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Supreme Court Hears Arguments on Emergency Abortion Case; Speaker Johnson Calls for the Resignation of Columbia University President; Biden Talks Following the Signing of Foreign Aid Funds for Israel and Ukraine. Aired 10:30-11a ET

Aired April 24, 2024 - 10:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[10:30:00]

MARY ZIEGLER, PROFESSOR OF LAW, UNIVERSITY OF CALIFORNIA DAVIS AND AUTHOR, "DOLLARS FOR LIFE": Not only patients seeking abortion, but patients with wanted pregnancies or experiencing miscarriage or stillbirth who are also being turned away because physicians are not exactly sure when their conduct is going to be deemed to violate the law by a prosecutor.

And laws like Idaho's have pretty steep penalties for physicians, right?

JIM ACOSTA, CNN NEWSROOM ANCHOR: Yes.

ZIEGLER: We're talking about at least several years in prison, loss of a medical license, things that would be essentially career ending for doctors.

ACOSTA: Got you.

ZIEGLER: And we're seeing many physicians are unwilling to take those risks.

ACOSTA: All right. Mary, I've got to jump in because Amy Coney Barrett, one of the conservative justices on the Supreme Court is speaking now. Let's go to that live.

JOSHUA TURNER, CHIEF OF CONSTITUTIONAL LITIGATION AND POLICY: -- make clear that there is no medical certainty requirement. You do not have to wait for the mother to be facing death.

AMY CONEY BARRETT, U.S. SUPREME COURT JUSTICE: Counsel, I don't --

JOHN ROBERTS, U.S. SUPREME COURT CHIEF JUSTICE: Thank you, Counsel. Is there -- what happens if a dispute arises with respect to whether or not the doctor was within the confines of Idaho law, or was it? Is the doctor subjected to a review by a medical authority? Exactly how is that evaluated?

Because it's an obvious concern if you have an individual exception for a doctor. And they were having a debate about is that covered by your submission that nothing in Idaho law prohibits complying with EMTALA. I mean, who makes the decision whether or not something's within or without?

TURNER: So, I mean, I imagine there are two ways the law can be enforced, or at least two. The Board of Medicine has a licensing oversight over a doctor, and the Idaho Supreme Court made clear that that doctor's medical judgment is not going to be judged based on an objective standard what a reasonable doctor would do. That's not the standard.

The second way would be if a --

ROBERTS: Well, what is the standard?

TURNER: The doctor's good faith medical judgment, which is subjective.

ROBERTS: And that's not subject to review by any medical board if there's a complaint against the doctor that his standards don't comply and say he's the only doctor at the particular emergency room, and he has his own particular standard?

TURNER: What the Idaho Supreme Court has said is that you may consider another doctor's opinion only on the question of, was it a pretextual medical judgment? Not a good faith one.

ROBERTS: Thank you.

UNIDENTIFIED MALE: Justice Thomas? Justice Alito?

SAMUEL ALITO, U.S. SUPREME COURT JUSTICE: Well, I would think that the concept of good faith medical judgment must take into account some objective standards, but it would leave a certain amount of leeway for an individual doctor. That was how I interpreted what the State Supreme Court said.

Now, you have been presented here today with very quick summaries of cases and asked to provide a snap judgment about what would be appropriate in those particular cases. And honestly, I think you have hardly been given an opportunity to answer some of the hypotheticals.

But would you agree with me that if a medical doctor who is an expert in this field were asked, bang, bang, bang, what would you do? In these particular circumstances, which I am now going to enumerate, the doctor would say, wait, I don't -- this is not how I practice medicine. I need to know a lot more about the individual case. Would you agree with that?

TURNER: Absolutely. And ACOG has, you know, in the case of PROM, for example, ACOG doesn't just knee jerk say an abortion is the standard of care. ACOG itself says that expectant management is oftentimes the appropriate standard of care. And so, these are difficult questions that turn on the facts that are on the ground between the doctor as he is assessing them, with his medical judgment that he's bringing to bear, but he's also necessarily constrained by Idaho law, just like every other area of the practice of medicine. State law confines doctor judgment in some ways.

ALITO: Thank you.

UNIDENTIFIED MALE: Justice Sotomayor.

