The Supreme Court will hear oral arguments tomorrow morning in a case highlighting the clash between federal emergency care requirements and state laws banning abortion services.
The question at hand is whether the Emergency Medical Treatment and Active Labor Act (EMTALA), which was enacted by Congress in 1986 to prevent hospitals from turning away patients with life-threatening health emergencies, preempts Idaho’s Defense of Life Act, which makes it a crime to perform or assist with an abortion.
The conflict speaks to the legal ambiguity hospitals and other care providers faced following the top court’s landmark decision overturning Roe v. Wade in 2022. In media reports and testimonies in front of Congress, patients and providers have described cases where emergency care was delayed out of fear of criminal enforcement.
Wednesday also marks the second case on reproductive health the justices will hear this term and since the 2022 decision. The Supreme Court’s decision on the Idaho case could also apply to a similar conflict between the federal government and Texas.
The Biden administration argues in favor of EMTALA. Shortly after SCOTUS’ 2022 ruling and in recent months, federal departments have issued notices strongly reinforcing its position that hospitals are expected to provide emergency care under EMTALA despite state restrictions.
In August 2022, the Department of Justice (DOJ) filed the suit challenging Idaho’s soon-to-be-enacted law. At the time, the law did not have exceptions for the pregnant person’s life or health but allowed physicians to assert a defense after the fact. A district court barred the state from enforcing portions of the law that conflict with EMTALA, leading to an appeal that’s made its way to the top court.
In filed briefs, Idaho and other organizations taking its side have argued that the Biden administration “reinterprets EMTALA as an abortion mandate,” and that, until 2022, there had never been any statute or federal guidance specifying that particular procedures, “much less an abortion,” be provided. They also argued that the law does not conflict with the current EMTALA statute, which provides protections for both a pregnant person and an “unborn child,” and noted EMTALA’s primary focus of addressing instances in which a patient does not have medical insurance.
The DOJ has argued that there is a direct conflict between EMTALA and state law when a pregnant person’s health is threatened and an abortion is the standard of care to stabilize. It also pointed to portions of the Affordable Care Act and a portion of the law referencing stabilizing treatment when a pregnant woman is “having contractions” as evidence that abortion care was not meant to be excluded.
Medical groups including the American Medical Association have filed briefs taking the position that abortion is a stabilizing treatment under federal law.
Wednesday’s hearing comes about a month after oral arguments for the term’s other major reproductive health case, in which federal regulators’ sign-off on mail-order medications to terminate a pregnancy was challenged by anti-abortion providers. Amid questioning, the justices appeared hesitant to limit nationwide access based on the plaintiffs’ claimed injuries.