Washington — The Supreme Court will hear arguments Wednesday in a case that opposes Idaho’s near-total ban on abortion violates federal law this requires hospitals to provide stabilizing care to patients facing medical emergencies.
The dispute between the Biden administration and Idaho officials in the case known as Moyle v. United States This is the second time the justices will hear in the month following the Supreme Court’s decision less than two years ago. overturn Roe v. Wade. The outcome of the case could determine whether the Biden administration can require hospitals in states with strict abortion laws to offer terminations in emergency situations.
The court battle involves the Emergency Medical Treatment and Labor Act, or EMTALA, which requires Medicare-participating hospitals to stabilize patients facing an emergency medical condition.
The Biden administration argues that in some cases this treatment will be abortion, and in July 2022 – following the overturning of Roe – it said hospitals accepting Medicare funds require doctors to provide abortions in certain medical emergencies. If a state law prohibits the procedure or includes a narrower exception than EMTALA provides, it is overridden by federal law, the Centers for Medicare and Medicaid Services said.
But Idaho officials and abortion rights opponents say EMTALA remains silent on whether stabilization care includes abortions and cannot move a state’s own restrictions on the procedure.
Under Idaho law, which took effect after Roe was overturned, abortions are allowed only when necessary “to prevent the death of pregnant women,” or in cases of rape or incest. Doctors who perform abortions in violation of the measure can be charged with a felony and face up to five years in prison.
The Biden administration continued Idaho in August 2022, arguing that its law is preempted by EMTALA. A federal district court in Idaho sided with the federal government and allowed doctors to perform abortions in certain emergency situations.
A three-judge panel of the U.S. Court of Appeals for the 9th Circuit then allowed the law to be fully implemented while the litigation continued. But the full 9th Circuit, which reviewed the panel’s decision, reinstated the district court’s order in October.
In early January, the Supreme Court declared that it decide whether EMTALA exceeds state laws that ban most abortions, but allowed Idaho to continue enforcing its ban in certain emergency medical situations until it issues a ruling, expected by the end of June.
The fight for EMTALA
EMTALA was enacted in 1986 to address concerns that hospitals were engaging in “patient dumping” by dismissing or transferring patients who did not have insurance. The law created a national minimum standard of care for hospitals participating in Medicare by requiring them to provide stabilizing treatment to any patient presenting with an emergency that threatens their life or health.
The Biden administration says the Department of Health and Human Services, Congress and health care providers have long recognized that EMTALA requires hospitals to provide abortions when necessary to save the life of the mother or avoid serious damage to your health.
Although stabilizing care sometimes involves terminating the pregnancy, cases where EMTALA and Idaho’s abortion ban are at odds are rare, Solicitor General Elizabeth Prelogar told the Supreme Court in a folder.
If an illness occurs later in pregnancy and the fetus can be born, there is no conflict between federal and state laws, she wrote. But it happens when a pregnant woman suffers an emergency medical condition that, while not terminating the pregnancy, seriously threatens her health, but not her life, Prelogar continued. Under these circumstances, EMTALA overturns Idaho’s ban, she said.
“Delaying care until the woman’s condition deteriorates and the doctor can say that termination of pregnancy is necessary to prevent her death, as required by Idaho law, piles tragedy on top of tragedy with little further chance of fetal survival,” Prelogar wrote.
The Biden administration has argued that the gap between what EMTALA requires and what is allowed under Idaho law — an abortion to protect a mother’s health versus an abortion to save her life – has “devastating real-world consequences”.
“Many pregnancy complications do not pose a threat to a woman’s life when she arrives at the emergency room – but delaying care until it is needed to prevent her death could allow her condition to deteriorate , putting him at risk of acute and long-term complications,” Prelogar wrote.
Bloomberg
If Idaho prevails and the Supreme Court agrees that state abortion restrictions replace EMTALA’s stabilization requirements, Prelogar warned that it would allow care under the law to vary from state to state. the other, “thwarting Congress’s promise of essential emergency care to all Americans.”
But lawyers for Idaho’s Republican legislative leader argued that EMTALA does not include a requirement for abortion care, and they accused the Biden administration of recasting the law to make it one abortion mandate.
“EMTALA is not (the Department of Health and Human Services’) Trojan horse for state abortion rules. EMTALA does not mention abortion anywhere,” state Republican lawmakers said in a file filed with the court. “Interpreting EMTALA as authorizing HHS to override the nation’s abortion laws defies standard expectations of how Congress legislates and distorts the Constitution’s separation of powers.”
Led by Idaho House Speaker Mike Moyle, Republican lawmakers asserted that the Biden administration’s reading of EMTALA was an “intolerable federal power grab,” and they called the law “a law of dumping of patients, not a law on access to abortion.”
In a separate filing from Idaho’s attorney general, state lawyers, alongside the conservative legal group Alliance Defending Freedom, claimed the Biden administration was trying to “create a national abortion mandate” in theaters emergency services that participate in Medicare.
“This would allow the federal government to pay hospitals for violating state law, exempting emergency room doctors from state-legal standards of practice that govern the treatments they are allowed to provide,” a writes Idaho Attorney General Raúl Labrador. “Nothing about this reversal of state law is limited, and it is not and will not be limited to abortion.”
Labrador, a Republican, told CBS News chief legal correspondent Jan Crawford that Idaho law and EMTALA are not in conflict.
“There’s a lot of misinformation about what Idaho law does, and it’s really important that people understand that if the mother’s life is in danger, Idaho law actually allows abortion “, did he declare.
Labrador accused the Biden administration of “trying to scare people into thinking women are going to die.”
The landscape after the overthrow of Roe
Idaho is one of 14 states that ban abortion, with few exceptions, according to the Guttmacher Institute, a pro-abortion rights research organization, while seven other states ban abortion in First 18 weeks of pregnancy.
A group of 22 states, many of which have the strictest abortion laws, are siding with Idaho in this conflict, arguing that the Biden administration is trying to invalidate state laws that protect children from to be born.
No doctors have been prosecuted or charged in Idaho for violating this ban. But the battle before the Supreme Court demonstrates the consequences of its ruling stripping the constitutional right to abortion and the challenges facing doctors who must deal with narrow state exceptions to abortion bans.
Dr. Jim Souza, chief medical officer of the Boise-based St. Luke’s Health System, said there are now “doubts” and “concerns” about whether an abortion can be performed within the limits of Idaho law.
In 2023, when Idaho doctors could perform abortions in certain emergency situations under a district court order, a patient was transferred out of state, Souza said. But in the months since the Supreme Court allowed Idaho to enforce its law in all circumstances, six patients with medical emergencies have been flown out of the state, Souza said. He estimates that number will reach 20 by the end of 2024.
While abortion rights supporters are sounding the alarm about the consequences of a ruling in favor of Idaho, the case has not received as much attention as a second challenge related to abortion heard by the Supreme Court last month, which concerns mifepristone, a widely used abortion pill.
In that case, a group of anti-abortion doctors and medical groups argued that the Food and Drug Administration took a series of illegal actions that made the drug easier to obtain.
The Supreme Court seems ready reject the challenge for procedural reasons. But this court battle and the dispute over Idaho’s abortion ban and EMTALA underscore the chaotic landscape of abortion access in the wake of Roe’s reversal. The High Court’s decisions in these two cases are expected by the end of June.
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