WASHINGTON — Outside the front steps of the U.S. Supreme Court on Wednesday morning, anti-abortion groups and abortion rights advocates battled to make their stances known, each wielding signs, stickers and blaring PA systems.

Inside the court’s cool marble walls, the tension over abortion access — specifically whether Idaho can enforce its abortion ban when medical emergencies threaten pregnant patients’ health — pitted Idaho against the U.S. Department of Justice.

Attorneys for each side argued in front of the nine U.S Supreme Court justices Wednesday morning. At times, the hearing seemed tense as the court’s more liberal justices pounced on Joshua Turner, Idaho’s chief of constitutional litigation and policy. In turn, the conservative justices raised substantial questions about U.S. Solicitor General Elizabeth Prelogar’s argument.

The women on the bench seemed especially skeptical of Idaho’s argument. The first half-hour of questioning for Turner came from the four female justices, including conservative Justice Amy Coney Barrett, who questioned the point of bringing the case to the court if, as Turner argued, there is no discord between state and federal law.

But the court is heavily conservative, and that split was apparent as Prelogar stood before the justices. She faced scrutiny from Barrett as well, along with the five right-leaning men on the court. If the justices rule in line with their previous stances on abortion, Idaho could see a majority in its favor.

The case dates back to 2022, when the federal government sued the state over its abortion ban, which went into effect when the Supreme Court overturned Roe v. Wade. While Idaho’s abortion law allows an exception to prevent a pregnant patient’s death, it does not carve out an option for abortion as a means of preserving patients’ health in a medical emergency. Doctors and medical associations told the Idaho Statesman and the court that abortion is a recommended stabilizing procedure for several emergency conditions.

The court’s decision will have broad impacts outside Idaho. At least six other states have similar laws, and others are in the process of implementing more strict abortion regulations, Prelogar told the court.

Does Idaho abortion law conflict with EMTALA?

At the core of the disagreements between the federal government and Idaho is whether the Emergency Medical Treatment and Labor Act, or EMTALA, is in conflict with Idaho abortion law. The Department of Justice — and numerous medical institutions — says there is a conflict; Idaho says there isn’t.

In briefs submitted to the court ahead of the oral arguments, Idaho attorneys said EMTALA neither requires hospitals to perform procedures that violate state law, nor does it expressly mention abortion as a stabilizing treatment. Idaho officials also said attempting to enforce EMTALA over state law opens the door to unconstitutional federal intervention.

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