WASHINGTON (AP) – USA Federal Supreme Court did not resolve the debate on whether federal law requires hospitals to stabilize pregnant patients with emergency abortions Wednesday, despite saying Idaho hospitals can provide abortions in medical emergencies even with the state’s restrictions.
The court handed down a 6-3 procedural ruling that left important questions still outstanding about whether states can prohibit doctors from performing emergency abortions that save a woman from serious infection or organ loss.
Legal and health experts say Thursday’s order that divided Supreme Court conservatives does nothing to protect pregnant women in other states with strict abortion bans, where state bans could conflict with a federal law that the Biden administration argues that it requires emergency abortions.
“The ruling the Supreme Court released this morning sheds no light on how this conflict will or should be resolved,” said Joanne Rosen, co-director of the Johns Hopkins Center for Law and Public Health.
Here’s a look at emergency abortions in the U.S., the federal law that the Biden administration says requires hospitals to provide them, and why the debate over the legality of these abortions is far from resolved.
How often does pregnancy threaten a woman’s health?
Every year, about 50,000 women in the U.S. develop life-threatening complications during pregnancy, including sepsis, hemorrhage or loss of reproductive organs.
In rare cases with some of these complications, doctors may terminate the pregnancy, especially when there is no chance of the fetus surviving. For example, if a woman’s water breaks during the second trimester, a condition known as premature rupture of membranes, the fetus may not be viable and continuing the pregnancy means the patient may be at risk of developing sepsis, a infection that can be deadly.
Sepsis and blood loss are some of the most common causes of maternal deaths in the US. Last year, nearly 700 women died during pregnancy, during childbirth or immediately after giving birth, according to the Centers for Disease Control and Prevention.
Idaho doctors say at least a half-dozen pregnant women have been airlifted to receive emergency treatment in other states since January, when strict abortion bans, which allow doctors to perform abortions if the woman’s life but not your health, is at risk, has come into force.
What protections does federal law offer pregnant patients in emergency rooms?
The law, called t Emergency Medical Treatment and Active Labor Act or “EMTALA,” requires emergency rooms to offer a medical exam if you come to the facility. The law applies to almost all emergency rooms – any that accept Medicare funding.
These emergency rooms are required to stabilize patients if they have a medical emergency before discharging them or transferring them to another hospital. And if the emergency room does not have the resources or staff to adequately treat the patient, team members will be required to arrange a medical transfer to another hospital after confirming that the facility can accept the patient.
Hospitals that violate federal law risk Medicare funding and can face heavy fines from the federal government.
Why are Idaho and the US Supreme Court involved?
Since the Supreme Court annulled the constitutional right to abortionDemocrat President Joe BidenEMTALA management has told hospitals that abortion is considered stabilizing care that EMTALA requires.
The Biden administration sued Idaho about the strict abortion ban, which only allowed exceptions to save a woman’s life, arguing that the law prevented emergency room doctors from offering an abortion if a woman needed it in a medical emergency.
Idaho lawyers argued that there is no conflict between state and federal laws, since Idaho allows doctors to perform an abortion if the woman’s life is at risk.
The justices on Thursday reinstated a lower court order that allowed hospitals in Idaho to perform emergency abortions to protect the health of a pregnant patient, saying the U.S. Supreme Court got involved in the case too quickly.
What does the ruling mean for other states with strict abortion bans?
Very little – for now. The U.S. attorney general said several other states have abortion bans so strict they may conflict with federal law. But the Supreme Court did not directly address possible conflicts between the laws in its decision.
Texas, for example, is suing the federal government over its guidance that hospitals must provide abortions to women who require abortions in medical emergencies.
The 5th Circuit Court of Appeals ruled against the administration in January, concluding that EMTALA does not require Texas hospitals to provide abortions in emergency rooms. The Department of Justice appealed that decision.
“The availability of emergency medical abortions in Texas will continue to be extraordinarily limited,” said Rosen of Johns Hopkins.
Doctors in states like Florida and Missouri have said they have been afraid to treat abortion patients since the bans were enacted. The federal government also found that hospitals in those states violated EMTALA in some cases where pregnant patients were turned away or not treated properly.
On Thursday, in a concurring opinion that also expressed dissent, Justice Ketanji Brown Jackson argued that the court should have resolved the debate for both doctors and patients.
“As long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas and elsewhere will pay the price,” Jackson said.
Could the Supreme Court review this issue?
Yes. With the Idaho case being sent back to the trial court and the Texas case on appeal, it’s an issue that could return to the Supreme Court soon.
And six judges have already given their hand.
The court’s three liberal justices — Jackson, Elena Kagan and Sonia Sotomayor — said in their ruling that federal law says women should be able to have abortions in medical emergencies, despite state prohibitions. Three conservative justices — Samuel Alito, Neil Gorsuch and Clarence Thomas — disagreed that the federal law was so specific and pointed out that it was written in a way that requires hospitals to treat the “unborn child.”
That leaves Justices Amy Coney Barrett, Brett Kavanaugh and John Roberts up for grabs.
“They don’t want to make a decision right now,” said Rob Gatter, a law professor at St. Louis University who specializes in health policy. “That’s a recipe for saying: someone else deals with it first, you fail first, you try first, let me see how it goes.”
