Federal law drives latest abortion battle in U.S. Supreme Court

The Supreme Court will consider yet another high-stakes abortion case that could have major implications for emergency rooms across the country.

The case comes nearly two years after a court overturned abortion rights nationwide, including a federal law that required hospitals to provide stable care to patients who presented with “emergency medical conditions.” focuses on law.

At issue before the Supreme Court is whether that law, known as the Emergency Medical Labor Act, or EMTALA, is in question. Emergency abortions are covered even in states where emergency abortions are prohibited.

In other words, if a doctor determines that abortion is the best treatment for a patient at risk, are patients protected from prosecution everywhere?

The Biden administration said yes. The state sued Idaho over its near-total abortion ban, which included an exception for the mother's life rather than her health.

“A woman does not have to be close to death to receive care,” Health and Human Services Secretary Xavier Becerra said in a statement announcing the lawsuit.

Idaho countered that EMTALA cannot supersede state law.

Here's a look at the debate and what's at stake.

Congress enacted legislation in 1986 to ensure that all patients, regardless of insurance status or ability to pay, receive a basic standard of emergency medical care. This was aimed at stopping patient “dumping,” the practice of transferring uninsured patients to public hospitals regardless of the health consequences.

This law would require all Medicare-funded hospitals (most hospitals in the U.S.) to provide stabilization treatment to patients who arrive at a hospital emergency room with an “emergency medical condition.” It is mandatory to do so.

This includes conditions that go beyond fatal and “put a person's health at serious risk” or cause “serious impairment of bodily functions or organs.”

Doctors and hospitals that violate the law could face fines and loss of federal funding.

The text of the law does not specifically mention abortion or list specific treatments for various emergencies. It simply requires health care providers to use accepted standards of care for each patient.

“If a state law prohibits abortion and does not include an exception for the life of the pregnant person or provides an exception narrower than EMTALA’s definition of an emergency medical condition, then that state law takes precedence. ”, the memo states.

Major medical organizations, including the American Medical Association and the American Hospital Association, agreed, telling the Supreme Court in briefs that abortion could be provided as necessary stabilizing care under EMTALA. .

Shortly after the Roe bill was overturned, the Idaho Defense for Life Act was signed into law. The law bans abortion from the point of conception in almost all cases and makes performing or facilitating an abortion a felony, punishable by up to five years in prison.

The law has an exception to prevent the death of pregnant people. However, there are no exceptions in the case of threats to the mother's health or long-term medical complications.

In August 2022, the Department of Justice sued the state of Idaho, charging that the EMTALA ban was in violation because it lacked a maternal health exception.

The Justice Department said in a court filing that the Idaho law prohibits abortions “even if the physician determines that the treatment is medically necessary to prevent a serious risk to patient care.” Stated.

According to EMTALA's own language, EMTALA must supersede state law when a “direct conflict” exists.

The Supreme Court allowed Idaho's ban to remain in place while it considered the case.

Idaho lawyers argued that EMTALA does not cover abortion at all and does not authorize doctors to perform illegal procedures.

“Patients who request an abortion but are denied cannot invoke EMTALA to force an emergency room to perform an abortion, and neither can the federal government,” they wrote in a brief to the state Supreme Court.

And they write that there is no conflict between the Idaho ban and the federal protection law, both of which seek to protect the lives of women and their “fetuses.”

“All this litigation does is invalidate the Biden administration's choice to manipulate EMTALA to protect the lives of Idahoans,” said John Bursch, senior counsel for the state's leading right-wing legal advocacy group, the Alliance Defending Freedom. It means that we are doing so.”

Doctors in Idaho said the ban is already having a negative impact on women with severe pregnancy complications who are denied treatment.

A group of 678 doctors in Idaho estimated the number of women who were sent home from the hospital or transferred out of state for treatment because they faced high risks of infections, sepsis, kidney failure and infertility. A brief was submitted explaining the example.

And doctors say they are now working under extreme stress, fearing they will have to turn away patients in emergency situations or risk losing their licenses or even jail time. .

“There's a lot of fear on our team that goes beyond physicians,” said Caitlin Gustafson, a family physician and obstetrician in McCall, Idaho, adding that nurses and other health care providers are also involved. He added that there is a possibility that

Anti-abortion activists claimed that doctors were intentionally misinterpreting the law to allow life-threatening cases.

“This is staged and hyped,” said John Barsh of the Alliance Defending Freedom. “Idaho is protecting lives, so we won't have an influx of doctors fleeing the state.”

A verdict is expected to be handed down this summer.

With additional reporting by Rebecca Hartmann and Nomia Iqbal