To say that a lot of things are changing since President Donald Trump took office for the second time is like saying a hurricane has rearranged some features of a neighborhood.
In addition to rescinding scores of President Joe Biden’s executive orders and cancelling ideological policies across executive branch agencies, the Trump administration is changing its position on some important court cases.
For example, take the case United States v. Skrmetti, which is a constitutional challenge by both parents and the federal government to Tennessee’s law banning so-called “gender-affirming” medical interventions for minors. The U.S. Court of Appeals upheld the law and the Supreme Court heard arguments in the government’s appeal on Dec. 4, 2024.
In a letter dated Feb. 7, 2025, the Justice Department informed the court that “the government’s previously stated views no longer represent the United States’ position” but, likely anticipating a favorable decision, did not ask that the court dismiss the case.
The latest change for the federal government’s position in court cases comes in a dispute over whether the Emergency Medical Treatment and Labor Act requires hospitals to perform abortions in certain circumstances even when state law prohibits them.
In 2020, Idaho enacted a law to ban most abortions in the event that the Supreme Court overruled Roe v. Wade, the 1973 decision inventing a right to abortion and invalidating most pro-life legislation.
Less than two weeks after the court did so in 2022, Biden issued an executive order for agencies and departments to find new ways to promote abortion. One of those ways was the Center for Medicare and Medicaid Services issuing “guidance” claiming that Emergency Medical Treatment and Labor Act was, in effect, an abortion mandate that could override state law. Emergency Medical Treatment and Labor Act, it said, gave physician free rein to perform abortions that they felt would be a “stabilizing treatment.”
The Biden administration then actually sued Idaho to prevent it from applying its abortion ban to emergency rooms. In August 2022, a U.S. District Court judge issued an injunction against Idaho. More than a year later, the U.S. Court of Appeals for the Ninth Circuit affirmed that injunction, and Idaho subsequently appealed to the Supreme Court.
The Supreme Court stayed the injunction in January 2024 and positioned the case as an actual appeal on the merits of the underlying Emergency Medical Treatment and Labor Act issue rather than just a request for a temporary procedural hold. The court directed that arguments in the case occur in April 2024 but, after that deadline came and went, the court dismissed the appeal as “improvidently granted.” In this case, that’s a fancy term for jumping the gun.
So the case is now back in Idaho, this time amid speculation that the incoming Trump administration would no longer insist that Emergency Medical Treatment and Labor Act overrides state pro-life laws. St. Luke’s Health System, a Boise nonprofit that operates medical centers and pharmacies, asked a U.S. District Court judge for another injunction against Idaho enforcing its pro-life law in emergency rooms. The judge agreed.
As expected, the Trump administration decided to no longer try to force Idaho to allow emergency room abortions and, joined by the state of Idaho, asked that the case be dismissed on March 5, 2025. The previous day, however, St. Luke’s obtained a temporary restraining order keeping the case in place for now.
If you’re scratching your head, you’re not alone. Even CNN reported that “how higher courts will view this lawsuit is not clear,” an understatement now that the original plaintiff—the federal government—has basically dropped out.
Although the Supreme Court avoided any decision on the merits in the Idaho case, the state of Texas and two medical associations separately challenged this Emergency Medical Treatment and Labor Act guidance, arguing that it amounts to a substantive policy change that would require a formal rulemaking process rather than a mere guidance letter. The Fifth Circuit agreed in January 2024. Emergency Medical Treatment and Labor Act, the court explained, requires that doctors stabilize emergency room patients but does not “mandate any specific type of medical treatment, let alone abortion.” The “practice of medicine is to be governed by the states.”
The Trump administration appears to be casting a wide net for actions taken by various executive branch departments and agencies under the previous president that need to be changed or scrapped altogether. This effort can help reverse the Biden administration’s distortion of federal statutes, such as Emergency Medical Treatment and Labor Act, to serve a political agenda Congress never intended.
