and london's hiring hundreds of police officers, and arresting drug dealers. san francisco has been through difficult times, but our hard work is paying off. working together, we're building a better future for the city we all love. ad paid for by re-elect mayor london breed 2024. financial disclosures are available at sfethics.org. because we need each other tomorrow night. my for midland, the most anticipated moment of this election, biden made america just the future because that we are a nation of possibility well we had the best economy. we had the best border, we had the best of everything. and now we got to do it all over again. we're going to do it even better two very different visions for america. >> one, unprimed that's it ended night moderated by jake tapper and dana bash, the cnn presidential debate tomorrow night at nine live on cnn and streaming on max this is cnn breaking news we're following breaking news into cnn, the supreme court appears poised to side with the biden administration on a critical abortion case. that's according to a document that was mistakenly and briefly posted to the court's website. which was reviewed by bloomberg news before it was taken down bloomberg has since published the full text of the document which shows the court voting 63 to allow abortions in emergency situations in idaho on a temporary basis while the case continues idaho's strict abortion laws ban the procedure in nearly all cases. it prohibits er, doctors from providing abortions to women whose pregnancies are causing medical emergencies that are not life threatening. >> the league marks yet another stunning breach of protocol at the supreme court, which usually safeguards the release of its opinions cnn is covering this from all angles. we have our chief legal affairs correspondent, paula reid, are medical correspondent, meg tirrell, and also with us, we have emergency room physician, dr. meghan ranney. first you, paula, what are you learning about what happened here and what the supreme court is saying about it? it's two big issues here. the first is what appears to be opinion on what are the biggest cases that the supreme court is taken up. this term. and the other is the fact that there was a yet another leak out of the supreme court. but let's first look at the opinion or what appears to be the opinion. is reporting is coming from bloomberg law. they say that they saw this document that was posted a briefly by the supreme court. we did not see that posted by the supreme court, but they have now posted this documents and the court has released a statement appearing to confirm that, yes, this document was inadvertently released. they said, quote, the courts publication unit inadvertently and briefly uploaded a document to the court's website. the court's opinion in moyle v. united states and idaho, the united states will be issued in due course. so this statement appearing to differentiate between the document that was posted and an opinion that will be released soon. and in this document, it appears that the supreme court is siding with the biden administration. this case comes out of idaho oh, and the decision would allow abortions to be performed in emergency situations to preserve the health, health of the mother, but not necessarily having to wait until a woman's life is at risk met the decision as it is written. again in this document that was posted leaves a lot of uncertainty. it has a little larger question after roe v. wade was overturned about what happens when there are conflicts between state and federal laws. but the other issue here is of course, this incredible breach of protocol. this is the second time that a major abortion case has leaked out of the supreme court in this case being an inadvertently posted. now this comes the timing is significant. this comes roughly 36 hours before a presidential debate that i think most people would agree is probably the most significant moment in this campaign season so far. the supreme court also been a little slow to roll out their final big cases. they still have roughly ten cases left to be released. it's unclear if this abortion opinion would have come before tomorrow's debate i've reached out many of the stakeholders in this case, the justice department that argued on behalf of the government, the white house that was watching this very closely. and of course, the trump campaign, because while a lot of folks are waiting for the trump immunity case, watching that closely, we have repeatedly said that it was this case, the abortion-related case that could have the biggest impact on the election so far, all these stakeholders declining to comment until the actual opinion is officially released by the supreme court and of course, you know, tomorrow and friday, both opinion days at the high court you will watch to see if they officially published it. >> paula reid. thanks so much. at the heart of this case is emtala this federal law, the emergency medical treatment and active labor act help us understand what it is and how it clashed with idaho's abortion law. >> yeah. so this is a law that goes back to 1986 and it applies to hospitals that participate in medicare and provide emergency services, which is sort of most hospitals. i never requires these hospitals to provide care when necessary