Judge rules Idaho can't criminalize abortion needed for emergency medical care

Abortion bans complicate access to essential medication

A federal judge has paused a portion of an Idaho abortion ban which was set to go into effect Thursday and would have prevented doctors from performing abortions in emergency situations. The judge ruled in favor of the Justice Department in its first challenge to a state abortion law since the Supreme Court overturned Roe v. Wade.  

Judge B. Lynn Winmill issued the injunction Wednesday after the Justice Department sued the state of Idaho earlier this month, alleging Idaho Code 18-622 violates federal law, which requires emergency room doctors at institutions accepting Medicare provide patients in distress with the care necessary for their survival.

The Emergency Medical Treatment and Labor Act (EMTALA) "requires that ER physicians at hospitals receiving Medicare funds offer stabilizing treatment to patients who arrive with emergency medical conditions," according to the judge, and Idaho's law would criminalize abortions at any level, even in such emergency situations.

Winmill agreed with the Justice Department that the law, specifically as relates to EMTALA requirements, should be suspended as the merits of the case are fully worked out. This is a temporary injunction, not a full ruling on the validity of the Idaho law, and it will pertain to circumstances where EMTALA is in effect.

Idaho's near-total abortion ban was enacted in 2020 as a so-called trigger law in the event that Roe v. Wade was overturned. Under Idaho's new law, performing an abortion on a "clinically diagnosable pregnancy" is a felony which could carry a prison sentence of up to five years. A majority of the law will still take effect Thursday.

Earlier this month, the Idaho Supreme Court ruled that abortion restrictions could move forward while several lawsuits against them played out. On Aug. 12, the Idaho Supreme Court allowed a different law to go into effect, one which allows potential relatives of an embryo or fetus to sue abortion providers, according to the Associated Press.

In his ruling, Winmill described a scenario in which a doctor is faced with a quandry when a patient requiring an abortion presents at a hospital.

"The doctor believes her EMTALA obligations require her to offer that abortion right now," the judge wrote. "But she also knows that all abortions are banned in Idaho. She thus finds herself on the horns of a dilemma. Which law should she violate?"

The answer, according to the judge, is that federal law takes precedent, and EMTALA must be enforced over the Idaho state law criminalizing abortion.

"During the pendency of this lawsuit, the state of Idaho will be enjoined from enforcing Idaho Code 18-622 to the extent that statute conflicts with EMTALA-mandated care."

The judge is clear that this case does not prevent the Idaho law from taking effect Thursday, but is a more narrow ruling specifically for "emergency medical" situations, explaining "Idaho Code 18-622 will take effect on Aug. 25, 2022, regardless. The United States is not trying to stop that. The only question this Court is addressing is whether the statute must include a carve-out for EMTALA-mandated care."

"In short, given the extraordinarily broad scope of Idaho Code 18-622, neither the State nor the Legislature have convinced the court that it is possible for healthcare workers to simultaneously comply with their obligations under EMTALA and Idaho statutory law. The state law must therefore yield to federal law to the extent of that conflict."

"Delayed care is worse care," the judge wrote. "The wait for care is troubling enough on its own. Even worse, delayed care worsens patient outcomes."

Attorney General Merrick Garland issued a statement Wednesday in response to the ruling which read in part: "Today's decision by the District Court for the District of Idaho ensures that women in the State of Idaho can obtain the emergency medical treatment to which they are entitled under federal law. This includes abortion when that is the necessary treatment."

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