SCOTUS ruling restores emergency abortion rights in Idaho, leaves Texas case hanging

The U.S. Supreme Court declined to intervene on behalf of Texas women in need of emergency abortions Thursday, temporarily restoring federal protections for the procedure when a woman's health is at risk in Idaho but dodging a ruling that would have affected a similar Texas case.

In the first decision on state abortion laws since Roe v. Wade, the court on Thursday declined to rule on the merits of a clash between Idaho's near-total ban on abortion and a 38-year-old federal law that requires hospitals to provide stabilizing care to emergency room patients.

The justices dismissed the Idaho case as "improvidently granted" in a 6-3 split, returning the case to federal courts in the state.

While a merits ruling would have directly impacted a major Texas case about the same law, Thursday's decision, also known as a "dig," keeps federal emergency abortion protections on ice in the state until the next Supreme Court term — or the next presidency.

Both cases center the Biden administration's guidance saying the federal Emergency Medical Treatment and Labor Act requires hospitals to terminate pregnancies when a patient's life or health is at risk, preempting state abortion bans with more narrow exceptions. The law at issue, EMTALA, was enacted in 1986 largely to prevent hospitals from turning away uninsured and indigent patients — particularly women in labor.

More: Texas hospitals not required to provide emergency abortions, federal appeals court rules

Thursday's mea culpa from the Supreme Court reinstates a lower federal court's order that paused Idaho's near-total abortion ban and compelled hospitals to terminate pregnancies when doing so would save a woman from death or a severe health outcome.

But it also leaves in place a January order from the largely conservative 5th Circuit Court of Appeals that reached an opposite conclusion, keeping Texas' ban on all but lifesaving abortions in place and suspending federal guidance in the state of 30 million people. That decision granted Texas Attorney General Ken Paxton's request that courts block the guidance entirely — including the requirement that hospitals perform lifesaving abortions — in July 2022.

"It's a temporary reprieve for pregnant people in Idaho. It's not a win for abortion rights," said University of Texas law professor Elizabeth Sepper, who specializes in health law.

Though the Department of Justice has asked the Supreme Court to review the Texas EMTALA decision, the impending end of this term means the justices cannot do so until after the new term begins in October, Sepper said, if they review it at all.

"It could just be that the Supreme Court is hoping that they never have to consider the question of EMTALA's primacy over state abortion laws because what they're hoping is for a second Trump administration that comes in and reinterprets EMTALA," Sepper said.

The decision marks the second time this term that the justices have dodged weighing in on the substance of a major abortion case, leading some critics to argue that conservative jurists are hoping to avoid the land-mine issue in the run-up to the November presidential election.

Earlier this month, the Supreme Court ruled that groups seeking to strip away federal approval for abortion and miscarriage medication mifepristone did not have standing to bring the lawsuit, throwing out their case.

More: Texas abortion laws are preventing women from accessing crucial miscarriage care

In dismissing the case and throwing out their block on federal guidance, the justices are saying that "they made a mistake in taking the case at this juncture but they can't really support," Sepper said. However, it doesn't preclude them from needing to address the merits of the issue next term, should the guidance still be in effect. The Department of Justice has asked the court to take up its appeal of the 5th Circuit's decision in the Texas case.

An identical but non-final version of the opinion was leaked Wednesday morning after it was "inadvertently" posted to the Supreme Court website, a court spokesperson told the American-Statesman, and published by Bloomberg News. The breach was the second time a leak had occurred in an abortion-related case in less than two years, following Politico's publication of a draft of the decision to overturn the federal right to abortion in Roe v. Wade.

The case highlights the way that delays and even self-admitted mistakes from the judicial branch can significantly impact lives on the ground.

Idaho's largest emergency services provider was forced to airlift pregnant women out of the state roughly every other week, as compared to just once last year, while federal guidance was suspended, Justice Elena Kagan noted in a concurring opinion.

"The fact that women have been airlifted out of Idaho in situations where EMTALA would require care for the last five months, that entirely is the fault of the U.S. Supreme Court at this point," Sepper said.

And while hospitals can now provide that care to Idaho women because of an emergency injunction from a trial court, a final ruling after trial could leave them without the protections they currently have.

Dr. Stella Dantas, president of the American College of Obstetricians and Gynecologists, condemned the ruling in a press release Thursday morning.

"Doctors have a duty to treat the patients in front of them, especially in emergency situations," Dantas said in a Thursday morning press release. "While the decision today was a momentary victory for immediate access, we must continue to combat legislative and political interference in the practice of medicine and work to restore the sanctity of the patient-clinician relationship. We urge the courts to affirm the availability of stabilizing emergency abortion care in every single state."

This article originally appeared on Austin American-Statesman: U.S. Supreme Court dodges emergency abortion case with ties to Texas