Justices seem set to allow emergency abortions in Idaho for now, a prematurely posted opinion says

WASHINGTON (AP) — The Supreme Court appears poised to allow emergency abortions in Idaho when a pregnant patient’s health is at serious risk, according to a copy of the opinion briefly posted on the court's website Wednesday and obtained by Bloomberg News.

The document suggests the court will find that it should not have gotten involved in the case over Idaho's strict abortion ban so quickly. By a 6-3 vote it would reinstate a lower court order that had allowed hospitals in the state to perform emergency abortions to protect a pregnant patient’s health.

Such an outcome would leave the issues at the heart of the case unresolved. It would also mean key questions remain unanswered, Justice Ketanji Brown Jackson wrote in a concurrence.

“Today’s decision is not a victory for pregnant patients in Idaho. It is delay,” she wrote.

The Supreme Court acknowledged that its publications unit inadvertently posted a document Wednesday. An opinion in the Idaho case would be issued "in due course,” court spokeswoman Patricia McCabe said in a statement.

Conservative Justices Clarence Thomas, Samuel Alito and Neil Gorsuch are listed as dissenting from the decision.

The finding may not be the court's final ruling because the justices' decision has not been officially released. The decision would mean the case would continue at the 9th U.S. Circuit Court, and could end up back before the justices.

The Supreme Court may be reluctant to make an abortion-related decision on the merits – rather than procedural grounds – in an election year, said Greer Donley, a reproductive law scholar and professor at the University of Pittsburgh School of Law.

A new poll from The Associated Press-NORC Center for Public Affairs Research found that about 7 in 10 U.S. adults favor protecting access to abortions for patients who are experiencing miscarriages or other pregnancy-related emergencies.

The decision would reverse the Supreme Court's earlier order that allowed an Idaho abortion ban to temporarily go into effect, even in medical emergencies. Several women have since needed medical airlifts out of state in cases in which abortion is routine treatment to avoid infection, hemorrhage and other dire health risks, Idaho doctors have said.

The nation’s top health official, Xavier Becerra, held a scheduled meeting with Idaho doctors and patients to discuss the state’s strict abortion ban in Boise Wednesday. Sarah Thompson, an Idaho OB/GYN, said that if a woman’s water breaks early in pregnancy, when the fetus has no chance of survival, she is unable to treat the patient by delivering the baby early.

“While there’s nothing we can do to save her baby, there is something we can do to preserve her health and her future fertility,” Thompson said.

The American College of Obstetricians and Gynecologists said that it hoped the court "listened to the scientific evidence and medical experts and will ultimately affirm the availability of emergency abortion care for people in every state,” said general counsel Molly Meegan.

The case started when the Biden administration sued Idaho, arguing that its abortion ban conflicted with federal healthcare law because doctors wouldn't be allowed to provide abortions to stabilize pregnant patients in rare emergency cases when their health is at serious risk.

Idaho argued its ban does allow abortions to save a pregnant patient’s life and that federal law does not require the exceptions to expand. The state attorney general’s office declined to comment Wednesday.

Katie Daniel, the state policy director of Susan B. Anthony Pro-Life America, said an Idaho state court had ruled that women’s lives don’t need to be in immediate danger to act.

Most Republican-controlled states began enforcing restrictions after the justices overturned Roe v. Wade two years ago, and Idaho is among 14 states that outlaw abortion at all stages of pregnancy with very limited exceptions.

The case is likely to return to the Supreme Court again, said Rachel Rebouche, dean of the Temple University Beasley School of Law and a reproductive law scholar. The New Orleans-based 5th U.S. Circuit Court of Appeals has ruled in a similar case that the federal law does not take precedence over an abortion ban in Texas.

So while the Supreme Court’s ruling would allow abortion in medical emergencies in Idaho, at least for now, Rebouche said, “Nearly 38 million people live in the 5th Circuit. That’s a lot of people whose lives aren’t changed at all by this.”

Alexis McGill Johnson, president and CEO of the Planned Parenthood Federation of America, said that a decision without explicit guarantees that patients could get abortions in medical emergencies would be "catastrophic.”

Reports of pregnant women being turned away from U.S. emergency rooms spiked after the Supreme Court's 2022 ruling overturning the constitutional right to abortion, according to federal documents obtained by The Associated Press.

If the high court were to rule in Idaho’s favor, it would create a “world in which women would have to lose their reproductive organs,” said Sara Rosenbaum, a George Washington University health law and policy professor who is an expert on the federal EMTALA law.

The Justice Department’s lawsuit came under a federal law that requires hospitals accepting Medicare to provide stabilizing care regardless of a patient’s ability to pay. The law is the Emergency Medical Treatment and Labor Act, or EMTALA.

