Supreme Court allows emergency abortions in Idaho

WASHINGTON — The Supreme Court cleared the way Thursday for Idaho hospitals to provide emergency abortions, for now, in a procedural order that left key questions unanswered and could mean the issue ends up before the conservative-majority court again soon.

The order was briefly posted on the court's website accidentally on Wednesday and abruptly removed. By a 6-3 vote, it reverses the court's earlier order that had allowed an Idaho abortion ban to go into effect, even in medical emergencies.

Abortion is an animating issue in the 2024 election campaign, a direct result of the court's seismic ruling two years ago that overturned the nationwide right to abortion. But in this decision and another that preserved access to abortion medication, they stopped short of issuing broader rulings.

The Idaho order doesn't answer key questions about whether doctors can provide emergency abortions elsewhere, a significant issue as most Republican-controlled states have moved to restrict the procedure.

In Texas, for example, an appeals court has sided with the state, finding federal health care law does not trump a state ban on abortion. Complaints of pregnant patients being turned away from emergency rooms in Texas immediately spiked following the Supreme Court's 2022 decision to overturn Roe v. Wade, according to federal documents obtained by The Associated Press.

The Supreme Court took up the Idaho case after the Biden administration sued to allow abortions in emergency cases where a woman's health was at serious risk. Idaho had argued that its law does allow life-saving abortions and the federal government was wrongly pushing for wider exceptions.

But the contours of the issue have changed in the months since the court agreed to hear it, Justice Amy Coney Barrett wrote in a concurrence joined by Chief Justice John Roberts and Justice Brett Kavanaugh.

"I am now convinced that these cases are no longer appropriate for early resolution," Barrett wrote, pointing to revisions Idaho made to its abortion ban and the Biden administration making clear it was only seeking to allow emergency abortions in rare cases. Kavanaugh and Barrett were both part of the majority who voted to overturn Roe v. Wade.

Justice Ketanji Brown Jackson said the court should have decided now, arguing its earlier order meant Idaho doctors were forced to watch as patients suffered or were airlifted out of state for care.

"While this court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position," she said, underscoring her views by reading a summary of her opinion aloud in the courtroom. "This court had a chance to bring clarity and certainty to this tragic situation, and we have squandered it."

Her fellow liberals agreed with the dismissal.

White House Press Secretary Karine Jean-Pierre said, "No woman should be denied care or wait until she's near death or forced to flee her home state just to receive the healthcare she needs."

Conservative Justice Samuel Alito, who authored the Dobbs v. Jackson decision that overturned Roe, disagreed with the decision to dismiss the case now. Joined by Justice Neil Gorsuch and Clarence Thomas, he suggested the court should side with Idaho. Federal health care law "conclusively shows that it does not require hospitals to perform abortions," he wrote.

The opinion's premature release marked the second time in two years that an abortion ruling went out early, though in different circumstances. The court's landmark ruling ending the constitutional right to abortion was leaked to Politico.

President Joe Biden said the court's Wednesday order ensures that Idaho women can get the care they need while the case continues to play out.

"Doctors should be able to practice medicine. Patients should be able to get the care they need," he said.

White House Press Secretary Karine Jean-Pierre said, "No woman should be denied care or wait until she's near death or forced to flee her home state just to receive the healthcare she needs."

Attorney General Merrick Garland said the Justice Department will continue pressing its case and using "every available tool to ensure that women in every state have access to that care."

A new poll from The Associated Press-NORC Center for Public Affairs Research found that about seven in 10 U.S. adults favor protecting access to abortions for patients who are experiencing miscarriages or other pregnancy-related emergencies.

Dr. Kara Cadwallader, a family medicine doctor in Boise, said she's hopeful the ruling will allow for appropriate medical care when a patient's health is threatened in Idaho. She described a pregnant patient whose membranes ruptured halfway through her pregnancy, leaving her at risk for bleeding to death and sepsis. An Idaho hospital said they couldn't care for her because she needs an abortion and instead recommended she go out of state.

It took the patient two weeks to get an appointment set up in Seattle, Cadwallader said. Now, patients like her can get treatment in Idaho.

"That is incredibly important for those of us on the ground actually seeing patients, because we've been shipping these patients out of state unnecessarily for something we could be easily taking care of for them here at home," she said.

Abortion-rights groups said the opinion would bring temporary relief, but leave "devastating" uncertainty about the larger picture. "This fight is far from over," said Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project.

Idaho State Attorney General Raúl Labrador said the Biden administration's position had shifted to become "far more modest" than it appeared with the case was first filed. Idaho will still be able to enforce its law in the vast majority of circumstances, he said, citing Barrett's concurrence.

Still, he also expected the issue to end up back before the Supreme Court. "We feel pretty strongly we're going to win this case in the end," he said.

The Biden administration has also appealed the Texas emergency abortion ruling to the high court, leaving another avenue for the issue to appear again. The justices are unlikely to even consider whether to take up the Texas case before the fall.

Associated Press writers Fatima Hussein, Coleen Long and Amanda Seitz in Washington, Darlene Superville aboard Air Force 1, Christine Fernando in Chicago and Hallie Golden in Seattle contributed to this report.