In a ruling late Wednesday, U.S. District Judge B. Lynn Winmill said the statute violates a federal law requiring hospitals participating in the federally funded Medicare program to provide medical care when a person’s life or health is at stake. The ‘trigger’ law was written by Idaho state lawmakers long before the Supreme Court was struck down Roe v. Wade in June, with the expectation that it would come into effect automatically shortly after the court made that landmark ruling.
Idaho may still have a strict abortion law. But by issuing a preliminary injunction, Winmill ruled that a doctor cannot be punished if he or she performs an abortion to protect the health of a pregnant patient.
“It’s not about the bygone constitutional right to abortion,” the judge said. “This Court is not wrestling with that bigger, deeper question. Rather, the Court is being asked to consider a much more modest issue — whether Idaho’s criminal abortion statute violates a small but important piece of federal law. It does.”
A spokesman for the Idaho Attorney General did not immediately return a request for comment.
The ruling creates a potential clash in the federal justice system, with a Texas court ruling Tuesday that the federal statute in question does not require states to allow abortions in cases where it could protect the health of a pregnant patient. With many states adopting increasingly strict abortion bans, legal experts expect the trial on the health exception issue to continue and potentially reach the Supreme Court.
Still, the core of Idaho’s abortion law remains intact, with the state continuing to prohibit abortion in most cases. The limited scope of the decision underscores how few legal tools the Biden administration has to significantly shape abortion rights in the country since roe was struck down, removing the right to terminate a pregnancy, which had been enshrined in federal law for nearly 50 years.
The Justice Department had no legal pathway to access abortion for all women in Idaho. Instead, the lawsuit was intended to protect access to abortion in extreme health crises and to ensure that doctors could not be sued for terminating pregnancies in these emergencies.
Winmill, who was appointed to the federal bench by President Bill Clinton in 1995, opened his hearing Monday morning by saying that the Idaho case was limited in scope, related only to pregnancies posing a significant health risk, and would not serve as a broad debate on whether abortion should be allowed in other cases.
Justice Department attorneys based their lawsuit on their interpretation of a 1986 law rarely associated with abortion in courts: 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 all patients with necessary, health-stabilizing treatment, even if that treatment is an abortion.
Idaho accused the Justice Department of federal overspending as the Supreme Court ruled that states can set their own abortion restrictions under Dobbs v. Jackson Women’s Health Organization.
Winmill appeared skeptical Monday of the arguments of the Idaho attorneys that a “real world” attorney from Idaho would never sue a doctor for performing an abortion on a critically ill patient. “The concern is that real world events are very difficult to predict, but the text of the law is very clear,” he said.
“As the court has ruled, a state law that attempts to prevent a hospital from fulfilling its obligations under EMTALA violates federal law and the supremacy clause of the U.S. Constitution,” Attorney General Merrick Garland said in a statement Wednesday night. “The Department of Justice will continue to use all resources 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 tried to force hospitals that receive Medicare funds to perform abortions that harm health. of a patient.
In July, shortly after the Dobbs ruling, the Centers for Medicare and Medicaid Services — the federal agency charged with enforcing EMTALA — issued guidelines to hospitals saying the statute takes precedence over any state law prohibiting performing an abortion. prohibited when a woman’s health is in danger.
In response, the state of Texas sued the Secretary of Health and Human Services, saying the guidelines amounted to a federal overrun. On Tuesday, a federal judge in Texas agreed, ruling that the requirements in EMTALA do not violate the state’s strict abortion laws.
Lawrence Gostin, a professor of global health law at Georgetown University, said he expects courts across the country to be divided over whether access to abortions in health emergencies is part of EMTALA. He said the public should anticipate many calls in the coming months.
“When EMTALA was introduced, was Congress planning to pre-empt the state law banning certain medical procedures? My opinion is absolute,” Gostin said. “If EMTALA stands for anything, it stands for any person in America, anywhere in America, who can walk into an emergency department expecting doctors to do everything possible to save their lives and prevent their health from deteriorating. to prevent.”
Ever since roe was overturned, Justice Department officials and abortion rights advocates have also considered other legal strategies to protect abortion rights, including protecting women who travel to states where the procedures are legal and ensuring people have access to pills that can prevent abortion. cause.
