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January 12, 2024
Health Law Weekly

Supreme Court to Consider EMTALA’s Reach in Idaho Abortion Law Challenge

  • January 12, 2024

The Supreme Court agreed January 5 to review whether the Emergency Medical Treatment and Labor Act (EMTALA) preempts an Idaho law that criminalizes most abortions.

The Court, which plans to hear oral arguments for the case in April, stayed without explanation a district court decision enjoining enforcement of the Idaho law.

The case is the second consequential abortion-related litigation that the Court will hear this term. In December 2023, the Court granted review of a Fifth Circuit decision finding the Food and Drug Administration improperly lifted certain restrictions on the abortion pill mifepristone that expanded access to the drug. Food and Drug Admin. v. Alliance for Hippocratic Med., No. 23-235, and Danco Labs., L.L.C. v. Alliance for Hippocratic Medicine, No. 236 (U.S. cert. granted Dec. 13, 2023).

The Idaho law, which was enacted in 2020 and set to go into effect after the Supreme Court’s decision overturning Roe v. Wade, makes it a crime for a health care provider to perform an abortion unless “[t]he physician determine[s], in his good faith medical judgment . . . that the abortion was necessary to prevent the death of the pregnant woman.”

The federal government challenged the law, arguing it was preempted by EMTALA. The district court granted a preliminary injunction in August 2022 enjoining its enforcement. On appeal, a Ninth Circuit panel agreed to stay the lower court's injunction, finding a strong likelihood that the abortion law did not implicate EMTALA. But then in October 2023, the full Ninth Circuit agreed to rehear the panel decision and to vacate the panel decision, putting the injunction back in place.

The case is one of two challenges involving EMTALA brought in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, 142 S. Ct. 2228, 2243 (2022). While the U.S. District Court for the District of Idaho found EMTALA preempted Idaho’s abortion restrictions, the U.S. District Court in the Northern District of Texas came to the opposite conclusion, finding no direct conflict between the federal statute and Texas’ abortion law. State of Texas v. Becerra, No. 5:22-CV-185-H (N.D. Tex. Aug. 23, 2022).

The Texas case specifically challenged Department of Health and Human Services guidance indicating that physicians must provide abortion care under EMTALA as a stabilizing treatment to pregnant women experiencing an emergency medical condition regardless of state restrictions on the procedure. The Fifth Circuit on January 2 upheld the lower court’s injunction blocking enforcement of the guidance in Texas. See related item in this issue.

United States v. Idaho, No. 23-727 consolidated with Moyle v. United States, No. 23-726 (U.S. cert. granted Jan. 5, 2024).