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Supreme Court lets Idaho enforce abortion ban for now and agrees to hear case

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Washington — The Supreme Court on Friday agreed to let Idaho enforce its near-total ban on abortion in certain emergency medical situations while legal proceedings continue and said it will take up the dispute involving whether the Biden administration can require under federal law hospitals in states that ban abortion to perform the procedure on pregnant patients whose lives are at risk.

The question raised in the case is whether that law, the Emergency Medical Treatment and Labor Act, preempts state laws restricting access to abortion. The dispute, between the Biden administration and the state of Idaho, is one of several involving abortion that has arisen following the Supreme Court's landmark decision unwinding the constitutional right to abortion.

The Supreme Court said in a brief order that it would put on hold a lower court ruling that blocked Idaho from enforcing its abortion ban in certain medical emergencies until it issues a decision in the case. Arguments will be heard in its April session.

Enacted in 2020, Idaho's measure makes it a felony for doctors to perform most abortions, with an exception for procedures performed when necessary to save the life of the mother. The law took effect when the Supreme Court overturned Roe v. Wade in June 2022, joining so-called trigger bans in more than a dozen states that went into force following the high court's ruling.

In the wake of Roe's reversal, the Justice Department sued Idaho in federal court over the law, arguing that it violates the Constitution and is preempted by the Emergency Medical Treatment and Labor Act, or EMTALA. The law requires health care providers that receive Medicare funds to provide necessary stabilizing treatment, such as emergency abortion care, to a mother whose health is at risk.

A U.S. district court in Idaho found the state's law conflicts with EMTALA's requirements and blocked it from being enforced for abortions necessary to avoid a "serious impairment" to the patient or placing the health of the mother in "serious jeopardy."

"We should not forget the one person with the greatest stake in the outcome of this case — the pregnant patient, laying on a gurney in an emergency room facing the terrifying prospect of a pregnancy complication that may claim her life," U.S. District Judge B. Lynn Winmill wrote in an August 2022 order imposing a preliminary injunction. 

He continued: "One cannot imagine the anxiety and fear she will experience if her doctors feel hobbled by an Idaho law that does not allow them to provide the medical care necessary to preserve her health and life."

Winmill said "it's impossible to comply" with both EMTALA and Idaho's measure.

A three-judge panel of the U.S. Court of Appeals for the 9th Circuit granted the Idaho legislature's request to enforce the law while litigation continued. But after reviewing the panel's decision, the full 9th Circuit reinstated the lower court's injunction in October. The appeals court set oral arguments in the case for late January.

Idaho officials sought emergency relief from the Supreme Court in late November, arguing that the federal government can't use EMTALA "to override in the emergency room state laws about abortion any more than it can use it to override state law on organ transplants or marijuana use."

The injunction put in place by the district court, they wrote, "effectively turns EMTALA's protection for the uninsured into a federal super-statute on the issue of abortion, one that strips Idaho of its sovereign interest in protecting innocent human life and turns emergency rooms into a federal enclave where state standards of care do not apply."

But the Biden administration told the high court that the exception to Idaho's ban is narrower than EMTALA and criminalizes care that is required by federal law, as an emergency room doctor who decides an abortion is necessary to stabilize a patients' condition cannot do so until her condition has deteriorated significantly.

If Idaho's law were allowed to take effect, it "would cause serious, tangible harms to the United States and to the public," Solicitor General Elizabeth Prelogar told the court in a filing.

"A stay would increase the risk that pregnant patients will face irreversible injuries, such as strokes, amputations, hysterectomies, and organ failure, that could have been prevented with appropriate emergency care," she wrote. "If a stay issues, physicians will be placed in an impossible position, unable to provide 'medically necessary' care and 'put[ting] the health of Idaho women at significant risk.'"

President Biden said in a Friday statement that healthcare decisions should not be made by politicians.

"These bans are also forcing doctors to leave Idaho and other states because of laws that interfere with their ability to care for their patients. This should never happen in America, " Biden said. 

A case similar to Idaho's is proceeding in Texas. A federal district court there sided with the state and blocked the Biden administration from requiring Texas hospitals and doctors to perform abortions in emergency medical situations when it conflicts with the state's law outlawing most abortions.

A three-judge panel for the U.S. Court of Appeals for the 5th Circuit affirmed the district court's ruling earlier this month, siding with Texas.

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