On April 24, the U.S. Supreme Court will hear a case that is truly life or death. Moyle v. United States and Idaho v. United States involve a disturbingly familiar post-Roe playbook – a state finding yet another way to take a sledgehammer to federally-protected rights, to wrestle health care decisions away from providers and patients, putting patients’ lives at risk.
Idaho’s trigger ban on abortion care immediately went into effect after the Supreme Court reversed Roe. The law made it a crime for anyone to perform or assist with an abortion in Idaho, with a prison term of two to five years and no exceptions for medical emergencies. This is despite the fact that a 1986 federal law called EMTALA requires Medicare-participating hospitals nationwide to provide emergency treatment for all patients, including emergency abortion care for pregnant people.
Anti-abortion policy makers in Idaho now want to prohibit doctors from fulfilling this federally-mandated duty. Without this requirement, a hospital could refuse to treat a pregnant person experiencing a health emergency, like pre-eclampsia (which can cause seizures and brain injury) or uncontrollable hemorrhage (which can cause kidney failure and sepsis).
As more than 250 members of Congress recently noted in an amicus brief calling on the Supreme Court to uphold the emergency care requirement, “Because Idaho’s abortion ban contains no clear exceptions for the ‘emergency medical conditions’ covered by EMTALA, physicians are forced to wait until their patients are on the verge of death before providing abortion care. [...] Federal law does not allow Idaho to endanger the lives of its residents in this way.”
So, what does this mean and what can we do about it? Here are answers to some common questions about the Emergency Medical Treatment and Active Labor Act (EMTALA).
How does the EMTALA case relate to other abortion-related cases?
Like the recent medication abortion case, this case is part of a coordinated national effort by anti-abortion extremists to attack access to abortion care and reproductive rights at all levels and from every direction. The Dobbs decision overturned Roe v. Wade and removed nationwide abortion protections, but it didn’t change the fact that states must still comply with other federal laws, like EMTALA, which supersedes state laws, including abortion bans.
Under EMTALA, states should not be able to deny federally-mandated emergency health care for a particular patient group (like pregnant people) or for particular types of care (like abortion), just because they want to. By suggesting that they can prohibit that emergency abortion care, policymakers in Idaho and elsewhere have sown chaos and confusion among medical providers. They are forcing doctors to choose between their duty to care for patients (in accordance with federal law) and possible jail time or losing their license if they don’t abide by unclear, ill-informed state-level bans.
What is being done to protect EMTALA?
This case was brought by the Biden administration, which is suing Idaho over their extremist abortion ban because it violates EMTALA’s requirement that hospitals continue to provide emergency abortion care. More than 250 members of Congress have joined together to file an amicus brief in this case, calling on the Supreme Court to uphold protections for emergency abortion care in hospitals as federal law requires. This includes 49 U.S. Senators and 209 Members of the U.S. House of Representatives. Planned Parenthood Federation of American also joined over 100 other organizations in an amicus brief outlining the dire ramifications if EMTALA is not upheld.
What are the consequences if the Supreme Court sides with Idaho?
If Idaho gets away with this, people who are having pregnancy complications in Idaho will suffer and might die from being denied basic stabilizing care. And doctors who want to provide necessary care could be forced to withhold it, under the threat of prison and losing their medical license. Plus, this will encourage other states with abortion bans to bypass EMTALA, like Texas, and individual activist doctors or hospitals across the country could choose to refuse patients care.
If the Supreme Court upholds Idaho’s abortion ban, what does this mean for places where abortion is legal – like Maryland, DC, and Virginia?
Even if abortion rights are “safe” in Maryland, DC, and Virginia, without federal protections, no state-level abortion law is guaranteed. EMTALA offers federal protection for emergency abortion care; if it weren’t enforced, emergency abortion care would be at risk nationwide. As we know from the Dobbs decision, we would also see cascading effects if the court reversed the precedent set by EMTALA, with more patients from states with bans being forced to seek emergency care farther from home, including in Maryland, DC, and Virginia.
What is being done to protect providers and patients?
Several states have moved to include abortion rights in their constitutions – the highest state-level protection possible. This November, Maryland voters can support a ballot measure to enshrine reproductive freedom in the Maryland Constitution. And Virginians are organizing a Virginia Right to Reproductive Freedom Amendment campaign.
Many states have also enacted abortion shield laws to protect providers from liability or extradition if they help patients from abortion ban states access care. Maryland has an abortion shield law and protects electronic health records, but Virginia Gov. Glenn Youngkin recently vetoed bills that would have created shield laws for reproductive health care providers, despite the fact that abortion remains protected in Virginia.
DC is currently a “safe haven” for abortion access – with both protected abortion rights and abortion shield laws – but DC’s lack of statehood continues to pose a direct threat to abortion access in the District. The Dornan Amendment has long prohibited DC from spending locally-raised tax dollars on funding abortion for Medicaid recipients, as many states are able to, and more restrictions could be put in place without true DC self-governance.
How can PPADMV supporters get involved?
While we do not elect federal judges, we do elect the politicians who appoint them. PPADMV and other advocacy groups are sending the clear message that voters will not stand for politicians stripping away their rights and jeopardizing their health. We encourage all Maryland, DC, and Virginia residents to register to vote and to support candidates with a demonstrated record of championing reproductive freedom.
You can also volunteer for PPADMV, support Maryland’s ballot measure to protect reproductive freedom, and support abortion access funds at our sister affiliates PPMW and PPM, as well as independent abortion funds, like the DC Abortion Fund, Baltimore Abortion Fund, and Blue Ridge Abortion Fund. To learn more, read, “Five ways to stay engaged in the fight for reproductive freedom.
Tags: SCOTUS, abortion_care, EMTALA