SONIA SOTOMAYOR, U.S. SUPREME COURT JUSTICE: There is a difference between stabilizing a person who presents a serious medical condition requiring stabilization than a person who presents with a condition quoting Idaho's words, "Where there is a -- poses a great risk of death to the pregnant women." You agree there's daylight between the two?

TURNER: We agree, and I think this is most important --

SOTOMAYOR: And so, there will be some women who present serious medical condition that the federal law would require to be treated who will not be treated under Idaho law.

TURNER: No, I disagree with that. Idaho hospitals are treating these women. They're not treating these women with abortions --

SOTOMAYOR: Stop.

TURNER: -- necessarily, Your honor. And as an --

SOTOMAYOR: And that's my point. Just answer -- the point which is, they will present with a serious medical condition that doctors in good faith can't say will present death, but will present potential loss of life.

[10:35:00]

Those doctors -- potential loss of an organ or serious medical complications for the woman, they can't perform those abortions.

TURNER: Yes, Your Honor, if that hypothetical exists, and I don't know of a condition that is so certain to result in the loss of an organ, but also so certain not to transpire with death. If that condition exists, yes, Idaho law does say that abortions in that case aren't allowed. And I think --

SOTOMAYOR: All right. Let me stop you there, because all of your legal theories rely on us holding that federal law doesn't require, cannot preempt state law on these issues. And so, when I ask you the question, if a state defines likelihood of death more stringently than Idaho does, you would say there's no federal law that would prohibit them from doing that.

TURNER: Well, I would say that EMTALA does not contain a standard of --

SOTOMAYOR: So, there is no standard of care. In your briefing you made these SG's position here, and you almost argue that now, that their position that federal law requires stabilizing treatment and not equal treatment of patients, which was a position you took in your brief. You seem to have backed off from it here.

You seem to agree that federal law requires some stabilizing condition, whether or not you provide it to other patients. But I have countless briefs that say that both -- that HHS has filed that pre- Dobbs, pre-2009, this is not an unprecedented position. That HHS, in countless situations, cited hospitals for discharging patients who required an abortion as a stabilizing treatment.

Congress discussed that topic in the Affordable Care Act and explicitly said that nothing in the Affordable Care Act shall be construed to relieve any healthcare provider from providing emergency services as required by state or federal law. Medical providers have told us that for decades they have understood both federal law and state law to require abortions as stabilizing conditions for people presenting serious medical risk.

Lower courts, there's at least cases of lower courts saying, you have to provide abortion. So, this is not a post-Dobbs unprecedented position by the government.

TURNER: It absolutely is. The -- in footnote two, the administration cites to two spreadsheets that contain 115,000 rows of enforcement instances. The administration has not identified --

SOTOMAYOR: Counsel --

TURNER: -- a single instance --

SOTOMAYOR: Counsel, pre-Dobbs, this wasn't much of a question. But there is HHS guidance and there's at least three cases in which it was invoked. The fact that we didn't have to -- that HHS didn't have to do it much before pre-Dobbs doesn't make their position unprecedented --

TURNER: My point is more fundamental, Your Honor. It's not just that there are few instances. There are no instances, and not just on the issue of abortion. On any instance where HHS has come in and told a hospital, you have to provide a treatment that is contrary to state law. And this isn't just about abortion. Consider it both ways --

SOTOMAYOR: Oh, now we're back to that. OK. Thank you.

UNIDENTIFIED MALE: Justice Kagan.

ELENA KAGAN, U.S. SUPREME COURT JUSTICE: Mr. Turner, practicing medicine is hard, but there are standards of care, aren't there?

TURNER: Yes, there are.

KAGAN: And one of those standards of care with respect to abortion is that in certain tragic circumstances, as you yourself, as your own state's law acknowledges, where a woman's life is in peril, and abortion is the appropriate standard of care. Isn't that right?

TURNER: That's right.

KAGAN: And EMTALA goes further. It says that the appropriate standard of care --

ACOSTA: And you've been listening to Supreme Court arguments over the restrictive Idaho abortion ban. Some of the justices going back and forth there. You could hear Elena Kagan, sort of, going after Joshua Turner, who is the attorney representing the state of Idaho in all of this.

