In a ruling released late Wednesday, U.S. District Judge B. Lynn Winmill said the law violates a federal law that requires hospitals participating in the federally funded Medicare program to provide medical care when the life or health of ‘trigger’ law was drafted by Idaho state lawmakers long before the Supreme Court struck down Roe vs. Wade in June, in the hope that it would automatically come into force shortly after the court issued this historic decision.
Idaho may still have a strict abortion law. But in issuing a preliminary injunction, Winmill ruled that a doctor cannot be punished if he performs an abortion to protect the health of a pregnant patient.
“This is not about the past constitutional right to abortion,” the judge’s ruling states. “This Court is not grappling with that larger, deeper question. Rather, the Court is called upon to deal with a much more modest question — whether Idaho’s criminal abortion law conflicts with a small but important corner of federal law. It does.”
A spokesperson for the Idaho attorney general did not immediately return a request for comment.
The ruling creates a potential conflict in the federal justice system, with a Texas court ruling on Tuesday that the federal law in question does not require states to allow abortions where doing so could protect a pregnant patient’s health. As many states enact increasingly strict abortion bans, legal experts expect litigation over the health exception issue to continue, potentially reaching the Supreme Court.
Still, the core of Idaho’s abortion law will remain intact, with the state continuing to ban abortion in most circumstances. The narrow scope of the decision underscores how few legal tools the Biden administration has had to meaningfully shape abortion rights in the country since then. deer was struck down, overturning the right to terminate a pregnancy that had been enshrined in federal law for nearly 50 years.
The Justice Department had no legal avenue to seek access to abortion for all women in Idaho. Instead, the lawsuit sought to protect access to abortion in extreme health crises and to ensure that doctors could not be sued for terminating pregnancies in such emergencies.
Winmill, who was appointed to the federal bench in 1995 by President Bill Clinton, opened his hearing Monday morning saying that the Idaho case was narrow in scope, dealing only with pregnancies that pose a significant health risk, and would not serve as a broad debate over whether abortion should be permitted in other case.
Lawyers for the Justice Department based their lawsuit on their interpretation of a 1986 law that has rarely been associated with abortion in court: the Emergency Medical Treatment and Active Labor Act. They say the law, known as EMTALA, requires hospitals participating in the federally funded Medicare program to provide necessary, health-stabilizing treatment to all patients, even if that treatment is an abortion.
Idaho has accused the Justice Department of federal abuse since the Supreme Court ruled that states can set their own abortion restrictions under Dobbs v. Jackson Women’s Health Organization.
Winmill seemed skeptical on Monday of arguments by Idaho attorneys that in the “real world,” an Idaho attorney would never sue a doctor for performing an abortion on a critically ill patient. “The problem is that real-world events are very difficult to predict, but the text of the law is very clear,” he said.
“As the district court has ruled, a state law that attempts to prevent a hospital from fulfilling its obligations under the EMTALA violates federal law and the Supremacy Clause of the U.S. Constitution,” said Attorney General Merrick Garland in a statement Wednesday evening. “The Department of Justice will continue to use every tool at its disposal to defend reproductive rights protected by federal law.”
While this is the first time the Biden administration has argued in court that EMTALA protects the right to abortion in certain cases, the federal government last month attempted to require hospitals that receive funds from Medicare that they perform abortions that would protect a patient’s health.
In July, shortly after the Dobbs ruling, the Centers for Medicare and Medicaid Services — the federal office responsible for enforcing EMTALA — issued guidance to hospitals stating that the law takes precedence over any state law prohibiting perform an abortion when a woman’s health is in danger.
The state of Texas, in response, sued the Secretary of Health and Human Services, saying the guidelines amounted to federal government overreach. On Tuesday, a Texas federal judge agreed, ruling that the requirements set out in the EMTALA do not conflict with the state’s strict abortion laws.
Lawrence Gostin, a professor of global health law at Georgetown University, said he expects circuit courts across the country to be split on whether access to abortions in health emergency is part of the EMTALA. He said the public should anticipate many calls in the coming months.
“When EMTALA was enacted, did Congress intend to preempt state law that prohibits certain medical procedures? My view is, absolutely,” Gostin said. , that means anyone in America, anywhere in America, can walk into an emergency department expecting doctors to do everything possible to save their life and prevent their health from deteriorating.”
Since deer was overturned, Justice Department officials and abortion rights advocates were also weigh other legal strategies protect the right to abortion, including protecting women who travel to states where procedures are legal and ensuring people have access to pills that can induce abortions.