(AP) – The Trump administration signaled on Tuesday, March 4, 2025, its intent to allow Idaho to enforce its stringent abortion ban, even in cases involving pregnant women experiencing medical emergencies. This marks a significant policy reversal from the previous administration in a closely watched legal battle.
Idaho’s largest hospital system, St. Luke’s Health System, warned that it might be forced to airlift women out of state for emergency care if the federal lawsuit challenging the ban is dismissed. Concerned about the immediate impact, a judge swiftly issued a temporary order permitting doctors to continue performing emergency abortions when deemed medically necessary.
The lawsuit, originally filed by the Biden administration, could be dismissed as early as Wednesday, according to a court filing by St. Luke’s Health System. The filing referenced communications with the Department of Justice regarding the case.
If dropped, this would represent one of the Trump administration’s first major actions on abortion policy. During his first term, Republican President Donald Trump appointed several Supreme Court justices who voted to overturn the nationwide right to abortion in 2022. Since then, Trump has stated that abortion laws should be left to individual states.
Following the repeal of Roe v. Wade, complaints about pregnant women being denied care in U.S. emergency rooms surged, as hospitals grappled with legal uncertainties regarding the provision of abortion-related medical treatment, according to federal records.
A spokesperson for the Justice Department did not immediately respond to requests for comment.
Legal Battle Over Emergency Abortion Care
The Biden administration’s initial lawsuit against Idaho argued that federal law mandates doctors to perform abortions in emergency situations when a patient’s life or health is at serious risk—even if doing so conflicts with Idaho’s abortion ban, which is among the most restrictive in the country.
Idaho officials have refuted this claim, asserting that the state law already permits abortion in life-threatening circumstances and that the Biden administration was attempting to broaden federal exceptions beyond their intended scope.
The Supreme Court intervened in the Idaho case last year, delivering a narrow ruling that allowed hospitals to continue making independent determinations on emergency pregnancy terminations. However, the ruling did not resolve the fundamental legal questions at stake. The case was subsequently argued before the 9th U.S. Circuit Court of Appeals in December, though a ruling has yet to be issued.
Idaho Deputy Attorney General Brian Church urged the court to reject St. Luke’s request for a restraining order, arguing that the hospital system was attempting to reinterpret federal law and override the state legislature.
“The United States is abandoning its erroneous interpretation that federal law requires emergency abortions,” Church wrote in a legal filing. “It is now seeking to usurp the role of the Idaho Legislature in setting statewide medical standards of care.” He added that any modifications to state policy should be decided through the legislative process, not the courts.
Impact on Medical Care and Patient Safety
Each year, approximately 50,000 people in the U.S. experience life-threatening pregnancy complications, including severe hemorrhaging, sepsis, or loss of reproductive organs. In some cases, doctors may determine that terminating a pregnancy is the only viable option to protect the pregnant person’s health, particularly when fetal survival is impossible.
When Idaho was fully enforcing its abortion ban in emergency cases, some doctors reported delays in care for pregnant patients, with some women being flown to out-of-state hospitals for treatment that would have otherwise been available locally.
“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 stated in court documents.
While Idaho law does permit life-saving abortions, physicians argue that it remains unclear at what precise point a medical emergency legally warrants termination under state law.
Broader Implications for Abortion Policy
In another abortion-related case this week, the Trump administration received additional time to file a response—allowing it the opportunity to shift the government’s position on the matter. In that case, the states of Idaho, Kansas, and Missouri are seeking to restrict the abortion pill mifepristone. Under the Biden administration, the federal government had defended access to the medication.
Since 2022, most Republican-controlled states have enacted new abortion bans or restrictions. Currently, 12 states prohibit abortion at all stages of pregnancy, with limited exceptions, while four states enforce bans at approximately six weeks—before many women even realize they are pregnant.
