Case Summary
LWVUS and nearly 100 other organizations joined an amicus brief arguing that the federal Emergency Medical Treatment and Labor Act (EMTALA) preempts Idaho’s abortion ban, which prohibits abortion in all instances unless necessary to save the life of the mother. EMTALA requires hospitals participating in Medicare to provide stabilizing care to any individual experiencing a medical emergency, regardless of their ability to pay.
In 1986, Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA). The law requires hospitals participating in Medicare to screen patients and determine whether they have an emergency medical condition, which is broadly defined as “acute symptoms . . . such that the absence of immediate medical attention could reasonably be expected to jeopardize an individual’s health or result in serious impairment to bodily functions or dysfunction to bodily organs or parts.” For pregnant people, an emergency medical condition can be one that endangers the health of the pregnant person or the health of the fetus.
On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, ruling abortion was no longer a federal constitutional right. The United States Department of Health and Human Services then issued guidance stating that abortion was included under EMTALA’s definition of stabilizing care.
Subsequently, Idaho’s Defense of Life Act was set to take effect on Aug. 25, 2022, making it a felony for any abortion to be performed in the state unless to save the life of a pregnant person or if a pregnant person reported themselves as a victim of rape and/or incest to the police and provided a copy of the police report to the physician performing the abortion.
On Aug. 2, 2022, the United States filed a federal lawsuit in the United States District Court for the District of Idaho, asserting the Defense of Life Act’s ban on abortion directly conflicted with EMTALA’s mandate to provide stabilizing and lifesaving medical care during pregnancy complications, and was therefore preempted under the Supremacy Clause.
On Aug. 24, 2022, the District Court granted a preliminary injunction, preventing the Defense of Life Act from taking effect. The court ruled it was impossible for health care workers to comply with both EMTALA and the Defense of Life Act, the latter obstructing Congress’ objective to ensure a minimum level of emergency care. Idaho then requested a stay of the injunction from the Ninth Circuit Court of Appeals, which ultimately denied the request on Nov. 13, 2023.
Idaho then petitioned the United States Supreme Court for a stay of the preliminary injunction. On Jan. 5, 2024, the Court granted a stay and treated the motion as a petition for a writ of certiorari, agreeing to hear the case.
On March 29, 2024, the League of Women Voters of the United States (LWVUS) joined more than 100 other organizations on an amicus brief led by the National Women’s Law Center (NWLC), urging the Court to affirm that EMTALA covers pregnant patients, including lifesaving and stabilizing abortion care. The brief highlighted the ongoing maternal health crisis in the United States, as well as the existing racial disparities in maternal morbidity and mortality rates. The amici emphasized that ruling for Idaho would worsen these disparities and crises while further degrading care for all pregnant patients.
LWVUS was represented by NWLC in this matter.
LWV Timeline
United States Supreme Court overturns Roe v. Wade
The United States Supreme Court, in a 6 – 3 ruling, overturns Roe v. Wade, removing federal protection from the right to abortion.
United States files lawsuit
The United States files a complaint, asserting the Defense of Life Act directly conflicts with EMTALA and is therefore preempted by the United States Constitution’s Supremacy Clause.
Court issues preliminary injunction
The District Court of Idaho issues a preliminary injunction, preventing the Defense of Life Act from taking effect. The court’s ruling states it is impossible to comply with both EMTALA and the Defense of Life Act, and that the latter directly conflicts with Congress’ objectives for enacting the former.
Three-judge panel grants stay pending appeal
A three-judge panel grants Idaho’s request for a stay of the decision pending appeal of the preliminary injunction.
Ninth Circuit grants motion for en banc rehearing
A majority of non-recused sitting active judges vote to rehear the application for a stay pending appeal en banc.
Ninth Circuit denies stay
The Ninth Circuit Court of Appeals, sitting en banc, denies Idaho’s request for a stay of the preliminary injunction, overturning the three-judge panel’s decision.
Idaho requests stay from United States Supreme Court
Idaho asks the United States Supreme Court to stay the preliminary injunction, arguing the trial court had no authority to issue the injunction, and that EMTALA does not require Idaho to allow the performance of abortions in its hospitals.
United States files response
The United States responds to Idaho’s petition, stating abortion care is stabilizing treatment in several circumstances under EMTALA, and that Congress did not intend to exclude abortion from the law’s mandates.
United States Supreme Court grants certiorari
The United States Supreme Court agrees to hear Idaho’s appeal of the preliminary injunction. The Court stays the preliminary injunction, allowing the Defense of Life Act to go into effect.
LWVUS files amicus brief
The League of Women Voters of the United States (LWVUS) joins the National Women's Law Center (NWLC) and 100 other organizations on an amicus brief urging the US Supreme Court to affirm EMTALA covers pregnant patients, including necessary abortions. The brief highlights the racial disparities in maternal morbidity and mortality rates that could worsen if Idaho prevails.
United States Supreme Court dismisses case
The Court dismisses the case as improvidently granted. The order allows the district court's preliminary injunction placing the Defense of Life Act on hold to remain in effect pending further proceedings in the lower courts.
United States Department of Justice dismisses case
After the change in administration, the Department of Justice decides to voluntarily dismiss the lawsuit.