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So is the court is throwing out the law or saying that the state doesn't get to question physicians, which would logically have the same result?
It's neither. They want the medical gridlock where physicians are afraid to perform abortions, all while keeping them technically legal.
The court is saying they don't want to be involved and that the law 'allows for abortions in cases of medical emergency.' The problem is the state is separately saying that they'll prosecute her for trying to get an abortion in the state. Basically Texas is trying to have it both ways where the state courts claim she is already entitled to have an abortion so there is no legal dispute, while the state is saying she'll be prosecuted for having an abortion.
"A pregnant woman does not need a court order to have a life-saving abortion in Texas. Our ruling today does not block a life-saving abortion in this very case if a physician determines that one is needed under the appropriate legal standard, using reasonable medical judgment," it said in its decision.
Kimberly Mutcherson, a professor of law at Rutgers Law School, said that part of what the Texas Supreme Court judges had to consider was whether they wanted “to be in the business of having every single medical exemption case end up” in their hands.
As the people above me have said it's that the courts are not to be pre-determining the validity of every instance where an abortion is claimed to meet the statutory exemption, and the consequential effect is that no woman wants to proceed in state and no doctor will touch it both for fear of being charged criminally and/or sued civilly. Nobody wants to be a test case that can cause that person criminal prosecution, civil prosecution, legal expenses, loss of medical license, loss of ability to support themselves and their families, and god knows what vigilante actions from the lunatic holy rollers. It's a damned if you do and damned if you don't situation, especially with Paxton threatening to bring the full weight of the government of the State of Texas against you. All of which is just how the Republicans who passed this wanted. They only put the exemption in there to make the law give the appearance of giving a shit about the mother's health.