to stabilize a patient's condition regardless of their ability to pay. and this was implemented at the time to avoid something called patient dumping or maybe private hospitals would want to move patients who couldn't pay to public hospitals for cost reasons. and it applies to pregnant women as well. now, the u.s government, the biden administration, argued in this case that this law clashed with idaho's very strict abortion ban. this was one of the strictest abortion laws in the country. it prohibits abortion in most cases, except to prevent the death of the person who's pregnant. and a few other narrow circumstances. this is punishable by two to five years in prison. and there are certain circumstances that doctors have pointed out as well as the department of justice in its brief, where this would clash when pregnant woman's health is at risk for future fertility, her organs, but she's not yet on death's door where they say that the federal law preempts idaho's law, things like a premature rupture of membranes, for example, uncontrolled hemorrhaging, detach placenta, severe pre-eclampsia. so these are some of the places where the government has argued that the federal law needs to supersede the state law and we've been to idaho and talk to doctors and patients there and dr. say, they've had to ship patients out of state to get care because there is so much uncertainty over what is legal and so this may continue because there may still be uncertainty as this still moves through the courts, guys. >> yeah. and that was something they were doing increasingly once these things became in conflict. meg, thank you so much for that. i want to bring in dr. ronny. you are an emergency room physician and we do need to be clear here. this is about an injunction, meaning as the core issue here is determined by the courts what happens with idaho's law as it may be in conflict here with emtala. so this is temporary until that's worked out, but that said if this ultimately is what is decided, that there can be an exception when it comes to health what does that going to mean for care provided an emergency rooms across the country? >> what it would mean is that care continues as it currently exists in most states across the united across the u.s basically that we as emergency physicians have both a moral and legal obligation to take care of anyone who walks through the door for any reason? and stabilize them. we make sure they don't have a medical emergency if they do have a medical emergency, we do everything within our power to treat them. the thing that is so worrisome about this idaho law, we're at upheld is that it would stop my and my colleagues ability to provide needed care. it would force us to decide in between legal regulations and the patient in front of us it would make us wait until patients are literally on death's door to act and let's be clear, there's no bright line. it's not like, oh, at this minute, this person is totally fine. and the next minute we can say they're about to die. there's no clear dividing line between those as two conditions. so it would make folks wait until women are incredibly dangerous positions. now should this injunction actually be what they're saying it is that's great news for physicians, for patients, for families in idaho. but here's the thing that's really worrisome already, just the way that the idaho law has been written. even though it has not been enforced. we've seen one out of five ob, gains in the state of idaho leave that state. we've seen a dramatic increase in the number of out-of-state transfers of severely ill pregnant women. so even without this law being enforced as written or pretty seen, negative effects on the health of women and families, and negative effects on the number of physicians providing much-needed reproductive care in that state. my worry is that this injunction does not actually create clarity for the health care system. it's just pushing it down the road and basically showing other ways to pass devious laws that restrict abortion and critical reproductive health access. for patients in need that question of delay was something that was pointed out by justice ketanji brown jackson saying that this essentially just kicks the can down the road. >> doctor, i wanted to do to expand if you could for a moment on on that line that you were describing that you see with patients and their conditions in what situations might a woman need an emergency abortion when it doesn't get to the point of being a risk to her life gosh, i've taken care of dozens of such patients over the course of my career. >> let me give you two examples. one, a patient who comes in, who's having a miscarriage, who's been unable to completely finish the miscarriage on their own at home. who's actively bleeding? who's still perhaps has a fetus maybe with a heartbeat, but it's so clear that that pregnancy is over now that women may not be on death's door at the moment that i first see her, but i can predict that if we don't do what's called a d&c, which is essentially an abortion to help finish that miscarriage, she will continue to bleed to hemorrhage until she is potentially on death's door. we shouldn't make her have to wait to sit in a hospital bed for hours or for days actively bleeding until she gets to that point when