Judge sides with DOJ, issues “modest” preliminary injunction on Idaho abortion law in emergencies

By Melissa Davlin, Idaho Reports

When Idaho’s abortion ban goes into effect, medical professionals working in emergency rooms and labor departments will not face prosecution if emergency medical care includes abortions for pregnant patients.

In a Wednesday ruling, U.S. District Judge B. Lynn Winmill ruled in favor of the US Department of Justice, which sued Idaho over its near-total abortion ban, set to go into place Thursday. The order prohibits only prosecution of abortions in emergency situations at hospitals that receive Medicare funds; most abortions will still be illegal.

Though Idaho’s abortion ban has narrow exemptions for reported rape, incest, and life of the mother, it doesn’t include language for the health of the mother. That, the DOJ argued, conflicts with a federal law known as the Emergency Medical Treatment and Labor Act. 

Under EMTALA, every hospital that receives Medicare funds must provide necessary stabilizing treatments to patients in medical emergencies. 

“At its core, the Supremacy Clause says state law must yield to federal law when it’s impossible to comply with both. And that’s all this case is about,” Winmill wrote in his order. “It’s not about the bygone constitutional right to an abortion. This Court is not grappling with that larger, more profound question. Rather, the Court is called upon to address a far more modest issue—whether Idaho’s criminal abortion statute conflicts with a small but important corner of federal legislation. It does.” Winmill called the injunction “modest” and said the state will suffer no real harm from the limited order.

As he did during Monday’s hearing, Winmill cited hypothetical scenarios in which a woman’s life might not be in danger, but continuing a pregnancy in which a physician can still detect a fetal heartbeat could cause severe injury, including organ failure or stroke.

“In those situations, the physician may be called upon to make complex, difficult decisions in a fast-moving, chaotic environment. She may conclude that the only way to prevent serious harm to the patient or save her life is to terminate the pregnancy—a devastating result for the doctor and the patient,” Winmill wrote. But because Idaho’s statute provides an affirmative defense for life of the mother, and not health of the mother, the physicians put themselves at risk.

“If the physician provides the abortion, she faces indictment, arrest, pretrial detention, loss of her
medical license, a trial on felony charges, and at least two years in prison. Yet if the physician does not perform the abortion, the pregnant patient faces grave risks to her health—such as severe sepsis requiring limb amputation, uncontrollable uterine hemorrhage requiring hysterectomy, kidney failure requiring lifelong dialysis, hypoxic brain injury, or even death,” Winmill wrote.

Winmill’s order comes a day after a federal judge sided with Texas over the Biden administration’s EMTALA guidance. In a late Tuesday ruling, US District Court Judge James Wesley Hendrix said the guidance goes beyond the text of EMTALA, which makes no mention of abortion and which mentions the lives of both the mother and the unborn child – a point brought up by Monte Stewart, attorney for the Idaho Legislature, during Monday’s hearing in United States v Idaho.

Unlike the Idaho lawsuit, in which the DOJ sued the state over its law, Texas preemptively sued the Biden administration. And unlike the Idaho law, Texas includes exemptions for the health of the mother and specifically cites ectopic pregnancies as exceptions to its abortion ban.

The decision in Texas has no effect on Idaho’s law or the injunction, but may set the two decisions up for a collision course in front of the United States Supreme Court. 

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