A yearslong legal battle over the right to an emergency abortion in Idaho has been abruptly upended now that President Donald Trump has moved to drop the high-profile case.
Under the Biden administration, the Justice Department had argued that emergency-room doctors treating pregnant women had to provide terminations if it was needed to save their lives or to avoid serious health consequences.
Yet a little more than a month after taking over the White House, Trump’s decision to abandon the legal fight signals how the Republican administration plans on interpreting federal law designed to protect urgent care when up against states’ abortion bans.
Here’s what to know:
In 2022, the U.S. Supreme Court overturned the constitutional right to an abortion. The ruling came down while President Joe Biden, a Democrat, was in office, but many of the justices who helped reverse Roe v. Wade were appointed under Trump.
So in response, Biden warned that his administration considered abortion part of the stabilizing care that federal law requires facilities to provide to patients who show up at an emergency room. A month later, Biden sued Idaho, which had enacted an abortion ban that makes it a crime with a prison term of up to five years for anyone who performs or assists in an abortion.
The Biden administration argued that Idaho’s abortion ban prevented ER doctors from offering an abortion if a woman needs one in a medical emergency. But Idaho’s attorney general has pointed out that federal law also requires hospitals to consider the health of the “unborn child” in its treatment, too.
The lawsuit has twisted and turned in the legal system ever since. Last year, the Supreme Court agreed to step into the Idaho case, but it handed down a narrow ruling: Hospitals were allowed to make determinations about emergency pregnancy terminations, but the key legal question about what care hospitals should legally provide remains unresolved.
Known as the Emergency Medical Treatment and Active Labor Act, or EMTALA, the 1986 law requires emergency rooms to offer a medical exam if you turn up at their facility. The law applies to any ERs that accept Medicare funding — so nearly all of them.
Those ERs are also required to stabilize patients experiencing a medical emergency before discharging or transferring them. Notably, if the ER doesn’t have the resources or staff to treat a patient, medical staffers must arrange a medical transfer to another hospital — they can’t simply direct a patient to go elsewhere.
EMTALA is more scrutinized than ever since Roe was overturned. Multiple doctors and families have told media about pregnant women with dangerous medical conditions showing up in hospitals and doctors’ offices only to be denied the abortions that could help treat them. Some women described facing harmful delays.
Not yet. And the DOJ’s three-page motion didn’t explain why they wanted to abandon the lawsuit either. However, since having a hand in revoking the constitutional right to abortion, Trump has repeatedly touted his support of leaving abortion regulations up to the states.
Meanwhile, ending the effort to use federal law to protect emergency abortions was a goal of Project 2025, the blueprint created by the Heritage Foundation for a second Trump term, which calls for reversing what it describes as “distorted pro-abortion” interpretations of federal law. Trump insisted during his 2024 presidential campaign that Project 2025 was not part of his agenda.
“Their move to drop this case against Idaho I think really shows what their true priorities are — and it is to push an anti-abortion political agenda rather than support the lives, health and well being of pregnant women and people, not just in Idaho but across the country because this case does have far-reaching impact,” said Brittany Fonteno, president and CEO of the National Abortion Federation, an association of abortion providers.
Trump’s decision to drop the Idaho case comes several months after the Supreme Court said the federal government couldn’t require hospitals to provide pregnancy terminations when it would violate Texas’ abortion ban.
Texas had sued over the Biden administration’s enforcement of EMTALA, and a lower federal court eventually sided with the state. But similar to the case in Idaho, the Supreme Court stopped short of deciding whether the federal law can supersede a state’s abortion ban.
Meanwhile, concern has grown over whether Trump’s decision in the Idaho case is a sign that his administration may also reverse course in a longstanding legal battle over telehealth access to mifepristone, the medication used in the nation’s most common abortion method.
The Department of Justice under Biden had sought to dismiss a complaint brought by a handful states seeking to roll back access to mifepristone. It’s currently unclear how Trump plans on proceeding.
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