Idaho’s abortion ban has caused preventable medical crises and chaos in the state’s health system, according to an amicus curiae brief filed by Physicians for Human Rights (PHR) for the Ninth Circuit U.S. Court of Appeals hearing in Idaho v. United States, which opens in Pasadena, California on Tuesday.
While PHR’s amicus brief documents delayed medical care and adverse health outcomes during “the injunction hiatus” – when Idaho’s abortion ban was allowed to pre-empt the federal Emergency Medical Treatment and Active Labor Act (EMTALA) protections – PHR’s evidence also foreshadows the medical care crisis likely to ensue if the incoming Trump administration follows through on the promises made in the Project 2025 strategy to rescind the government’s guidance around EMTALA and drop its case in Idaho v. United States.
“The horrors we documented in Idaho are likely to repeat themselves in the state and across the country if the new administration allows state abortion bans to trump long-standing federal guidance around EMTALA,” said Payal Shah, JD, director of research, legal, and advocacy at PHR. “The impacts are clear: women with dangerous health conditions left to become ‘sick enough’ before receiving care; patients airlifted out of the state for basic medical services; women forced to continue their pregnancies against their will, including especially marginalized populations who face greater barriers to travel; and a decimation of the health system as hospitals close, health care providers flee the state, and medical students opt to train elsewhere to avoid prosecution.”
PHR’s amicus brief highlights how “if the injunction is reversed and the Idaho Act is permitted to be enforced again, the devastating results for the citizens of Idaho will not only immediately resume, but likely escalate with time.” These compounding consequences will also be borne by Idaho’s health providers, who are caught between their duty to provide evidence-based care to their patients and an unworkable law:
“Physicians face an impossible choice of either following the Idaho Act, but jeopardizing their patients’ health, or acting in accordance with basic medical standards of care and professional ethics. The difficulties of this choice are only exacerbated by the harsh civil, criminal, and professional penalties clinicians may face for violating the Idaho Act, while they are placed in a double bind’ where they may face a medical malpractice suit if they follow the law by delaying treatment or not treating at all.”
Idaho’s abortion ban only permits the termination of pregnancy to prevent the pregnant patient’s death and in certain other limited circumstances. However, the law does not allow health providers to provide abortions when the patient’s health is endangered. PHR’s amicus, cited by Justice Kentanji Brown Jackson of the Supreme Court of the United States when it heard this case in June 2024, documents cases in which pregnant patients experience dire health conditions but are barred from receiving abortion care, such as severe pregnancy-induced health conditions, including preeclampsia’ Preterm Premature Rupture of Membranes (PPROM); Hemolysis, Elevated Liver enzyme levels, and Low Platelet levels (HELLP syndrome); placental abruption; uncontrollable uterine hemorrhage; and infection. The Idaho ban caused delays and denials of care that harmed pregnant patients and risked causing maternal death. Pregnant patients diagnosed with fatal fetal impairments have been forced to continue their pregnancies and denied the care necessary to prevent the deterioration of their condition, adversely impacting their physical and mental health.
“If the Ninth Circuit lifts the injunction, the harms PHR documented will return to Idaho,” said Shah. “And with the Trump administration, we are likely to see state abortion bans sow chaos and damage around the country. The modest protections offered by federal backing of EMTALA will be gone. Legislative interference in medical care will endanger patients. It will be open season for state lawmakers to make medical decisions that should be left to pregnant patients and their clinicians.”
“Make no mistake – the harms from abortion bans don’t only affect abortion care and abortion providers,” said Shah. “As we have documented from Florida to Louisiana to Oklahoma, abortion bans lead to other forms of essential medical care being withheld or delayed. Many other types of care – from maternal health care to cancer care to miscarriage management – can be affected, and the impacts will be felt by a wide range of providers throughout the health system.”
“While the new presidential administration is likely to revoke guidance explicitly protecting abortion care under EMTALA, the Biden administration should uphold and enforce EMTALA while it can and state legislatures should work to enact measures to protect abortion access, pregnant patients, and health workers from the coming attacks on reproductive freedom,” said Shah.
PHR’s counsel of record for the amicus brief is Gerson H. Smoger, JD, PhD, PHR board chair, and was co-authored with Payal Shah, JD, PHR director of research, legal, and advocacy.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.