Supreme Court must decide if state abortion bans can defy federal law

The Supreme Court's decision about the Idaho abortion ban that contradicts federal law will have significant implications for even stricter anti-abortion laws.

The Supreme Court will decide whether states can pass anti-abortion legislation that contradicts federal law; the outcome of that decision will have serious consequences.

 As a result of the Supreme Court’s decision to overturn Roe v. Wade, Idaho passed a very strict anti-abortion law which made performing an abortion a felony, with very limited and vague exceptions. The Biden administration sued Idaho to prevent the law coming into full effect, alleging that the abortion ban was preempted by a federal law. The Supreme Court heard oral arguments for the case on April 24, 2024.

The federal law at the heart of this case, the Emergency Medical Treatment and Labor Act, requires that hospitals provide stabilizing treatment necessary to prevent the deterioration of a patient's health. Congress passed the statute to ensure that all patients receive emergency medical care. To prevent states from denying that care, the federal statute includes a preemption of all state laws that directly conflict with the federal statute.

Idaho argued before the Supreme Court that it's abortion ban isn't preempted by federal law because it permits everything the Emergency Medical Treatment and Labor Act requires. However, Idaho's arguments misrepresent the text and purpose of the federal statute. Furthermore, Idaho disregards the real-world consequences and the danger the law poses to women seeking emergency medical care in Idaho.

Idaho is contradicting federal law

The foundation of Idaho's argument is the idea that the Idaho abortion ban does not conflict with federal law. Idaho claims that the exception included in the abortion law covers everything the Emergency Medical Treatment and Labor Act requires. However, the Idaho law is far more limiting than the federal statute.

According to the Idaho abortion law, all abortions are illegal. Medical professionals can only avoid criminal charges if they can convince a jury that the abortion was "necessary to prevent the death of the pregnant woman." If they fail to convince a jury, medical professionals face a minimum prison sentence of two years and losing their medical license.

In contrast, the Emergency Medical Treatment and Labor Act has much broader requirements for medical treatment. Under the federal statute, medical professionals must provide medical care "required to stabilize the medical condition" of a pregnant woman. That not only includes treatment of conditions that will likely lead to death, but also conditions that will likely result in serious "impairment to bodily functions" or "dysfunction of any bodily organ."

As a result, medical professionals are put in an impossible position. If a medical professional performs an abortion when a woman’s heath is deteriorating but it is uncertain whether the woman will die, then the medical professional could face severe criminal penalties under Idaho law. But, if they do not perform an abortion in that same situation, they will be violating federal law.

This discrepancy creates a direct conflict between the Idaho abortion law and federal law because it is impossible for medical professionals to abide by both laws. Given the clear conflict created by the Idaho abortion law, the Supreme Court should recognize the preemption of the law by the Emergency Medical Treatment and Labor Act.

Real-world consequences of abortion bans

If the conflict between the Emergency Medical Treatment and Labor Act and the Idaho abortion ban isn't convincing enough. The real-life consequences of abortion bans illustrate the need for abortions to be allowed as a method of care.

One example is a woman from Austin, Texas, who almost lost her life to an infection that was preventable.

The Austin, Texas woman went to the emergency room because her water broke after 18 weeks of pregnancy and was diagnosed with premature rupture of the membranes surrounding the fetus. Were it not for the Texas abortion ban, she would have had an abortion to stabilize her condition. However, she was denied an abortion until her condition deteriorated enough to comply with the Texas abortion law.

Four days later, she developed an infection that landed her in the intensive-care unit for three days. The doctors finally felt her condition was severe enough to perform an abortion. However, she was left with significant scaring in her uterus, compromising her ability to become pregnant in the future.

As another example, a woman from Burnet, a town in central Texas, almost died because of being denied an abortion by doctors for fear of prosecution.

The Burnet, Texas woman was diagnosed with an ectopic pregnancy, a condition where the fetus develops in a fallopian tube rather than the uterus and is fetal for the fetus, but she was denied an abortion. Though terminating an ectopic pregnancy may fall under the Texas abortion law's exception, the doctors were unsure whether it would be considered unlawful abortion by a Texas prosecutor.

After multiple visits to the hospital, the doctors finally agreed to perform an abortion. However, it was too late. Only a few days later, the woman began bleeding, and almost passed out. At the hospital she was told she was bleeding out, and emergency surgery was required to save her life. The woman survived, but the impact on her fertility is unknown.

It is not hypothetical that similar scenarios could unfold under the Idaho abortion ban. Similar situations have been unfolding in Idaho since the law came into effect.  One hospital system in Idaho says that it currently must transfer pregnant women in medical crisis out of the state about once every other week because of Idaho's abortion ban.

Now, the Supreme Court must decide whether it values the lives of women, or if the conservative majority on the Court wants to continue pushing the anti-abortion agenda. If the Supreme Court decides an abortion ban that so clearly contradicts federal law is allowed, it will establish a precedent that erodes the federal government's ability to uphold federal law and open the door to even stricter abortion bans that disregard federal authority.