A federal appeals court panel this week upheld an injunction blocking Idaho Attorney General Raúl Labrador from prosecuting Idaho medical professionals for referring patients to out-of-state abortion providers.

Three federal judges in the Ninth Circuit U.S. Court of Appeals issued the decision Wednesday, upholding a preliminary injunction issued by U.S. District Court of Idaho Judge B. Lynn Winmill in July 2023.

The injunction stems from a lawsuit filed in April 2023 by two Idaho doctors and Planned Parenthood Great Northwest, Hawaii, Alaska, Indiana and Kentucky.

They sued Labrador after the attorney general issued a legal opinion saying medical professionals who referred or prescribed abortion pills to pregnant patients across state lines were subject to Idaho’s criminal penalties under the state’s near-total abortion ban.

The lawsuit alleged Labrador violated the First Amendment, due process laws and the commerce clause by issuing the opinion.

The Ninth Circuit panel agreed with Winmill that the suing parties “established a likelihood of success on the merits of their First Amendment claim.”

After Labrador’s letter became public with the permission of Republican state Rep. Brent Crane, who requested it, and Planned Parenthood filed its lawsuit, Labrador sent a follow-up letter stating it was procedurally improper and therefore void — but didn’t say his interpretation was incorrect.

The Ninth Circuit panel wrote Labrador’s withdrawal of the opinion “did not disavow the Attorney General’s interpretation” and he “remained free to enforce” it.

Idaho is surrounded by several states where abortion is legal, including Washington, Oregon and Montana.

Idaho physicians have historically referred patients to clinics in those states if they need care that is unavailable in Idaho, such as termination for medical reasons related to fetal anomalies or complications that put a pregnant patient’s health at risk.

In a statement, ACLU of Idaho and the Planned Parenthood affiliate that covers Idaho said Labrador’s opinion “poses a clear threat to Idahoans’ health, their lives, and their freedom.”

“Preventing health care providers from serving as trusted resources for patients would endanger Idahoans and recklessly encroach on their rights,” the groups said in a prepared statement. “Providers shouldn’t face the threat of punishment for helping their patients obtain the abortion care they need in states where abortion is legal.”

The Idaho Office of the Attorney General is reviewing the decision and considering appeal options, agency spokesperson Dan Estes told the Idaho Capital Sun in an email Thursday.