Two Lawsuits, in Texas and Idaho, Highlight Fight Over Emergency Medicine Law

In the weeks after the Supreme Court dismantled a constitutional right to abortion in 2022 and returned the issue of access to the states, a new series of court battles began.

After the Biden administration announced it would protect access to abortion under emergency situations through a decades-old federal law, conservative states pushed back, leading to dueling lawsuits in Texas and Idaho.

Those cases created a divide among federal courts, known as a circuit split. It intensified pressure on the Supreme Court to settle whether the law, the Emergency Medical Treatment and Labor Act, pre-empts state abortion bans, shielding doctors who perform emergency abortions in efforts to stabilize the health of a pregnant woman.

After Roe fell, the Department of Health and Human Services issued guidance to hospitals, including those in states with abortion bans, that federal law mandated that pregnant women be allowed to receive abortions in emergency rooms so long as doctors believed the procedures were required for “stabilizing treatment.”

In July 2022, days after the Biden administration announced it would use the federal law to ensure abortion access in some emergency situations, Texas’ state attorney general, Ken Paxton, sued. The administration’s interpretation of the federal law, he said, would “force abortions” in Texas hospitals.

In the complaint, Mr. Paxton accused the administration of trying to defy the Supreme Court’s ruling. “President Biden is flagrantly disregarding the legislative and democratic process — and flouting the Supreme Court’s ruling before the ink is dry,” he wrote.

The federal government was misinterpreting the Emergency Medical Treatment and Labor Act, he added, writing that the law “does not guarantee access to abortion.”

“On the contrary,” he continued, the law “contemplates that an emergency medical condition is one that threatens the life of the unborn child.”

In August 2022, Judge James Wesley Hendrix of United States District Court for the Northern District of Texas, a Trump appointee, ruled for Texas, finding that the federal guidance of how to interpret the act went “well beyond” the text of the law. The U.S. Court of Appeals for the Fifth Circuit upheld Judge Hendrix’s ruling.

In Idaho, a near-total ban on abortions had gone into effect after the court overturned Roe v. Wade. The Biden administration sued Idaho in August 2022, a few weeks before the state’s law was set to take effect. The federal law, it said, should trump the state law when the two directly conflict.

A federal judge in Idaho, B. Lynn Winmill, who was appointed by President Bill Clinton, temporarily blocked part of the state’s ban. He wrote that Idaho could not penalize doctors for acting to protect the health of endangered mothers.

In the fall of 2023, a three-judge panel from the U.S. Court of Appeals for the Ninth Circuit put the ruling on hold and reinstated the ban. But that decision was ultimately overridden by an 11-member panel of the appeals court, which temporarily blocked Idaho’s law as the appeal continued.

Idaho asked the Supreme Court to intervene, and the court reinstated the ban and agreed to hear the case.