Hospitals at Center of Next Supreme Court Abortion Battle

The Biden administration will go to the Supreme Court on Wednesday to defend one of its key efforts to protect abortion rights following the fall of Roe v. Wade.

At stake is whether a federal emergency care law passed 37 years ago trumps state laws that prohibit abortion in almost all circumstances.

The Justice Department says the law requires hospitals that receive Medicare funding to provide an abortion if necessary to stabilize an emergency room patient’s health, regardless of state abortion bans.

Conservatives say the government is trying to use the law to create a national abortion mandate for hospitals. They argue that federal law does not dictate the type of care people receive, only that they are stabilized.

This will be the second time in months that the Supreme Court has heard an argument on abortion after apparently returning the issue to the states, and the case represents the latest legal challenge that could reshape abortion access across the country.

Unlike a previous case involving the abortion drug mifepristone, this lawsuit has progressed largely under the radar. But it serves to further elevate abortion as an election year issue that Democrats want to put in the spotlight.

The case centers on a federal law known as EMTALA, or the Emergency Medical Treatment and Active Labor Act, which requires federally funded hospitals to provide stabilizing care to emergency room patients, regardless of their ability to pay.

The Biden administration invoked EMTALA in the wake of the Supreme Court ruling that overturned Roe v. Wade. The administration said state laws or mandates that employ a more restrictive definition of an emergency medical condition are preempted by federal law.

“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 necessary to prevent her death can allow her condition to deteriorate, putting her at risk of acute complications and long-term,” the Justice Department said in its summary.

Idaho’s abortion ban is one of the strictest in the country and offers a narrow exemption only to save the pregnant patient’s life. The Biden administration sued Idaho just weeks after Dobbs’ ruling.

A lower court quickly ruled in the administration’s favor and lifted Idaho’s abortion ban, but the White House has since lost several appeals.

In the latest setback for the administration, the Supreme Court, in an unsigned order, stayed lower court rulings that partially blocked Idaho’s abortion ban and agreed to take up the case before the lower courts had fully considered it on the merits. . Until the court decides the case later this summer, Idaho can continue to sue doctors who perform abortions in violation of state law.

Abortion rights advocates warn that if the court rules in Idaho, doctors will not be able to follow their best medical judgment.

“They want to provide the best care to their patients and help them get out of medical crises. But they are trapped in this web of cruel and incredibly unclear laws that make it impossible to act. So doctors are suffering along with their patients in these situations,” said Amy Myrick, senior staff attorney at the Center for Reproductive Rights.

Health care providers say state abortion laws contain too much uncertainty and do not protect them if they need to have an abortion. As a result, stories are becoming common about pregnant patients in medical distress who have been thrown out of hospitals or forced to wait in a parking lot until their lives are in danger.

Caitlin Gustafson, an obstetrician and gynecologist in Idaho, said the state’s abortion ban is driving doctors out of the state and creating a maternal care desert because many don’t want to be questioned in their medical decisions. That’s why EMTALA protection is critical, she said.

“It is unsustainable to force doctors to deviate from the standard of care, to ignore their training and medical judgment, just to respond to a political agenda that has nothing to do with the actual practice of medicine and the lives that lie ahead of us. . at risk,” Gustafson told reporters during a recent briefing.

“If you make standard medical care a crime when people in all kinds of difficult medical situations are present, especially in emergency situations, we will always see some kind of delay,” she added. “Because it is a criminalized service, doctors will naturally hesitate.”

But conservatives say doctors are being too cautious and argue that the abortion ban does not stop doctors from treating women with pregnancy complications.

“The Biden administration continues to say that women need to be at death’s door to receive care, and that is simply not true. Idaho law empowers doctors to make decisions in good faith in order to protect the mother’s life,” said John Bursch, vice president of appellate advocacy at the conservative legal group Alliance Defending Freedom (ADF), which is co- -Idaho lawyer on the case.

In short, Idaho argued that the text of EMTALA does not address abortion.

“EMTALA says nothing about abortion. Congress did not quietly mandate abortions it will not pay for, especially in a statute amended to protect the fetus of a pregnant mother,” wrote lawyers for Mike Moyle (R), Speaker of the Idaho House of Representatives.

ADF attorneys representing Idaho Attorney General Raúl R. Labrador (R), in a separate brief, similarly argued that EMTALA “does not require hospital emergency rooms to become abortion enclaves in violation of law state-owned”.