Washington — The Trump administration signaled Tuesday it will move to let Idaho enforce its strict abortion ban, even in the treatment of pregnant women suffering medical emergencies, a dramatic reversal from the previous administration in a closely watched lawsuit.
The state’s largest hospital system said it could be forced to airlift women out of state for care if the federal lawsuit is dismissed. That persuaded a judge to quickly grant a temporary order allowing doctors to keep providing abortions they deem necessary to treat emergencies.
The move to dismiss the lawsuit originally filed by the Biden administration could come as soon as Wednesday, St. Luke’s Health System wrote in a court filing, citing communication with the Justice Department.
Dropping the case would be among the new administration’s first major moves on abortion. In his first term, President Trump appointed many of the Supreme Court justices who voted to overturn the nationwide right to abortion in 2022. He has since said the issue should be left to the states.
Complaints that pregnant women were turned away from U.S. emergency rooms spiked after the overturning of Roe v. Wade amid questions about what care hospitals could legally provide, federal records showed.
A Justice Department spokesperson didn’t immediately respond to requests for comment.
History of legal battle over Idaho abortion ban
In its original lawsuit against Idaho, the Biden administration argued that federal law required doctors to perform abortions in emergency situations if a patient’s health or life were at serious risk – even if ending the pregnancy could run afoul of the state’s abortion ban, one of the country’s most restrictive.
Idaho has pushed back, saying that its state law allows for abortions in life-threatening situations and that the Democratic administration was trying to improperly expand its exceptions.
The Supreme Court stepped into the Idaho case last year and ultimately handed down a narrow ruling that allowed hospitals to keep making determinations about emergency pregnancy terminations.
The high court did not, however, resolve key legal questions in the case, and it was argued before the 9th U.S. Circuit Court of Appeals in December. The appeals court hasn’t ruled yet.
Idaho Deputy Attorney General Brian Church had urged the court to reject St. Luke’s request for a restraining order, saying the hospital system was trying to reinterpret federal law and wrest control from the state legislature now that, “the United States is abandoning its erroneous interpretation” that federal law requires emergency abortions.
“It is now seeking to usurp the role of the Idaho Legislature in setting statewide medical standards of care,” Church wrote. He said any changes to state policy should come from the ballot box, not the courts.
When might emergency abortions be performed?
About 50,000 people in the U.S. develop life-threatening pregnancy complications each year, including major blood loss, sepsis or the loss of reproductive organs. In rare cases, doctors might need to terminate a pregnancy to protect the health of the pregnant person, especially in cases where there is no chance for a fetus to survive.
When Idaho was able to fully enforce its ban during medical emergencies, some Idaho doctors reported that pregnant women were facing delays in care and in some cases being flown to out-of-state hospitals for treatment they would have previously been able to get at home.
“My colleagues and I lived in constant fear that patients would present in an emergency room who were not stable enough to transfer, yet the medically indicated stabilizing care-termination-could not be provided because it was not yet needed to prevent the patient’s death,” one doctor said in court documents.
While the law does allow for life-saving abortions, it’s still impossible to tell exactly when a dire case crosses the line to potentially fatal in the eyes of the law, she wrote.
In another abortion-related case this week, the Trump administration received additional time to make a filing – which would also give it time to change the government’s position on the issue. In that case, the states of Idaho, Kansas and Missouri are seeking to restrict the abortion pill mifepristone. Under Mr. Biden, the government was defending access.
Most Republican-controlled states have started enforcing new bans or restrictions since 2022. Currently, 12 states are enforcing bans on abortion at all stages of pregnancy, with limited exceptions, and four have bans that kick in at or about six weeks into pregnancy – often before women realize they’re pregnant.
