questions raised by conservative justices was whether the claim of serious mental health problems could be used to obtain an abortion under EMTALA.
‘Does health only mean physical health or does it also include mental health?’ asked Justice Samuel Alito.
“That could never lead to termination of pregnancy because that is not the accepted standard of practice for treating a mental health emergency,” Prelogar said.
The Supreme Court justices appeared divided largely along ideological lines, but there were several instances in which some conservative justices expressed agreement on specific details with liberal colleagues, suggesting the ruling might be more nuanced
Joshua Turner made arguments on behalf of Idaho. He said nothing in EMTALA undermines the state’s power to regulate medicine.
“Allowing ER physicians to administer whatever treatment they deem appropriate would allow physicians to ignore not only state abortion laws, but also state regulations on opioid use and informed consent requirements,” Turner argued.
He claimed that this leaves “emergency medicine unregulated under state law.”
Liberal justices have pushed back on the argument from states regulating medicine.
They asked Turner whether the state ban could prevent abortion in a situation where a woman could ultimately lose an organ or lead to serious medical complications.
“Idaho law says abortions are not allowed in that case,” Turner responded to a question from Judge Sonia Sotomayor.
The liberal justices were joined by conservative Judge Amy Coney Barrett, who at one point said she was “shocked” and pressed Turner when doctors could face criminal charges under state law.
“What if the prosecutor thought things through?” ‘I don’t think a doctor in good faith could draw that conclusion. I’m going to call in my expert,'” Barrett suggested when it comes to determining an emergency.
“That, Your Honor, is the nature of prosecutorial discretion and could lead to a case,” Turner responded.
Turner also made conservatives’ argument that if the court upholds the requirement to perform abortions needed in a medical emergency, women could get abortions by claiming the pregnancy causes them severe mental distress when they arrive at emergency rooms .
Abortion rights advocates participate in a ‘die-in’ outside the Supreme Court as the court hears the first case over a state’s abortion ban after Roe fell
Abortion rights advocates gathered outside the Supreme Court as it heard arguments in the case of Idaho v. United States. The American College of Obstetricians and Gynecologists urged the Supreme Court not to weaken EMTALA with its ruling
An anti-abortion activist outside the Supreme Court on Wednesday as the court heard arguments on Idaho’s law that bans abortion in almost all situations
Crowds of protesters, both for and against abortion rights, gathered outside the Supreme Court as arguments were made.
Some pro-abortion rights protesters held signs reading “abortion is health care” and “abortion saves lives.” Some protesters, dressed in white and covered in fake blood, even participated in a “die-in” in support of access to abortion in emergency rooms.
Anti-abortion protesters held signs that read, “Emergency rooms are not abortion clinics.”
This is the second abortion-related case the Supreme Court has heard in recent weeks. Last month, they heard arguments over the medical abortion drug mifepristone, in a case that could impact access to the drug not only in states that ban abortion, but also nationally.
The Supreme Court is likely to rule on the case in late June before the recess.