The U.S. Supreme Court on Wednesday, for the first time since overruling Roe v. Wade, will consider the scope of a state abortion ban and whether a federal law governing emergency care protects access to abortion at hospitals when a woman’s health is at risk.

Idaho’s Defense of Life Act, which took effect in August 2022, prohibits nearly all abortions, with exceptions for reported cases of rape or incest or when “necessary to prevent the death of the pregnant woman.”

The Biden administration sued the state, claiming its law conflicts with the Emergency Medical Treatment and Labor Act (EMTALA) of 1986, which requires emergency room physicians at hospitals that receive Medicare funds to offer “stabilizing treatment” to all patients whose health is in jeopardy.

The justices will decide whether EMTALA, which does not specifically address abortion, preempts Idaho’s abortion ban and similar measures in 20 other states, protecting a doctor’s ability to terminate a pregnancy in an emergency situation if care requires it.

The administration argues the federal law explicitly makes clear that state laws are overridden to the extent they “directly conflict with a requirement” of EMTALA.

“EMTALA requires us as physicians to act in an emergency to preserve health – even the health of an organ system, like the reproductive system, as one example,” said Dr. Jim Souza, chief physician executive at Idaho’s St. Luke’s Health System. “Idaho’s law only allows action to save life, not preserve health.”

Idaho contends that Congress enacted EMTALA solely to prevent hospitals from turning away indigent patients or otherwise discriminating against patients on the basis of their condition or status.

“EMTALA leaves the question of specific treatments for stabilizing care to state law,” Idaho told the Court in its brief. “Indeed, EMTALA treats medical emergencies faced by the unborn child of a pregnant woman no differently than emergencies faced by the mother herself.”

The state also argues that the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health – overturning constitutional protection for abortion – explicitly returned the issue to the states. It accuses the Administration of trying to “reimpose a federal abortion requirement.”

“The purpose of the law is to protect the life of mothers and their unborn children,” said Dr. Ingrid Skop, a Texas-based OBGYN and vice president of the Charlotte Lozier Institute, an anti-abortion group. “All states allow doctors to use reasonable and good faith judgment on when to intervene. Abortion is rare, if ever, necessary” in an emergency.

The stakes in the case are significant.

“If the Court sides with Biden, it would be incredibly troubling and a sweeping precedent for them to set,” said Katie Daniel, state policy director for SBA Pro-Life America.

Major American medical organizations have warned that state abortion bans without exceptions for a pregnant woman’s health could lead some women to experience lasting harm.

“Before the law, we practiced medicine to preserve the mom’s health and future reproductive capability. Since then, there’s been a lot of second-guessing and hand wringing,” said Souza, “Is she sick enough? Is she bleeding enough? Is she septic enough for me to do an abortion and not go to jail or lose my license?”

Hospital groups have reported increased difficulty hiring OBGYNs and emergency room physicians in states like Idaho because of potential liability from strict abortion laws with few exceptions.

“This case could radically alter how emergency medicine is practiced in this country,” said Alexa Kolbi-Molinas, an ACLU attorney supportive of abortion rights.

“For nearly 40 years, EMTALA has required every hospital with an emergency department that takes Medicaid funds to provide stabilizing treatment to any individual who needs it regardless of where they live,” she said. “No state law can force hospitals to provide a lesser standard of care. But now the court is deciding whether states can override that.”

BOISE, Idaho (AP) — A new Idaho organization says it will ask voters to restore abortion access and other reproductive health care rights in the state after lawmakers let a second legislative session end without modifying strict abortion bans that have been blamed for a recent exodus of health care providers.

The arguments are scheduled for 10 a.m. EDT on Wednesday, April 24. Listen live in the player above.

“We have not been able to get a fix from our lawmakers, our politicians. We are going to seek a fix from our people,” Melanie Folwell, a spokeswoman for Idahoans United for Women and Families, said Friday morning. “The people in Idaho understand the contours of this problem.”

Idaho has several anti-abortion laws on the books, including one that makes performing abortions a crime even in medical emergencies unless they are done to save the life of the pregnant patient. The federal government has sued Idaho over the ban, contending it violates a federal law that requires hospitals to provide stabilizing care — including abortion — if a patient’s life or health is at serious risk.

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Idaho’s attorneys say the ban allows for life-saving procedures for things like ectopic pregnancies, and they contend the Biden administration is trying to create a federal “abortion loophole” at Idaho hospitals.

The U.S. Supreme Court will hear arguments in that case on Wednesday.

Idahoans United for Women and Families is fundraising and hopes to have one or more ballot initiatives ready to propose this summer in an effort to get them on the 2026 ballot, Folwell said.

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Across the country, there have been increased efforts to put abortion rights questions to voters since the U.S. Supreme Court overturned Roe v. Wade and removed the nationwide right to abortion. Voters in seven states have sided with abortion rights supporters on ballot measures, and several other states have signature drives for future ballot initiatives underway.

Cynthia Dalsing, a certified nurse midwife in northern Idaho and a board member for Idahoans United for Women and Families, said her region went from offering a “premiere obstetric range of services” to becoming a maternal care desert after the four local obstetricians moved out of state.

Pregnant women in the state’s panhandle now must either travel as much as 80 miles away or leave the state entirely for obstetric care, Dalsing said. Some are delivering babies at home because of a lack of other options, she said.

Roughly one-quarter of Idaho obstetricians have stopped practicing since a near-total abortion ban took effect in August 2022, along with about half of the state’s maternal fetal medicine doctors, according to data compiled by the Idaho Physician Well-Being Action Collaborative. Three hospitals have closed their labor and delivery units.

Some physicians and businesses are warning that the abortion bans carry other ripple effects as well.

During a news conference on Thursday, Dr. Jim Souza said the reduced access to prenatal health care means some dangerous pregnancy conditions will be diagnosed later than normal. Souza, the chief physician executive at the Boise-based St. Luke’s Health System, said that could lead to increased need for intensive medical treatment for newborns or expensive medical interventions for mothers that could have been avoided with better access to obstetric care.

A coalition of groups including the U.S. Women’s Chamber of Commerce, Levi Strauss & Co., Yelp, Lyft and Match Group Inc. which runs dating apps like Tinder filed a friend-of-the court brief in the U.S. Supreme Court case contending that the abortion bans make it harder to recruit and retain workers and lead to increased time off of work for those who have to travel elsewhere for care.

— Rebecca Boone, Associated Press