Let me go back to Paula Reid, Sonia Suter, who are seated with me here in the studio. Paula, your assessment of what we've been hearing so far. We did hear Sam Alito a little while ago, one of the conservative justices, sort of, poking holes and some of the arguments that his liberal counterparts were making.

But you heard Elena Kagan there just a few moments ago. I mean, getting rather pointed, I think, with Joshua Turner.

PAULA REID, CNN SENIOR LEGAL AFFAIRS CORRESPONDENT: Yes, and that's after Justice Sotomayor decided she just was, sort of, done. It was clear --

ACOSTA: Yes, she's done.

REID: -- she had had it.

ACOSTA: Yes.

REID: She was frustrated. And look, this is Turner's first time arguing in front of the justices. And I think it's showing, especially, for example when Justice Sotomayor, she has diabetes and she shared a hypothetical about someone with diabetes, the type of care that -- they could be prevented from receiving.

[10:40:00]

She gave a hypothetical and he had a moment there where he could have maybe acknowledged the humanity there or something, but he just moved on to his legal argument. So, that was not winning him any friends with the liberal bloc.

But one of the things that we weren't able to hear on air but our colleagues are following this. I'm going to read it. It's the questioning from Justice Amy Coney Barrett, and it's interesting because she pushed the Idaho attorney, Joshua Turner, over when doctors could be criminally prosecuted for performing an abortion under state law. And she's making an interesting point here because really it was the liberals who dominated most of Turner's argument in their questioning.

But she asked him whether, if a doctor reached the conclusion, in good faith, that an abortion was medically necessary, but prosecutors disagreed, could they be prosecuted under Idaho law, right? What if the prosecutor thought -- and I'm quoting her now, "Well, I don't think any good faith doctor would draw that conclusion. I'm going to put on my expert." Turner responded saying, that, Your Honor, is the nature of prosecutorial discretion, and it may result in a case.

I think he might have missed the point she was trying to make. She's raising concerns that if they agree with his side, the doctors could potentially be prosecuted at the discretion, right, of lawyers. And he didn't defend his position very well.

ACOSTA: Yes. And Sonia, you wanted to make a point about how -- I mean, in a lot of these cases, when these emergencies arise and people arrive at the emergency room, the fetus is not going to survive.

SONIA SUTER, PROFESSOR, GEORGE WASHINGTON UNIVERSITY LAW SCHOOL: Right.

ACOSTA: At this point, we're talking about preserving the health and the life of the mother.

SUTER: Exactly. When these situations arise where the standard of care would be to terminate the pregnancy, these are usually pre- viability. There's usually no chance for the fetus to survive and it's a question of whether the mother is going to be brought to the brink of death, or whether we protect vital organs and health and avoid more -- you know, see loss of fertility and other outcomes like that.

So, I think this sort of idea that Idaho presents that you can save both the mother and the fetus is really mistaken. And I think this case just points out that pregnancy can be dangerous. And many of these cases are not people who wanted to end their pregnancy. Many of these cases are people who wanted to be pregnant and complications arose.

ACOSTA: Lots of complications can arise in pregnancies as we all know.

SUTER: Yes.

ACOSTA: It happens. All right. Thank you both. Really appreciate those discussion points.

And we're going to have more on all of this in just a few moments. Stay with us. We'll be right back.

(COMMERCIAL BREAK)

[10:45:00]

ACOSTA: All right. Some breaking news to tell you about House Speaker Mike Johnson says he will call on Columbia University's president to resign. Johnson is set to go to Columbia later today to meet with Jewish students. This comes as pro-Palestinian protests at the university have entered their eighth day as students are occupying the west lawn on campus.

CNN's Omar Jimenez is there. Omar, you've been covering this for days now. Tensions have been mounting, of course, and now the House Speaker is going to weigh in. What more can you tell us?

OMAR JIMENEZ, CNN CORRESPONDENT: Yes. So, of course, the big question or was -- what was the House speaker going to say as he met with Jewish students here on campus?

As you just mentioned, as we learned, he does plan to call for the resignation of Columbia University President Minouche Shafik. Saying on a radio show this morning, "That Shafik has shown to be a very weak leader." And then going on to talk about the wider climate of protests that we've seen, not just at Columbia, but at universities across the country. Calling it maddening what we're seeing on these college campuses across the country. Calling it disgusting and unacceptable.

