Moyle v. United States and Idaho v. United States

Becket Role:
Case Start Date:
August 2, 2022
Deciding Court:
U.S. Supreme Court
Original Court:
U.S. District Court for the District of Idaho
Practice Area(s):

Case Snapshot

After the Supreme Court overturned Roe v. Wade in 2022, the federal government attempted to expand abortion access by reinterpreting an old law, the Emergency Medical Treatment and Active Labor Act (EMTALA). This new EMTALA guidance does something unprecedented: it requires hospital ERs to perform abortions in certain situations, even if it conflicts with the religious beliefs of a doctor or hospital, and even if abortion is banned by state law. The federal government then sued Idaho, claiming its Defense of Life Act, which bans most abortions in the state, violated federal law. Idaho is asking the Supreme Court to reject the government’s attempt to override state law. Becket filed a friend-of-the-court brief, explaining how the government’s mandate runs roughshod over religious healthcare professionals' ability to care for patients according to their religious beliefs.


On February 27, 2024, Becket filed a friend-of-the-court brief at the Supreme Court on behalf of the Christian Medical and Dental Associations, arguing that the government’s actions violate the Religious Freedom Restoration Act (RFRA), a federal statute that provides strong religious liberty protections. The brief details the long history of the federal government weaponizing its health agencies to punish religious healthcare providers who follow their faith.
Exterior of the U.S. Supreme Court building

Case Summary

Feds weaponize the law to target pro-life states 

Congress passed the Emergency Medical Treatment and Labor Act (EMTALA) in 1986 to prevent hospitals from refusing care to uninsured patients. EMTALA applies to all hospitals with ERs who serve anyone who receives Medicaid or Medicare, as well as the hospitals’ physicians and other staff. Weeks after the Supreme Court overturned Roe v. Wade in 2022, the Department of Health and Human Services (HHS) reinterpreted EMTALA to expand abortion access. For the first time ever, HHS decided that the decades-old law contained a mandate to provide abortions. The government argues that EMTALA requires doctors and hospitals to perform abortions in certain situations, including when a woman presents “with an incomplete medical abortion.” HHS released its novel interpretation in a guidance document and letter and stated that these requirements override any conflicting state abortion law. 

The federal government quickly filed a federal lawsuit against Idaho over its Defense of Life Act, which bans abortion except when necessary to save the life of a mother, or in cases of rape or incest. A district court sided with the federal government and blocked Idaho’s law. Idaho then appealed the decision to the Ninth Circuit Court of Appeals, which put a hold on the lower court’s decision while the case was pending. Idaho and its legislature asked the Supreme Court to take the case, and it agreed. 

HHS’s history of punishing religious groups 

The EMTALA guidance is yet another example of the government weaponizing HHS to achieve its policy goals, regardless of its impact on religious objectors.  For example, in 2011, HHS issued a federal contraceptive mandate as part of the Affordable Care Act (ACA). This mandate required employers to provide contraceptives in their health insurance plans, including those that many religious groups consider to be abortion-causing drugs. Despite the many religious objections to the contraceptive mandate, HHS included only a narrow religious exemption. This exemption did not protect  groups like the Little Sisters of the Poor, a Catholic order of nuns that runs homes for the elderly poor. The Little Sisters were forced to litigate for over a decade to protect their religious exercise, with the Supreme Court stepping in three times. Their battle is still not over. 

Similarly in 2016, HHS issued regulations under the ACA that required doctors and hospitals to perform gender transition procedures and other treatments to alter a patient’s body in response to gender dysphoria. Healthcare professionals could be penalized for declining to help with a gender transition, even if it was against their medical judgment and religious beliefs. Becket represented the Christian Medical and Dental Associations (CMDA), a nonprofit organization of over 12,000 Christian healthcare professionals, and other parties who objected to this transgender mandate on religious grounds. CMDA spent more than six years in court fighting HHS’s transgender mandate before a federal appeals court ultimately concluded that the federal government had violated CMDA’s religious exercise.  

Becket defends religious healthcare professionals  

On February 27, 2024, Becket filed a friend-of-the-court brief on behalf of CMDA in support of Idaho. The brief argues that the government’s abortion mandate fails to consider the Religious Freedom Restoration Act (RFRA). When HHS issues regulations it is required to consider protections for religious Americans, and it failed to do so in this case. That is especially glaring given the government’s long history of losing in court when it fails to take RFRA seriously. 

The government’s mandate also runs counter to public opinion. According to the 2023 Religious Freedom Index, 71 percent of Americans think that healthcare workers should have the freedom not to participate in abortion if it goes against their religious beliefs. Religious healthcare professionals should never have to abandon their faith to care for those in need.  

Importance to Religious Liberty: 

  • Individual Freedom: The freedom of conscience is the human right to believe, express beliefs, and act according to the dictates of an individual’s conscience. Becket defends the right of all individuals to live according to their consciences without government coercion.