The Supreme Court on Thursday reversed its ruling on Idaho's near-total ban on abortions, leaving in place a judge's order that for now allows doctors to perform abortions when necessary in medical emergencies.
The judges, in an unsigned order, said they had “recklessly granted” Idaho's appeal in its dispute with the Biden administration over emergency care.
A draft of the order was inadvertently posted on the court's website on Wednesday.
The justices were deeply divided when they heard the Idaho case in April. Judge Amy Coney Barrett accused the state's attorney of giving shifting answers about whether certain emergencies could justify an abortion.
The judges could not agree on a majority ruling.
On Thursday, the justices divided into four positions in explaining their views. Barrett, joined by Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh, said the court made a “miscalculation” by intervening too soon. He said both sides have continued to change their positions on what state and federal laws require when it comes to emergency abortions.
Justices Elena Kagan and Sonia Sotomayor said the court was right to step back and allow emergency abortions to resume. They noted that because of the strict ban, women have been flown from Idaho to obtain abortions in other states.
Dissenting, Justice Samuel A. Alito Jr. said the Biden administration would say hospitals “must perform abortions on demand when a pregnant woman's 'health' is in serious danger.” That can't be right, he said, because the law is about protecting the “unborn child.” Justices Clarence Thomas and Neil M. Gorsuch agreed.
Justice Ketanji Brown Jackson, dissenting alone, said the court should have ruled in favor of the administration and held that hospitals must perform emergency abortions if they are necessary to stabilize a patient. “Today's decision is not a victory for pregnant patients in Idaho. It is a delay,” he wrote.
In January, the court issued an order allowing Idaho to temporarily enforce its law. That order was also vacated Thursday.
Idaho’s abortion ban is among the strictest in the country. It allows abortions only when “necessary to prevent the death of the pregnant woman.” It makes no exceptions for emergencies or medical conditions that could endanger the patient’s health.
The Biden administration sued Idaho in 2022, arguing that the federal Emergency Medical Treatment and Labor Act requires hospitals to provide “necessary stabilizing treatment” to patients arriving there. And in rare cases, U.S. health officials said, doctors may be required to perform an abortion if a woman suffers a serious infection or uncontrolled bleeding.
Idaho lawyers and state legislators disagreed. They said federal law has nothing to do with abortions.
But a federal judge in Idaho ruled in favor of the administration and issued a limited order allowing abortions in certain medical emergencies. The Ninth Circuit Court of Appeals declined to lift that order while evaluating the state's appeal.
He Moyle vs. United States case raised a clash between federal law requiring hospitals to provide emergency care and state authority to regulate doctors and the practice of medicine.
In her defense, Attorney General Elizabeth Prelogar said pregnant women “may suffer from dangerous conditions that require immediate medical treatment to prevent death or serious injury, including organ failure or loss of fertility. And in some tragic cases, the necessary stabilizing care – the only treatment that can save the woman's life or prevent serious damage to her health – involves the termination of the pregnancy.
He said Idaho was among six states that make no exceptions to protect the health of a pregnant patient.
After Idaho's law went into effect, doctors reported that six women who needed an abortion due to medical complications were transported to out-of-state hospitals.
Idaho doctors argued that the state's law endangers patients and spoke out against it during the court battle.
In medical emergencies, “delay puts the patient's life and health at risk. But the lack of clarity in the law is creating fear among our doctors,” Dr. Jim Souza, executive medical director of St. Luke's Health System in Boise, said in a previous interview.
He said doctors in emergency rooms often see pregnant women whose water has broken, or who have a serious infection or are bleeding a lot. In such a situation an abortion may be required, but doctors know they could be subject to criminal prosecution if they act too soon, she said.