her organs are shutting down. that's one example another example is an ectopic pregnancy. when the pregnancy lands outside of the uterus in the ovary, or even in the abdomen. it can burst and you can cause extensive bleeding inside the belly. i've taken care of countless patients for whom this has happened. it can cause severe pain, it can cause tachycardia. and if untreated, it can mean that a woman can't have future children so we're supposed to wait and watch while someone continues to bleed internally until that point when she's barely survivable and maybe her reproductive capacity has been hurt forever before we're allowed to treat that ectopic pregnancy. that also is a ridiculous situation. and there are many more for that. i've personally seen and cared for over the course of my career. this really puts doctors as well as patients and families in an untenable position. no wonder, a bunch of doctors are again leaving the state of idaho right now. >> yeah. we've seen that there has been quite the exodus. dr. meghan, ronnie, thank you so much for your insights. we do appreciate it thank you. still plenty mourners to gate to. it is debate iv for for joe biden and donald trump, the key issues both candidates are being pushed to hammer home during tomorrow night's big showdown on cnn plus, locked in a glass cage with noticeably his head shaved want to talk with a friend of journalist evan gershkovich about the start of his so-called trial in russia the most anticipated moment of this election and the stakes couldn't be higher. the president and the former president, one stage two, very different visions for america's future cnn presidential debate tomorrow net it live on cnn and streaming on max. >> i want a lot of businesses, so my 10:00 a.m. network need to keep up. thank you. verizon business now, our businesses get fast and reliable internet on the same network that powers our phone so whatever is next, we're cooking with fire switch to the partner. businesses rely on doctors, recommend coli stool softener, four gentle dependable relief from constipation. it's so gentle. doctors even recommended during pregnancy and after surgery, callie's increases water in the stool, making it softer, so it's easier to go? no harsh 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getting trump to hone in on the issues that they believe they have the upper hand on immigration crime, and inflation. those are areas they believed that they pull well in and they prefer the former for president focuses energy on going on the attack and those areas instead of going into his degree, vance's that he has focused on for the last four years. the other area is more related to style donald trump in the first debate of their last meeting in 2020 he was talking over the moderator. he was talking over joe biden, but one point biden told him to quote, shut up in an adviser to trump says that they believe that they lost the election in that moment. and so they are hoping that donald trump, this go around we'll, we'll, will try to adhere more to the format of the debates and trump himself in recent interview, did acknowledge that he was cold very aggressive in that first debate, and he felt that he did much better in this second debate. and so he, i think going into this, they are trying to urge him to be more like he was in that second debate, whether that happens will remain remains to be seen. trump camp the pain though. trump and his campaign, they'll keep insisting that this debate prep is, is not as extensive as what the president is doing. in fact, donald trump in an interview downplayed exactly what the benefits you can get from doing debate prep. listen to what he said i think i've been preparing for it for my whole life. if you want to know that truth and i'm not sure you can lock yourself into a room for two weeks or one week or two days and really learn what you have to know now trump does though he, you know, he said that he hasn't doing some prep behind the scenes, though he is mixing things up a little bit as you know, he was on the campaign trail the weekend. >> he has attended a fundraiser. he's still doing media interviews and just a little bit ago, he called into an event with both black supporters in the atlanta area all right. >> steve can torno. thank you so much for the very latest on that. we appreciate it. and joining us now is the democratic governor of minnesota, tim walz. he is a surrogate for the biden campaign governor. great to have you and i do wonder what are you hoping to see from president biden tomorrow night and what do you not want to see in this debate? >> yeah. well, thank you for having me, briana, look, i want to see the president be themselves, somebody who cares about minnesotans and american, somebody who's out there doing the work for others, you know, trying to make our country fair for everyone. and i just hope and i'm sure he won't just don't engage with the buffoonery that donald trump wants to be. and we know these debates are not real life. i've been governor long enough. i served under both with president trump and president biden and with president trump, it was always fighting with my neighbors to get ventilators during covid and telling my citizens to drink bleach with joe biden. it's about real solutions, so i just thin