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Texas, Idaho abortion bans challenge federal emergency treatment law

FILE - An attendee at Planned Parenthood's Bans Off Our Bodies rally for abortion rights holds a sign reading "Idaho the women as property state" outside of the Idaho Statehouse in downtown Boise, Idaho, on May 14, 2022. A new Idaho organization says it will ask voters to restore abortion access and other reproductive health care rights in the state after lawmakers let a second legislative session end without modifying strict abortion bans that have been blamed for a recent exodus of health care providers. . (Sarah A. Miller/Idaho Statesman via AP, File)

(NewsNation) — For decades, American hospitals have operated under a federal law requiring them to treat any patient having an emergency. Now, some conservative states that want a nearly complete abortion ban are putting this in jeopardy.

The Emergency Medical Treatment and Labor Act (EMTALA) requires that hospitals treat and stabilize anyone who has a medical emergency, regardless of their insurance status or ability to pay. This can include performing abortions in some cases.


The Biden administration has sued Idaho, saying the state’s abortion ban violates EMTALA for having too-narrow exceptions that don’t allow doctors to perform abortions if needed to stabilize a patient.

Meanwhile, Texas is suing the Biden administration, saying it is using EMTALA as an end-run around state abortion bans to “mandate that every hospital and emergency-room physician perform abortions.”

EMTALA defines an emergency medical condition as anything severe enough where not providing immediate medical attention could place the health of the patient — “or with respect to a pregnant woman, the health of the woman or her unborn child” — in serious jeopardy, or cause serious impairment to bodily functions, organs or parts.

A pregnant woman who is having contractions qualifies as having an emergency medical condition if there isn’t enough time to safely transfer her or if transferring her would threaten her or the pregnancy.

The U.S. Supreme Court will hear arguments about the Idaho case on April 24. The ruling is expected to impact the Texas case, as well as the future of both state-level abortion bans and national standards of emergency medicine.

“Nobody was thinking about EMTALA,” when Roe v. Wade was overturned, said Sara Rosenbaum, a professor emerita at the Milken School of Public Health at George Washington University.

“Except for the handful of us who are really, really steeped in EMTALA, we knew the day would come when the states’ standards would come into direct conflict with EMTALA,” Rosenbaum said. “We knew we’d be in exactly the position we’re in now.”

Before EMALTA, private hospitals often turned away patients who couldn’t pay, transferring them to public hospitals even if they were in an emergency situation.

In 1985, Dr. Ron Anderson, CEO of Parkland Memorial Hospital, pushed Texas legislators to pass the nation’s first anti-patient dumping law, requiring private hospitals to treat medical emergencies regardless of a patient’s ability to pay. Soon after, Congress followed in Texas’ footsteps and EMTALA was born the next year.

When Roe v. Wade was overturned in 2022, the Biden administration issued guidance to hospitals, reminding them if a doctor believes an abortion is necessary to stabilize a patient’s emergency medical condition, it must be performed.

“When a state law prohibits abortion and does not include an exception for the life of the pregnant person — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted,” the Biden administration said.

Now, Texas is suing the Biden administration for this guidance saying it was an effort to “force hospitals and doctors to commit crimes” and “transform every emergency room in the country into a walk-in abortion clinic.”

The future of the Texas case will likely be decided after the Supreme Court hears arguments in Idaho’s EMTALA case later this month. That case focuses on the state’s abortion ban, which was temporarily blocked from going into effect after the DOJ sued for it’s conflict with EMTALA.