Idaho Attorney General Raúl Labrador has said Idaho’s abortion ban allows doctors to address medical conditions that don’t threaten imminent death. At a news conference following oral arguments at the court in April, Labrador implied that Idaho doctors were lying about an increase in out-of-state transfers for pregnant patients after the Supreme Court allowed the Idaho abortion ban to take full effect.

Justices Elena Kagan and Sonia Sotomayor, who co-authored one of the opinions in the briefly published document, acknowledged the increase in transfers and said the “on-the-ground impact” of the court’s January order was immediate.

In another opinion, Justices Amy Coney Barrett, Brent Kavanaugh and Chief Justice John Roberts said the case had become murky and would be better handled by the District Court. The opinion, which Barrett authored, took aim at the state and federal governments’ arguments, which shifted over the duration of the case.

Barrett wrote that they “rendered the scope of the dispute unclear, at best.”

During April’s oral arguments, Barrett appeared frustrated with Joshua Turner, Idaho’s chief of constitutional litigation and policy, who told the court there was no conflict between EMTALA and Idaho law.

“If there’s no instance where EMTALA and Idaho law clash, then why are you here?” Barrett asked.

Barrett’s opinion said it would be “imprudent” to answer the questions of whether federal law can allow hospitals to perform treatments banned by state law, and whether EMTALA can preempt state law, because it applies private hospitals. She noted that the debate over private entities emerged for the first time in April, as justices questioned the federal government during oral arguments.

Barrett, Kavanaugh and Roberts said changes to Idaho abortion law since 2022 also complicates the case. The law at the heart of the Supreme Court discussion was altered by the Idaho Legislature to allow abortions in cases of ectopic or molar pregnancies and to recategorize the “life of the mother” affirmative defense to an exception.

Alito, the most conservative justice on the court, penned the dissent. He said the court took up the case and issued its January order based on “Idaho’s ‘strong’ likelihood of success.” He slammed the decision to hand the case back to the District Court and walk back the order.

“This about-face is baffling,” Alito wrote. “Apparently the court has simply lost the will to decide the easy but emotional and highly politicized question that the case presents. That is regrettable.”

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