Now, here at Columbia, we are in an eighth day of an encampment-led protest on campus here. Where they have said they are calling for divestment from -- they are encouraging or pushing Columbia University to divest from corporation they say are supporting Israeli apartheid and Israeli genocide.

Now, we are on eighth -- in an eighth day of that encampment protest, but what we have seen is that many Jewish students on campus do not feel safe with how that protest has been going on. One Jewish student we spoke to says that she just feels generally on edge with some of the confrontations that have happened with that encampment.

Now, we spoke to some folks in the encampment who have stressed that the majority of their interactions have been peaceful, and at the very least, they have been very distinct from some of the more violent messaging that we've seen from protests that have happened off campus grounds, usually happening at the gates of Columbia University.

So, those are the dynamics that we are dealing with. And of course, at the university level, the president is trying to figure out how to deal with the encampment moving forward. She previously set a midnight deadline of last night/this morning to reach an agreement with these students to clear the encampment.

That deadline came and went. Hours later, a university spokesperson said they made enough progress to where they feel they can push back that deadline by 48 hours, saying that they agreed for some of the encampment intents to be removed and also to remove any non-Columbia personnel from the -- what should be student led protests, according to the university.

But previously, the president said that if those conditions were not met, if they were not able to reach an agreement, they would have to find alternative ways to clear the encampment. We do not know what those alternative ways are. But last week she sent in the New York Police Department to clear out some of these encampments. A move that drew a lot of criticism from students and faculty who staged a walkout in support of the students that ended up arrested and suspended.

[10:50:00]

So, it will be interesting to see what happens in these 48 hours on that negotiation front. But Speaker Mike Johnson is scheduled to come here today. And as we have learned, he will call for the resignation of Columbia President Minouche Shafik.

ACOSTA: All right. Omar Jimenez, let us know if anything else develops out there. Really appreciate it.

We also want to caution our viewers. At any moment, we're expecting to see President Biden sign those foreign aid bills over at the White House. We'll go to that in just a few moments from now.

But I want to go back to CNN's Gabe Cohen. He is out the -- outside the Supreme Court for us, where protesters making their voices heard as the high court has been hearing arguments on emergency care abortions. Gabe, you've been speaking to some of the protesters out there. What are you hearing?

GABE COHEN, CNN CORRESPONDENT: Well, Jim, right now we're listening to these two protests happening simultaneously. Over here, beyond these barricades, this is the anti-abortion activists who have gathered. They're having a program. And then across, between these barricades, these are the abortion rights activists, a much larger crowd who have gathered people from all over the country, including Dr. Caitlin Gustafson, who I want to bring in.

You're in from rural Idaho, you said. You are a family medicine doctor. You said you used to do abortion care. Talk to me about what has changed in your eyes in Idaho from the patients you see over the past two years under this restrictive law.

DR. CAITLIN GUSTAFSON, FAMILY MEDICINE PHYSICIAN: Absolutely. Having access to safe abortion care is critical to a safe healthy healthcare system. And that's what we've seen fall apart in Idaho since our ban went into effect. We have lost a multitude of providers, particularly my OB/GYN colleagues who cannot continue to have themselves in the position of trying to make these decisions in emergencies where a patient's health and life is threatened. But if they make the wrong decision at the wrong moment, they can go to jail. They can lose their license.

COHEN: I can hear the emotion in your voice talking about this. As a doctor, can you tell me what do you believe is at stake with this Supreme Court case and the decision that will come?

DR. GUSTAFSON: Safe emergency healthcare across the board. This isn't just about abortion. This is about a protection, a lifesaving protection we've had in place that keeps any person, including our pregnant patients who come to the emergency room, safe.

Without this protection, it's happening right now in Idaho, patients with health threatening emergencies that can quickly become life- threatening emergencies are being sent out of state to get the care that they need. They're being sent away from their physician, their healthcare system, their community, their support system.

COHEN: And we're hearing protesters on the other side, just a few feet away, who are arguing Idaho should be able to control its own destiny when it comes to abortion. That it does have part of its laws that mothers whose lives are at risk could still get abortions. What would you say to that? To the folks who say, look, there is a law that allows people when their lives are in jeopardy to get abortion. This federal law, it's just looking for a loophole.

