Supreme Court to Rule Again on Abortion: A Primer on Idaho v. United States

Here’s what you need to know ahead of the Supreme Court’s oral argument in Idaho v. United States on April 24.

What is this case about? 

Two years ahead of the Supreme Court’s disastrous decision in Dobbs v. Jackson Women’s Health Organization, the Idaho state legislature passed an extreme abortion ban, anticipating that the Supreme Court would overturn Roe v. Wade and end the constitutional right to abortion. In 2022, shortly after the Supreme Court’s devastating decision in Dobbs that did in fact overturn the constitutional right to abortion, the Idaho ban went into effect. Idaho’s ban criminalizes nearly all forms of abortion, with few exceptions. The ban directly conflicts with the Emergency Medical Treatment and Labor Act (EMTALA), a longstanding federal law that requires hospitals to treat patients experiencing an emergency medical condition with stabilizing care. It puts pregnant people and providers into an impossible and dangerous situation — if providers administer stabilizing care, they could face criminal prosecution; but if they do not, they leave patients in medical crisis.

The Supreme Court will consider whether Idaho’s state abortion ban trumps the longstanding requirements of EMTALA and whether states can force doctors to turn away patients suffering from emergency pregnancy complications. The case, which was consolidated with another case brought on behalf of the Idaho state legislature in Moyle v. United States, has nationwide implications for the right for patients to receive emergency abortion care.

Why is this case important?

EMTALA is a nearly 40 year old federal law that guarantees treatment for emergency medical conditions for all people nationwide. Under Idaho’s abortion ban, anti-abortion extremists are attempting to exclude pregnant people from EMTALA’s long-standing protections. They would rather let a pregnant person die or suffer than allow that person to receive the emergency abortion care they desperately need.

Everyone experiencing a health emergency should be able to get the care they need, including an abortion, without interference from politicians. EMTALA has always required providers to administer emergency abortion care to protect pregnant people in medical emergencies. There are no exceptions: Hospitals must provide the treatment necessary to stabilize emergency medical conditions, and for some people, that means ending a pregnancy. Health care providers should not be deterred or threatened by politicians from doing their job or forced to put their patients’ lives at risk.

When pregnant people are denied the emergency abortion care they need, they may suffer lifelong consequences, including increased maternal health complications or loss of future fertility. And their families and communities suffer, too. Black and Indigenous women, who already face high rates of maternal mortality and morbidity, will face disproportionate harm if pregnant people are excluded from EMTALA’s protections.

What have the courts said so far?

In August 2022, the U.S. Department of Justice (DOJ) filed a lawsuit in federal district court challenging the Idaho abortion ban as conflicting with federal law under EMTALA. A federal district court granted a preliminary injunction, blocking the abortion ban from being enforced in cases of a medical emergency. Idaho appealed, and in September 2023, a panel of three Trump-appointed judges on the U.S. Court of Appeals for the Ninth Circuit reversed the district court, allowing Idaho to enforce its abortion ban. The Leadership Conference opposed the confirmations of two of these judges — Judge Lawrence VanDyke and Judge Kenneth Lee.

The DOJ appealed, asking the full Ninth Circuit to reconsider. Ultimately, the Ninth Circuit temporarily blocked Idaho from enforcing the abortion ban in medical emergencies, while also granting the request for the entire court to rehear the case. Idaho filed an appeal with the Supreme Court, and in January 2024, the Supreme Court took the unnecessary and dangerous step of allowing Idaho to enforce its abortion ban in medical emergencies while the case is pending. The Court also decided to review the case on the merits this term before the full Ninth Circuit hearing has even occurred.

What will happen in the Supreme Court?

Oral arguments will take place on April 24, and we expect a decision by the end of this term (likely in June). The Supreme Court will consider whether state abortion bans trump EMTALA’s long-standing guarantee that patients will receive treatment for emergency medical conditions, and whether states can now force providers to turn away patients suffering from emergency pregnancy complications. The Court’s decision to allow Idaho’s extreme ban to remain in effect until the case is pending is an alarming and dangerous decision that will put lives at risk while the litigation continues.

What happens if the Supreme Court rules in favor of extremists?

If the Supreme Court sides with extremists, it would mean pregnant people will be excluded from the right to treatment for emergency medical conditions under EMTALA. This case is part of the agenda of anti-abortion extremists to make it easier to ban emergency abortion care nationwide. These extremists care more about imposing their own personal beliefs on others than about the lives and health of pregnant people. Many of the communities our coalition represents will be especially impacted, including people of color and people with low incomes. A Supreme Court ruling that sides with extremists will harm those who visit ERs at disproportionate rates due to systemic barriers to health care, including pregnant patients who live in rural areas, have low incomes, are people of color, or are immigrants. And for those pregnant people who both disproportionately access ERs and face maternal mortality and morbidity inequities, the harm will be particularly devastating.

What is The Leadership Conference’s take on the case?

We believe all people should be free to make their own decisions about their bodies, lives, and futures. We joined a “friend of the court” brief led by the National Women’s Law Center in support of EMTALA’s long-settled protections for pregnant people in emergency medical situations. The brief argued that there will be devastating, lifelong consequences if federal protections guaranteeing a right to emergency abortion care for pregnant patients under EMTALA are removed. The impact of such a decision would disproportionately affect Black, Indigenous, and other people of color, people in rural communities, people with disabilities, people with low incomes, immigrants, and other people who already experience discrimination and other significant barriers in accessing health care, leading to worse health outcomes for these communities.