Pro-choice and pro-life protestors gathered outside the Supreme Court on Wednesday, April 24, as the justices heard another contentious abortion case in the wake of the Dobbs decision. The justices are going to decide whether the Emergency Medical Treatment and Labor Act (EMTALA) preempts state laws that “protect human life and prohibit abortions,” like Idaho’s Defense of Life Act.
EMTALA requires hospitals that receive Medicare funds to provide treatment, including abortions, for emergency conditions regardless of the patient’s ability to pay. Idaho outlawed abortion with exceptions for rape, incest or life of the mother, but not the health of the mother.
“EMTALA works precisely because states regulate the practice of medicine,” Joshua Turner, who argued the case for the Idaho Attorney General’s Office, said in his opening statement. “And nothing in EMTALA requires doctors to ignore the scope of their license and offer medical treatments that violate state law.”
The crux of this case is: What happens if a woman’s health is at risk, but not her life?
“If a woman comes to an emergency room facing a grave threat to her health, but she isn’t yet facing death, doctors either have to delay treatment and allow her condition to materially deteriorate, or they’re airlifting her out of the state so she can get the emergency care that she needs,” U.S. Solicitor General Elizabeth Prelogar told the justices. “That’s untenable and EMTALA does not countenance it.”
Justice Elena Kagan and other female justices seemed to side with Prelogar based on their questions and statements.
Kagan gave an example of an emergency in which a woman’s life is not at risk.
“She’s going to lose her reproductive organs,” Kagan said. “She’s going to lose the ability to have children in the future, unless an abortion takes place. Now that’s the category of cases in which EMTALA says, ‘My gosh, of course, the abortion is necessary to assure that no material deterioration occurs.’ And yet Idaho says, ‘Sorry, no abortion here.”
The justices are taking into account multiple constitutional provisions.
First is preemption and the supremacy clause, which according Cornell Law School, mean federal law displaces or preempts state law when the two conflict.
There’s also the spending clause that allows Congress to give states money for programs, like Medicare, but requires or prohibits certain actions by the recipient as a condition of receiving that money.
“How can you impose restrictions on what Idaho can criminalize, simply because hospitals in Idaho have chosen to participate in Medicare?” Justice Samuel Alito asked Prelogar.
“In a situation where Congress has enacted law it has full force and effect under the supremacy clause, and what a state can’t do is interpose its own law as a direct obstacle to being able to fulfill the federal funding conditions,” Prelogar responded.
A decision in this case should be released by June.