DR. GUSTAFSON: This federal law is what every doctor practicing in American right now has grown up under and what -- it is what keeps everyone safe. It is the reason that you come to any emergency room and you have to be provided that lifesaving care when you have an emergency. We must have that in place because laws like we have in Idaho are making pregnancy care unsafe for all. And that threatens our communities. And that makes the entire healthcare system unsafe in the end. And Idaho is living proof of that in this moment.

COHEN: Are you worried about what this could mean for your patients next year and the year after that?

DR. GUSTAFSON: Absolutely. We've been living under this in Idaho since we lost this protection. When the Supreme Court decided to hear this case, we no longer had this protection. And it has been a distinct change with my colleagues and the patients that we serve in our communities in these last four months.

It is untenable for physicians to continue to practice medicine this way. And we will continue to see that drain of excellent healthcare providers from our state, despite that what they want most to be able to do is take care of their patients and keep them safe.

COHEN: Dr. Gustafson, thank you so much. Really appreciate your time. Yes.

And Jim, I'm going to throw it back to you. We're continuing to monitor these protests. We have seen some tense moments. But again, there are barricades in between the groups. A much larger group of demonstrators here on the abortion rights side of things. So, we'll keep watching this in the minutes and hours ahead.

ACOSTA: Yes, Gabe. I mean, I think that interview you had with that doctor was really just perfect because it really outlines the real- world consequences that doctors and patients are dealing with in places like Idaho, where they have these restrictive measures in place.

[10:55:00]

It sounds as though they are going to have to live with if this Supreme Court does not rule in their favor, it is going to be very difficult for those kinds of services to be rendered in that state.

COHEN: That's right. And that -- that's a major concern that these doctors are already seeing patients who are fleeing to other states. We've even seen in Idaho and in other states, a lot of discussion about doctors themselves, practices moving out of state to places with less restrictive abortion laws. And the question is, what's left for the people left behind? That's a major concern I'm hearing from this doctor and that I've heard from others in many states across the country.

ACOSTA: All right. Gabe Cohen, thank you very much. We're going to continue to monitor the arguments at the Supreme Court, what's going on outside of the Supreme Court. A lot of news happening.

The President is also going to be speaking on the foreign aid package that was passed in the Congress. He's going to be signing that in just a few moments as well. You can see live pictures inside the White House as we speak. The President will be coming out to the podium shortly. We'll take that live as well. Stay with us. We'll be right back.

(COMMERCIAL BREAK)

WOLF BLITZER, CNN ANCHOR AND "SITUATION ROOM" HOST: We're following breaking news. I want to go to the White House right now. President Biden is speaking after signing the foreign aid funding packages for Ukraine, Israel, Taiwan. Let's listen in.

JOE BIDEN, U.S. PRESIDENT: And by the Senate yesterday. It's going to make America safer. It's going to make the world safer, and it continues America's leadership in the world, and everyone knows it. It gives vital support to America's partners, and I -- so they can defend themselves against threats to their sovereignty and to the lives and freedom of their citizens.

And it's an investment in our own security, because when our allies are stronger, and I want to make this apparent again and again, when our allies are stronger, we are stronger. I'm great for all those in Congress, Democrats, Republicans, Independents who voted for this bill. It's a path to my desk. It was a difficult path. It should have been easier and it should have gotten there sooner. But in the end, we did what America always does. We rose to the moment. We came together. And we got it done.

Now, we need to move fast, and we are. Over two years, Russia has been responsible for a brutal campaign against Ukraine. They've killed tens of thousands of Ukrainians, bombed hospitals, deliberately picked them out. Bombed hospitals, kindergartens, grain silos, tried to plunge Ukraine into a cold and dark winter by striking their power grid.

Ukraine's have fought -- the Ukrainians have fought. Defending their country and their families with extraordinary courage. Many of you have been there with me many times. It's amazing what they do. I mean, it's amazing against such a larger military. Ukraine has regained over half the territory Russia took from them in this invasion. And they won important victories against Russia's Navy.

But make no mistake about, they're a fighting force with the will and the skill to win. The will and the skill to win. For months, while MAGA Republicans are blocking aid, Ukraine's been running out of artillery shells and ammunition.

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