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What's at stake in Idaho abortion case


Tomorrow, the Supreme Court will consider another major case about abortion. This time, it is about emergencies in Idaho, which has a medical exception to its abortion ban that applies only when a patient faces death. As NPR's Selena Simmons-Duffin reports, there is a lot at stake for doctors and hospitals and patients in the state.

SELENA SIMMONS-DUFFIN, BYLINE: Sara Thomson is a member of a shrinking group. She's an OB-GYN in Boise, Idaho. She says, before the abortion ban in Idaho took effect...

SARA THOMSON: We already ranked 50th in number of physicians per capita, so we were already a strange state.

SIMMONS-DUFFIN: In the time since Idaho's abortion ban took effect, 58 OB-GYNs have left the state or retired, according to a report by the Idaho Physician Well-Being Action Collaborative. That's nearly 1 in 4 OBs gone.

THOMSON: And in that same time period, only two OB-GYNs moved into Idaho.

SIMMONS-DUFFIN: This exodus of doctors has led to three maternity wards in the state shutting down. Hospital administrators say there's no mystery about why this is happening. Dr. Jim Souza of St. Luke's Health System spoke to reporters last week.


JIM SOUZA: I can tell you that the reason they're leaving is because they're not willing to take the risk to go to jail and lose their license for practicing medicine.

SIMMONS-DUFFIN: That threat of prosecution complicates care and harms patients, Thomson says, including by causing delays while the medical team consults with lawyers.

THOMSON: As far as we know, we haven't had a woman die yet as a consequence of this law, but that is really on the top of our worry list of things that could happen because we know that if we watch as death is approaching and we don't intervene quickly enough, that when we decide finally that we're going to intervene to save her life, it may be too late.

SIMMONS-DUFFIN: The Biden administration says doctors in Idaho shouldn't be in this situation. In 2022, the federal government sued Idaho over its strict abortion law, saying patients who need an abortion to stabilize their health must be able to get one under a federal law, the Emergency Medical Treatment and Labor Act, known as EMTALA. Idaho is defending its law alongside the Alliance Defending Freedom, a Christian legal powerhouse that's providing pro bono assistance in the case. They say doctors in Idaho already don't have to wait until death is imminent. Here's ADF's senior counsel Ryan Bangert.

RYAN BANGERT: This case is - at root, it's really a question about whether or not the federal government can effect a hostile takeover of the practice of medicine in all 50 states.

SIMMONS-DUFFIN: He says the Biden administration is trying to use EMTALA to create a nationwide abortion mandate in emergency rooms. Thomson, the OB in Boise, says this isn't about requiring anyone to have an abortion. It's about giving patients all their options. Her view is that the current abortion law with a medical exception only to save a patient's life isn't working. Hundreds of Idaho healthcare workers signed onto an amicus brief in support of the federal government's position in this case.

THOMSON: So many of us, as physicians, are starting to speak up because we are seeing harm to our patients.

SIMMONS-DUFFIN: She says the community of Idaho physicians really feels that the state law has to change somehow, no matter what the Supreme Court decides.

Selena Simmons-Duffin, NPR News.

(SOUNDBITE OF DEBBIE SONG, "COUSIN'S CAR" ) Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Selena Simmons-Duffin reports on health policy for NPR.

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