Nearly all hospitals accept Medicare, so emergency room doctors in Idaho and other states with bans would have to provide abortions if needed to stabilize a pregnant patient and avoid serious health risks such as the loss of reproductive organs, the Justice Department argued.

Idaho argued that its exception for a patient’s life covers dire health circumstances and that the Biden administration misread the law to circumvent the state ban and expand abortion access.

Carol Tobias, president of the National Right to Life Committee, said his group was glad the Justice Department says its arguments apply to rare cases.

Doctors have said Idaho’s law has made them fearful to perform abortions, even when a pregnancy is putting a patient’s health severely at risk. The law requires anyone who is convicted of performing an abortion to be imprisoned for at least two years.

A federal judge initially sided with the Democratic administration and ruled that abortions were legal in medical emergencies. After the state appealed, the Supreme Court allowed the law to go fully into effect in January.

Associated Press writers Amanda Seitz and Linley Sanders in Washington, Geoff Mulvihill in Cherry Hill, New Jersey, Devi Shastri in Milwaukee and Hallie Golden in Seattle contributed to this report.

Follow the AP’s coverage of the U.S. Supreme Court at https://apnews.com/hub/us-supreme-court.

Left to right; Dr. Sara Thompson, an OBGYN provider in ldaho, Jillaine St. Michel, a patient who had to travel out of state to access abortive services, U.S. Health Secretary Xavier Becerra, Lauren McLean, Mayor, City of Boise, Dr. Julie Lyons, LY- UHNZ, St Luke's, Blaine County women's health initiative and Family Physician and Dr. Loren Colson, Cofounder, Idaho Coalition for Safe Healthcare participate in a conversation with local patients and providers who have been impacted by Idaho's abortion restrictions held at the Linen Building in Boise, Idaho, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

Lauren McLean, Mayor, City of Boise left, shakes hands with U.S. Health Secretary Xavier Becerra before a conversation with local patients and providers who have been impacted by Idaho's abortion restrictions held at the Linen Building in Boise, Idaho. Priya Helweg, Acting Regional Director for HHS Region 10 is also pictured in the background, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

Anti-abortion demonstrators protest outside the Supreme Court, Wednesday, June 26, 2024, in Washington. (AP Photo/Alex Brandon)

U.S. Health Secretary Xavier Becerra, right, listens as Jillaine St. Michel, a patient who was forced to travel to Seattle to access an abortion speaks during a conversation with local patients and providers who have been impacted by Idaho's abortion restrictions held at the Linen Building in Boise, Idaho, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

The Supreme Court building is seen, Wednesday, June 26, 2024, in Washington. (AP Photo/Alex Brandon)

DUBAI, United Arab Emirates (AP) — Early, seesawing results released Saturday in Iran’s presidential election put the race between reformist Masoud Pezeshkian and hard-liner Saeed Jalili, with the lead trading between the two men while a runoff vote appeared likely.

After counting over 12 million votes, Pezeshkian had 5.3 million while Jalili held 4.8 million, Iranian state television reported.

Another candidate, hard-line speaker of the parliament Mohammad Bagher Qalibaf, had some 1.6 million votes. Shiite cleric Mostafa Pourmohammadi had more than 95,000 votes.

It did not offer any turnout figures for the race yet — a crucial component of whether Iran’s electorate backs its Shiite theocracy after years of economic turmoil and mass protests.

Iranian law requires that a winner gets more than 50% of all votes cast. If that doesn’t happen, the race’s top two candidates will advance to a runoff a week later. There’s been only one runoff presidential election in Iran’s history: in 2005, when hard-liner Mahmoud Ahmadinejad bested former President Akbar Hashemi Rafsanjani.

THIS IS A BREAKING NEWS UPDATE. AP’s earlier story follows below.

DUBAI, United Arab Emirates (AP) — Early results in Iran's presidential election put hard-liner Saeed Jalili slightly ahead Saturday, followed closely behind by reformist Masoud Pezeshkian.

The early results, reported by Iranian state television, did not initially put Jalili in a position to win Friday's election outright, potentially setting the stage for a runoff election to replace the late hard-line President Ebrahim Raisi.

It also did not offer any turnout figures for the race yet — a crucial component of whether Iran's electorate backs its Shiite theocracy after years of economic turmoil and mass protests.

With over 10 million votes counted, Jaili had 4.26 million votes, followed by Pezeshkian with 4.24 million. Another candidate, hard-line speaker of the parliament Mohmmad Bagher Qalibaf, had some 1.38 million votes. Shiite cleric Mostafa Pourmohammadi had more than 80,000 votes.

