EMTALA-abortion debate heads to Supreme Court: 2 legal updates

The Emergency Medical Treatment and Labor Act has emerged as a pivotal issue in the abortion debate, as legal disputes unfold that could hold far-reaching implications for the country, The New York Times reported Jan. 18.

After the Supreme Court overturned Roe v. Wade in June 2022, the Biden administration issued guidance to hospitals clarifying that abortion is covered under EMTALA. The law requires hospitals to treat and stabilize all patients with emergency medical conditions. If a hospital is in a state that prohibits abortion by law and does not make exceptions for the health or life of a pregnant person, EMTALA preempts that state law, HHS said in its July 2022 guidance. 

Texas, Idaho and the federal government have been entangled in ongoing legal cases on how the decades-old federal law applies to abortion access. Texas and Idaho argue EMTALA does not preempt their state abortion bans and claim the law requires emergency departments to stabilize pregnant women and their unborn children. 

The latest on the two cases:

Idaho

The Justice Department filed a lawsuit in August 2022 to block Idaho's abortion ban from taking effect, claiming it violates EMTALA. Later that month, a federal judge temporarily blocked a portion of the law that would criminalize medical professionals who performed abortions in medical emergencies. On Jan. 5, the Supreme Court agreed to hear the case on an emergency basis and temporarily revived the blocked law, according to The New York Times. Arguments are scheduled for April. 

"The federal government has been wrong from day one," Idaho Attorney General Raúl Labrador said in a statement about the decision. "Federal law does not preempt Idaho's Defense of Life Act. In fact, EMTALA and Idaho's law share the same goal: to save the lives of all women and their unborn children."

President Joe Biden criticized the court's action, saying it allows "Idaho's extreme abortion ban to go back into effect and denies women critical emergency abortion care required by federal law," according to the Times.

Texas

Texas Attorney General Ken Paxton sued the Biden administration over HHS' guidance in August 2022, arguing EMTALA does not preempt state law. The same month, the federal government filed a lawsuit against Idaho to block the state's abortion ban, alleging it violates EMTALA. On Jan. 2, the U.S. Court of Appeals for the 5th Circuit ruled that Texas healthcare providers are not obligated to perform abortions under EMTALA.

The law "does not mandate any specific type of medical treatment, let alone abortion" and "does not govern the practice of medicine," the appeals court said. The court also determined that the Biden administration did not follow the proper rulemaking process when issuing its 2022 EMTALA guidance. 

Anti-abortion advocates celebrated the ruling, while the Biden administration said the decision would endanger the health and lives of Texas women, according to The Washington Post. The Justice Department will now decide whether to appeal the ruling to the Supreme Court.

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