ATLANTA (AP) — The Supreme Court’s pending Idaho abortion ruling may hinge on how federal spending power might protect doctors against a state’s criminal code. For guidance, the justices can look to the very beginning of Medicare in the 1960s, when the promise of federal funding finally persuaded hospitals in the Jim Crow South to desegregate.

In oral arguments for Idaho v. United States last month, Justices Samuel Alito, Clarence Thomas and Neil Gorsuch raised questions about the Biden administration’s power to pull Medicare money from hospitals whose doctors won’t perform emergency abortions for fear of being prosecuted.

Idaho law currently threatens doctors with prison if prosecutors challenge their medical determination that an abortion was necessary to save a woman’s life. Idaho also criminalizes abortions to preserve a woman’s bodily functions, contrary to federal requirements for emergency care.