## Facts

- Idaho enacted a near-total abortion ban permitting abortion only when “necessary to prevent the death” of the pregnant patient, with limited additional exceptions and criminal enforcement.
- The federal Emergency Medical Treatment and Labor Act (EMTALA) requires Medicare-participating hospitals to provide necessary stabilizing treatment to any patient with an emergency medical condition.
- After Idaho’s law was set to take effect, the United States sued Idaho, alleging that EMTALA preempts Idaho’s ban in a narrow class of cases where an abortion is necessary stabilizing treatment to prevent serious health harms short of death.
- The federal district court issued a preliminary injunction preventing Idaho from enforcing its ban in circumstances where EMTALA would require stabilizing abortion care.
- The court of appeals declined to stay the injunction pending appeal.
- The Supreme Court granted emergency relief, stayed the injunction, and granted certiorari before judgment, consolidating the cases.
- After briefing and argument, the Supreme Court dismissed the writs as improvidently granted and vacated its prior stay, restoring the preliminary injunction and returning the case for further proceedings.

## Issues

1. Whether EMTALA preempts Idaho’s abortion ban to the extent the state law criminalizes abortions that EMTALA requires as necessary stabilizing treatment for emergency medical conditions, including conditions threatening serious harm short of death.
2. Whether the Supreme Court should resolve the dispute on certiorari before judgment given the evolving posture and record in the lower courts.

## Decision

- The Court dismissed the writs of certiorari before judgment as improvidently granted.
- The Court vacated its prior stays that had blocked the district court’s preliminary injunction.
- The practical effect was to reinstate the preliminary injunction barring enforcement of Idaho’s ban in EMTALA-covered emergency situations while litigation continues in the lower courts.
- Separate writings reflected disagreement about EMTALA’s meaning and preemptive effect, but the Court issued no merits ruling on preemption.

## Legal Principles

- A dismissal as improvidently granted leaves merits questions unresolved and returns the case to the lower courts.
- Vacating a Supreme Court stay restores the operative effect of the lower court order that had been stayed.
- Federal preemption questions may turn on whether compliance with both state and federal law is impossible or whether state law obstructs federally required conduct, but no binding resolution was issued on EMTALA’s preemptive scope here.
- Certiorari before judgment and emergency stays are discretionary tools; the Court may withdraw from merits review when the dispute materially changes or is not suitable for immediate resolution.

## Conclusion

The Supreme Court ended its review on procedural grounds, vacated its earlier stay, and reinstated a preliminary injunction that prevents Idaho from enforcing its abortion ban where it conflicts with EMTALA’s emergency stabilizing-treatment duties, leaving the preemption question for further lower-court adjudication.


Moyle v. United States, 144 S. Ct. 2015 (2024)