Case update: An Idaho state court issued a ruling April 11, 2025 broadening the medical exception to the state’s total abortion ban for patients facing life-threatening pregnancy complications and health conditions. However, the ruling fails to include fatal fetal conditions and mental health conditions. Read more below.

Summary

Summary

The Center for Reproductive Rights filed this lawsuit on September 11, 2023, challenging the limited scope of the medical exceptions to both of Idaho’s abortion bans: a total trigger ban and a six-week ban that has “vigilante”-style civil liability provisions.  

The medical exception to Idaho’s near-total ban permits abortion only to prevent death, and its six-week ban similarly has a narrow medical exception. Clarifying the laws’ medical exceptions would allow physicians to provide life-saving care without waiting for patients to be near death. The lawsuit also seeks to clarify and expand the exceptions under the two bans to ensure physicians can provide abortion care to preserve a pregnant person’s health, including when the pregnant person has received a fatal fetal diagnosis.

The Center filed this case on behalf of seven plaintiffs: four women who were denied medically necessary abortion care in their home state; two Idaho physicians who provide obstetrical care; and a professional membership organization consisting of Idaho physicians, medical residents and medical students.

The lawsuit was filed simultaneously with challenges to similar laws banning abortion in Oklahoma and Tennessee.

Background

Background

In 2020, Idaho enacted a trigger ban that would ban abortion entirely in the state if the U.S. Supreme Court overturned Roe v. Wade. This total abortion ban made it a felony for any person to provide an abortion, without exceptions. Instead, the law noted only that a physician, when prosecuted, could rely on an affirmative defense, having “determined, in his good faith medical judgment . . . that the abortion was necessary to prevent the death of the pregnant woman”—and to bear the burden of proof. 

In 2021, Idaho enacted a second abortion ban—a criminal six-week abortion ban, with the effective date delayed until a federal appeals court upheld a similar ban. A narrow exception is also included for a “medical emergency,” allowing an abortion to avert the pregnant person’s “death or for which a delay will create serious risk of substantial and irreversible impairment of a major bodily function.” The ban made no exceptions to preserve the health of the pregnant person, including when they have a lethal fetal condition. In 2022, the six-week abortion ban was amended to include a civil provision (similar to Texas’s S.B. 8) allowing family members of patients to sue the abortion provider for at least $20,000. 

Shortly after the Supreme Court eliminated the federal constitutional right to abortion in June 2022, both the total abortion ban and the six-week ban were scheduled to go into effect in Idaho. Before the total abortion ban could take effect, the U.S. Department of Justice sued Idaho in federal court, arguing that because the total ban included only an affirmative defense to prevent a patient’s death, and not a true exception, it violated the federal Emergency Medical Treatment and Labor Act (EMTALA). In August 2022, the federal court issued a preliminary injunction blocking enforcement of the trigger ban to the extent it conflicted with EMTALA’s mandates.  

In July 2023, the Idaho legislature replaced the trigger ban’s existing affirmative defense provisions with exceptions and amended the definition of abortion to include “[t]he removal of a dead unborn child,” “[t]he removal of an ectopic or molar pregnancy,” and “[t]he treatment of a woman who is no longer pregnant.”  

The Center’s lawsuit asks the court to clarify the medical exceptions to Idaho’s abortion bans to ensure that physicians can legally perform lifesaving and health-preserving care without waiting for the patient to be near death, including when the fetus has been diagnosed with a fatal fetal condition.

Doctors Leaving the State Due to Idaho’s Strict Abortion Bans

Because of Idaho’s abortion bans and their threats of punishment—which include imprisonment and loss of medical license—many doctors have left the state. Since the bans took effect in 2022, Idaho has lost nearly one in four OB-GYNs and six of its initial nine maternal-fetal medicine specialists.  

The loss of doctors has led to the closure of some of the state’s hospital labor and delivery units. Research has shown that patients who lack access to hospitals with obstetrics care are more likely to face health consequences.

About the case

About the case

The Center’s request to clarify the medical exceptions to Idaho’s abortion bans would assure physicians that they can legally provide lifesaving and health-preserving care without fear of criminal prosecution, civil liability or licensing penalties. Specifically, the Center’s lawsuit asks the court to issue a declaration that, at a minimum, Idaho’s abortion bans do not preclude a physician from providing abortion care when, in the physician’s good faith judgment and in consultation with the pregnant person, a pregnant person has: (i) a physical medical condition or complication of pregnancy that poses a risk of infection, bleeding or otherwise makes continuing a pregnancy unsafe for the pregnant person; (ii) a physical medical condition that is exacerbated by pregnancy, cannot be effectively treated during pregnancy or requires recurrent invasive intervention; and/or (iii) a fetal condition where the fetus is unlikely to survive the pregnancy and sustain life after birth. 

The Center’s lawsuit argues that the current limited scope of Idaho’s medical exceptions violates the Idaho’s Declaratory Judgment Act as well as Article I, Sections 1 and 13 of the Idaho Constitution, which guarantee as “inalienable” the rights to defend and enjoy life, as well as the rights to pursue happiness and secure safety. Specifically, the lawsuit argues that:

• The medical exceptions unconstitutionally deprive pregnant people’s rights to life, happiness and safety. It also argues that the bans violate the right to equal protection under Article I, §§ 1 and 2 of the Idaho Constitution because the bans deprive pregnant Idahoans (and only pregnant Idahoans) of access to life-saving and health-preserving healthcare.
• The limited scope of the medical exceptions unconstitutionally violates physicians’ inalienable rights of “acquiring, possessing and protecting property,” under Article I, § 1 of the Idaho Constitution, by depriving them of their medical licenses and ability to practice their professions without due process of law.

About the ruling

About the ruling

On April 11, an Idaho state court issued a ruling broadening the medical exception under Idaho’s strict abortion bans—meaning patients facing life-threatening pregnancy complications and health conditions can obtain abortion care in the state, and doctors won’t face prosecution for providing that care.

The ruling states that:

• The bans’ medical exception should be interpreted broadly by doctors and could apply to numerous serious health conditions.
• Patients can access abortion care if they have a health condition or pregnancy complication that creates some risk that they may die without an abortion.
• Patients cannot access abortion care for fatal fetal conditions unless the condition also poses a risk to the mother’s life.
• Patients cannot access abortion care due to mental health conditions, even if the patient is at risk of death from self-harm.

Ruling Is Limited, But Significant, Due to Trump Administration’s Action

In March 2025, the Department of Justice under the Trump administration dismissed a case—originally filed by the Biden Administration—that sought to ensure that people could obtain emergency abortion care at Idaho hospitals, despite the state’s abortion ban. 

The Biden Administration had argued that Idaho’s strict abortion ban violated the Emergency Medical Treatment and Labor Act (EMTALA), a federal law requiring hospital emergency departments to provide “stabilizing treatment.”  Since the Trump Administration’s dismissal of the case, Idaho doctors have been even more hesitant to provide abortion care, even in dire situations. The ruling helps to clarify when they can and cannot provide care.

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