Voters faced a choice between the three hard-line candidates and the little-known reformist Pezeshkian, a heart surgeon. As has been the case since the 1979 Islamic Revolution, women and those calling for radical change have been barred from running, while the vote itself will have no oversight from internationally recognized monitors.

The voting came as wider tensions have gripped the Middle East over the Israel-Hamas war in the Gaza Strip.

In April, Iran launched its first-ever direct attack on Israel over the war in Gaza, while militia groups that Tehran arms in the region — such as the Lebanese Hezbollah and Yemen’s Houthi rebels — are engaged in the fighting and have escalated their attacks.

Meanwhile, Iran continues to enrich uranium at near weapons-grade levels and maintains a stockpile large enough to build — should it choose to do so — several nuclear weapons.

There had been calls for a boycott, including from imprisoned Nobel Peace Prize laureate Narges Mohammadi. Mir Hossein Mousavi, one of the leaders of the 2009 Green Movement protests who remains in house arrest, also has refused to vote with his wife, his daughter said.

There’s also been criticism that Pezeshkian represents just another government-approved candidate. One woman in a documentary on Pezeshkian aired by state TV said her generation was “moving toward the same level” of animosity with the government that Pezeshkian’s generation had in the 1979 revolution.

Iranian law requires that a winner gets more than 50% of all votes cast. If that doesn’t happen, the race’s top two candidates will advance to a runoff a week later. There’s been only one runoff presidential election in Iran’s history: in 2005, when hard-liner Mahmoud Ahmadinejad bested former President Akbar Hashemi Rafsanjani.

The 63-year-old Raisi died in the May 19 helicopter crash that also killed the country’s foreign minister and others. He was seen as a protégé of Iran’s Supreme Leader Ayatollah Ali Khamenei and a potential successor. Still, many knew him for his involvement in the mass executions that Iran conducted in 1988, and for his role in the bloody crackdowns on dissent that followed protests over the death of Amini, a young woman detained by police over allegedly improperly wearing the mandatory headscarf, or hijab.

This story has been corrected to say 10 million was the overall number of votes initially counted.

A man casts his ballot during the presidential election as he holds a picture of the late President Ebrahim Raisi in a polling station, in Tehran, Iran, Friday, June 28, 2024. Iranians were voting Friday in a snap election to replace the late President Ebrahim Raisi, killed in a helicopter crash last month, as public apathy has become pervasive in the Islamic Republic after years of economic woes, mass protests and tensions in the Middle East. (AP Photo/Vahid Salemi)

A woman fills out her ballot during the Iranian presidential election in a polling station at the shrine of Saint Saleh in northern Tehran, Iran, Friday, June 28, 2024. Iranians were voting Friday in a snap election to replace the late President Ebrahim Raisi, killed in a helicopter crash last month, as public apathy has become pervasive in the Islamic Republic after years of economic woes, mass protests and tensions in the Middle East. (AP Photo/Vahid Salemi)

Iranian Supreme Leader Ayatollah Ali Khamenei waves to media after casting his vote during the presidential election in Tehran, Iran, Friday, June 28, 2024. Iranians were voting Friday in a snap election to replace the late President Ebrahim Raisi, killed in a helicopter crash last month, as public apathy has become pervasive in the Islamic Republic after years of economic woes, mass protests and tensions in the Middle East. (AP Photo/Vahid Salemi)

A woman prepares to casts her ballot during the presidential election at a polling station inside the Iranian embassy in Baghdad, Iraq, Friday, June 28, 2024. Iranians are voting in a presidential election to replace the late President Ebrahim Raisi, killed in a helicopter crash in May along with the country's foreign minister and several other officials. (AP Photo/Hadi Mizban)

Iranian Supreme Leader Ayatollah Ali Khamenei arrives to vote for the presidential election, in Tehran, Iran, Friday, June 28, 2024. Iranians voted Friday in a snap election to replace the late hard-line President Ebrahim Raisi, with the race's sole reformist candidate vowing to seek "friendly relations" with the West in an effort to boost his campaign. (AP Photo/Vahid Salemi)

A woman prepares to casts her ballot during the presidential election at the Iranian consulate in Basra southeast of Baghdad, Iraq, Friday, June 28, 2024. Iranians are voting in a presidential election to replace the late President Ebrahim Raisi, killed in a helicopter crash in May along with the country's foreign minister and several other officials. (AP Photo/Nabil al-Jourani)

In this photo provided by Iranian Students' News Agency, ISNA, hard-line former Iranian senior nuclear negotiator and candidate for the presidential election Saeed Jalili casts his ballot in a polling station, in Tehran, Iran, Friday, June 28, 2024. Iranians are voting in a snap election to replace the late hard-line President Ebrahim Raisi. (Alireza Sotakabr, ISNA via AP)