By Ruth Brown, Idaho Reports 

A Ninth Circuit Court of Appeals heard arguments Tuesday in the case brought by the federal government against Idaho, claiming the state’s abortion laws violate federal law.  

The arguments made in Pasadena, Calif., left the panel of 11 judges peppering attorneys with questions on both hypothetical scenarios in which a woman may need a medical abortion and logistical questions on if they should simply send the case back to the Idaho U.S. District Court.  

The case began in 2022 when the U.S. Department of Justice sued the state over its near-total abortion ban, claiming it violates the Emergency Medical Treatment and Labor Act, commonly referred to as EMTALA. That law mandates all hospitals that receive Medicare funds must provide necessary stabilizing treatment to a patient who arrives in an emergency room.  The federal government argues that in some cases, an abortion is stabilizing care. 

Idaho law bans nearly all abortions, with narrow exceptions for reported rape or incest or the life of the mother. The law does not include an exemption for the mother’s health.   

HISTORY OF THE CASE 

Idaho U.S. District Judge B. Lynn Wimill initially ruled that medical professionals working in emergency rooms and labor departments cannot face prosecution if emergency medical care includes abortions for pregnant patients. 

The Legislature’s legal counsel then successfully appealed that decision, and an appellate court determined that Idaho law does not conflict with federal law.   

In a 6-3 decision in June, the U.S. Supreme Court kept Idaho’s law in place and sent it back to a federal appellate court for further litigation. In the meantime, Idaho physicians may only provide emergency abortions to women in life-threatening situations, as opposed to women who are at risk of health complications – no matter how severe those complications may be.  

TUESDAY’S ARGUMENTS 

The state of Idaho is asking the court to modify its preliminary injunction to find there is no conflict between Idaho law and EMTALA. The United States is asking the court to keep the injunction in place while arguments are made in District Court.  

John Bursch, counsel for the Alliance Defending Freedom, argued on behalf of Idaho, noting that EMTALA mandates physicians also care for an unborn child.  

“Considering the irreparable harm to Idaho of having its law enjoined every day as well as to the harm to Idaho mothers and unborn children who are not being protected the way Idaho’s law intends, I don’t think we can afford to delay to go back to the District Court,” Bursch said. 

Taylor Meehan, who represented the Idaho Legislature, stressed that Idaho’s Defense of Life Act is about elective abortions and if a medical condition arose that required an abortion, a physician could do so. The law does allow for an abortion if “the physician determined, in his good faith medical judgment and based on the facts known to the physician at the time, that the abortion was necessary to prevent the death of the pregnant woman,” Meehan said.  

The judges questioned her about whether physicians would need to delay care to the mother until death became imminent and how physicians were supposed to know if prosecutors wouldn’t second guess their decisions.   

Catherine Carroll, who represented the United States, argued that recent changes in the law that lawmakers made since the case began do not eliminate the conflict with EMTALA. She said EMTALA requires hospitals to stabilize care and use reasonable medical judgement.  

Lindsay Harrison argued for St. Luke’s Health System and told the court that in the few months the injunction was stayed, the hospitals airlifted six patients out of state with pregnancy complications. She explained that not all of those patients had to terminate their pregnancies, but physicians wanted them to be in a state where the option was available, should their health deteriorate. 

Attorney General Raúl Labrador has previously said that such actions are unnecessary, as the existing law protects physicians who treat pregnant patients in good faith. In a separate trial in district court in November, physicians testified that vague language in the law makes them scared to face prosecution if they do perform an abortion.  

 The court will issue a written decision on the matter at a later date.  

STAKEHOLDER COMMENTS 

Rebecca Gibron, CEO of Planned Parenthood Great Northwest, Hawai‘i, Alaska, Indiana, Kentucky, issued the following statement Tuesday. 

“Patients in Idaho have already suffered enough under this dangerous and cruel ban,” said Gibron in the statement. “This hearing is a crucial opportunity to make clear that no one should be denied health- and life-saving emergency care because of anti-abortion politics. Lives are on the line, and we will continue to take action against extremist laws that put patients at risk. EMTALA is clear: when someone’s health or life is in danger, doctors must be able to provide the care they need, including abortion.” 

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