Idaho Defends Its Pro-Life Law at the Supreme Court

Published April 24, 2024


Today, Idaho officials are at the Supreme Court defending the state’s pro-life law against a suit from the Biden administration’s Department of Justice, which is aiming to prevent the state from enforcing the law. The outcome will have important implications for the future of pro-life legislation at the state level and the ability of pro-abortion administrations to block duly enacted state laws.

A bit of background on the case: In 2020, Idaho passed the Defense of Life Act, which prohibits all abortions except for cases in which a mother is pregnant as a result of rape or incest. The law also includes language permitting doctors to perform any procedure necessary to save the life of a pregnant mother in a medical emergency.

After the Supreme Court overturned Roe v. Wade in Dobbs v. Jackson Women’s Health Organization in June 2022, Idaho’s law was slated to take effect that August. But before the state could begin enforcing the statute, the Biden administration’s DOJ sued Idaho over the law, claiming that it would conflict with the federal Emergency Medical Treatment and Active Labor Act (EMTALA).

Enacted in 1986, EMTALA provides that hospitals that receive Medicare funding must care for uninsured patients in their emergency rooms regardless of ability to pay. Notably, EMTALA itself mentions the importance of care for pregnant women and “the unborn child” and presumably would require doctors to treat both pregnant mother and unborn child as patients in the case of a medical emergency.

In its initial suit, the DOJ requested that the federal district court rule that the Idaho law “is preempted and therefore invalid to the extent that it conflicts with EMTALA,” taking issue specifically with the law’s language regarding care for women in medical emergencies.

As Ed Whelan noted in a Bench Memos post shortly after the initial lawsuit was filed, EMTALA is a funding restriction that pertains only to hospitals that receive Medicare. At most, he argued, it likely would only allow the Biden administration to “take enforcement action against any Medicare-participating hospital in Idaho that actually fails to comply with EMTALA or to undertake to terminate its Medicare agreements with Idaho hospitals.” (All of Ed’s coverage of this case is well worth reading over at National Review Online, especially if you’re looking for legal analysis that I don’t provide here.)

In short, the administration seems to have cherry-picked a portion of EMTALA and used it as grounds to preemptively invalidate Idaho’s statute—without any evidence that enforcement of the statute has resulted or will result in violations of federal law.

Even so, the state now finds itself defending its law before the Supreme Court, thanks to an en banc ruling from the Ninth Circuit Court of Appeals that put Idaho’s law on hold. An earlier panel for the Ninth Circuit had ruled that the law was enforceable, on the rationale that EMTALA neither conflicts with nor overrides the statute. Idaho’s law has been in effect since the Supreme Court granted an emergency stay and agreed in January to hear the state’s appeal this term.

Legal group Alliance Defending Freedom (ADF), which is assisting Idaho officials in defending the state’s law, has argued that the case has significant implications for the future of pro-life legislation. If the Court agrees with the Biden administration’s interpretation of EMTALA, “it would invalidate the laws of more than 20 states,” according to an attorney for ADF.

This case isn’t the first time that the Biden administration has attempted to infringe on state pro-life laws by using a misreading of EMTALA. Earlier this year, a Fifth Circuit Court of Appeals panel ruled in Texas v. Becerra that Biden’s Department of Health and Human Services was wrong to argue that EMTALA allowed—or even required—doctors to perform abortions outside the emergency medical situations stipulated by state law. In a letter issued after the Dobbs ruling, HHS had advised health-care providers that EMTALA “protects your clinical judgment and the action that you take to provide stabilizing medical treatment to your pregnant patients, regardless of the restrictions in the state where you practice.”

These efforts by federal agencies to twist EMTALA into a pro-abortion tool with which to bludgeon pro-life states reveal that Biden’s pro-abortion bureaucrats care little for legal reality. Their chief aim is to ensure that abortion remains accessible in as many circumstances as possible, regardless of Dobbs and the political will in any given state.

What’s more, this particular argument from the administration is a reminder that abortion supporters regularly misconstrue abortion as emergency health care in order to justify elective abortion. As is the case in Idaho, every state pro-life law has language noting that medical professionals may use their best judgment when treating a pregnant mother in a health-care emergency.

If a mother’s life is at risk, it is always legally permissible for a doctor to attempt to save her life, even if that treatment would inadvertently harm her unborn child—and such cases are not considered an abortion. Elective abortion, or the direct and intentional killing of the unborn child, is never medically necessary to save the life of a pregnant mother. That’s why pro-life laws—and EMTALA itself, for that matter—stipulate that both mother and unborn child ought to be treated as patients; both lives are valuable, and both patients deserve as much life-saving care as possible.

EPPC Fellow Alexandra DeSanctis writes on culture and family issues, with a particular focus on abortion policy and pro-life advocacy, as a member of the Life and Family Initiative.

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