The Supreme Court punted on Thursday on a second abortion decision it heard this term, leaving open the question of whether a federal law that protects abortion care in emergency rooms preempts state abortion bans.

The U.S. Supreme Court dismissed Idaho v. U.S. on Thursday, sending the case back to the Ninth Circuit Court of Appeals. The Supreme Court also resumed the lower court’s stay so that Idaho hospitals can return to providing emergency abortion care if a patient needs it to protect their health. 

Idaho has one of the strictest abortion bans in the U.S. and it allows for an abortion in an emergency situation only if the patient is about to die. This means a patient could be on the verge of organ failure, or about to lose fertility or the fetus could be nonviable but emergency room providers cannot stabilize the patient if doing so requires an abortion. 

The U.S. Department of Justice sued before the Idaho law went into effect after the court’s Dobbs decision overturned Roe v. Wade. The Idaho court put a stay in place so that hospital emergency rooms could continue to provide stabilizing abortion care to patients whose health was in jeopardy. 

But when the Supreme Court agreed six months ago to consider the case, it removed the lower court’s stay so that pregnant patients in Idaho have had to be airlifted to neighboring states for emergency healthcare. One hospital in Idaho reported that it had had to airlift one patient to a neighboring state in the prior year for an emergency abortion but after the stay was removed, it had to airlift six patients in three months. 

Jazmyn Taitingong, reproductive rights attorney with American Civil Liberties Union of New Mexico, told NM Political Report that, while abortion remains safe and legal in New Mexico, the fight over whether federal protections override state abortion bans is a question that will return to the Supreme Court.

“I think that what’s clear is they kicked the can down the road instead of taking the opportunity to tell every pregnant person they have the right to emergency abortion care…this fight isn’t over,” she said. 

Idaho is not the only state to challenge the federal law, Emergency Medical Treatment and Labor Act, through its state abortion ban. Texas sued the U.S. Department of Health and Human Services in 2022 after the Biden administration issued guidance to hospitals reminding them of their obligation under EMTALA to treat all patients in an emergency room, including if that care required an abortion.

Under the EMTALA rule, a hospital that receives funding through Medicare must be in compliance with the federal law.

The state of Texas sued because its abortion ban has an exception allowing an abortion if necessary to save a person’s life, but that goes further than EMTALA which requires a hospital to save a patient if their health is threatened. The Texas case has been dormant while the Idaho decision was being considered. Rosemary Morgan, associate research professor in the Department of International Health at Johns Hopkins Bloomberg School of Public Health, said if the Supreme Court had decided the Idaho case, its decision would have also determined the Texas case.

She said that by dismissing the case, the court “leaves open the door for inconsistencies between states.” Morgan said that in her research into global health, she has found that if abortion is not legal, women will find other ways to access abortion. 

“We have evidence that shows this world wide,” she said. 

Morgan said the court’s dismissal of the case “is evidence of how deprioritized women’s health is in this country.”

Alexis McGill Johnson, president and chief executive officer of Planned Parenthood, said during a press conference on Thursday that the disruptions to women’s healthcare in Idaho has led to a 20 percent decline of OB-GYNs in that state. She said there has been what she called an exodus of OB-GYNs in Idaho, particularly those who specialize in high-risk pregnancy. She said this only creates maternal care deserts, particularly in rural communities which often are already suffering the consequences of OB-GYN deserts. She said states with abortion bans are experiencing higher rates of maternal mortality and marginalized communities are the most impacted.

Skye Perryman, president and chief executive officer of a legal organization called Democracy Forward, said during the press conference that she believes the court dismissed the case because this is an election year. The court’s Dobbs decision rallied voters in 2022 to vote for Democrats, which prevented Republicans from routing Democrats in Congress as many expected in a midterm election during a period with high inflation. The decision also led to constitutional amendments in a number of conservative-led states, such as Kansas and Ohio, to enshrine some abortion protections into those states’ constitutions.

Gov. Michelle Lujan Grisham reacted to the court’s dismissal by saying through a press release that “by not ruling on the substance of this critical issue, the court is perpetuating fear and uncertainty.”