Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 4.0

Cite as:  603 U. S. ____ (2024) 

3 

KAGAN, J., concurring 

EMTALA  requires  a Medicare-funded  hospital  to  offer  an
abortion when needed to stabilize a medical condition that 
seriously threatens a pregnant woman’s life or health.  See 
42  U. S. C.  §1395dd.  Idaho  allows  abortions  only  when 
“necessary to prevent” a pregnant woman’s “death.”  Idaho 
Code  Ann.  §18–622(2)(a)(i)  (Supp.  2023).    By  their  terms,
the two laws differ.  What falls in the gap between them are
cases  in  which  continuing  a  pregnancy  does  not  put  a 
woman’s life in danger, but still places her at risk of grave 
health consequences, including loss of fertility.  In that sit-
uation, federal law requires a hospital to offer an abortion, 
whereas Idaho law prohibits that emergency care.  And the 
record shows that, as a matter of medical reality, such cases
exist.  For example, when a woman comes to an emergency 
room with PPROM, the serious risk she faces may not be of 
death  but  of  damage  to  her  uterus,  preventing  her  from
having children in the future.  See 2 App. 594; see also id., 
at  615–616  (similar  for  pre-eclampsia).    Idaho  has  never 
suggested that its law would allow an abortion in those cir-
cumstances.  See Tr. of Oral Arg. 23 (stating that although 
the  threat  of  death  need  not  be  “imminen[t],”  only  that
threat can justify an abortion); see also id., at 25–28, 33– 
34. That is why hospitals in Idaho have had to airlift med-
ically  fragile  women  to  other  States  to  receive  abortions
needed to prevent serious harms to their health.  See id., at
66, 103–104, 113–115.  Those transfers measure the differ-
ence between the life-threatening conditions Idaho will al-
low hospitals to treat and the health-threatening conditions
it will not, despite EMTALA’s command.

Given that conflict, I agree with the Court’s decision to-
day to step back from its early intervention in this dispute.  
In the first stage of this suit, the District Court considered
both sides’ medical evidence and entered a preliminary in-
junction against Idaho’s law on the ground of preemption.
See  623  F. Supp.  3d  1096,  1103–1105,  1110,  1117  (2022).