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What is EMTALA, the federal law at the center of abortion fight?

FILE - Demonstrators march and gather near the Texas state Capitol in Austin following the Supreme Court's decision to overturn Roe v. Wade on June 24, 2022. A federal judge in Texas issued a ruling on Tuesday, Aug. 23, 2022, temporarily blocking the federal government from enforcing guidance against the state that requires hospitals to provide abortion services if the life of the mother is at risk. (AP Photo/Eric Gay, File)

(NewsNation) — Later this year, the U.S. Supreme Court will weigh in on a legal conflict over state abortion bans and protections granted by the federal Emergency Medical Treatment and Labor Act.

The conflict arose out of Idaho’s near-total ban on abortion, which took effect after the Supreme Court ruled to overturn Roe v. Wade in June 2022. Roe, decided in the 1970s, granted women a constitutional right to an abortion and has steadily been chipped away at in the proceeding decades.


Its total reversal led to a slew of conservative states enacting abortion bans, including Idaho. The Justice Department sued, arguing the ban violated the federal Emergency Medical Treatment and Labor Act, or EMTALA.

Here’s a look at the federal law.

What is EMTALA?

Enacted in 1986, the law requires emergency rooms to provide stabilizing treatment for anyone who arrives at the emergency room, regardless of their ability to pay. It applies to any hospital that receives Medicare funds, according to the Centers for Medicare & Medicaid Services.

If a facility cannot provide the care necessary to stabilize a patient, they must be transferred to another hospital. Hospitals may not delay in examining or treating someone, including to ask about their ability to pay or health insurance status.

The law is intended to prevent “patient dumping,” the National Law Review explained. It was largely unfunded at the time of its enactment but was later made a priority in the early 2000s when revisions were made in 2005 and 2006.

Patients can sue if they believe they have been denied proper emergency medical treatment.

What have courts ruled?

The Idaho case began in 2022 when the Biden administration sued over the ban, arguing it violated EMTALA.

U.S. District Judge B. Lynn Winmill agreed with the administration in a ruling that was appealed to the 9th Circuit. A three-judge panel there allowed the abortion ban to take effect, but a larger contingent of 9th Circuit judges threw out the panel’s ruling and set arguments in the case for late January.

Idaho appealed to the Supreme Court, which stayed the 9th Circuit decision, took up the case and is allowing the ban to remain in effect until it renders a decision. The justices will hear oral arguments in the case in April.

A legal back-and-forth has played out in Texas, too. In a separate case there, a district judge sided with the state after it was sued over its own abortion restrictions. The initial ruling was appealed but upheld by a federal appeals court.

A 5th Circuit panel sided with Texas, saying the language in the 1986 law requires hospitals to stabilize the pregnant woman and her fetus.

“We agree with the district court that EMTALA does not provide an unqualified right for the pregnant mother to abort her child especially when EMTALA imposes equal stabilization obligations,” said the opinion written by Judge Kurt Engelhardt.

What is the government’s argument?

The Biden administration argues EMTALA requires health care providers to perform abortions for emergency room patients when needed to treat an emergency medical condition, even if doing so might conflict with a state’s abortion restrictions.

Those conditions include severe bleeding, preeclampsia and certain pregnancy-related infections.

“For certain medical emergencies, abortion care is the necessary stabilizing treatment,” Solicitor General Elizabeth Prelogar wrote in an administration filing at the Supreme Court.

What are the states’ arguments?

Idaho argues the administration was misusing the law intended to prevent hospitals from dumping patients and imposing “a federal abortion mandate” on states. “EMTALA says nothing about abortion,” Idaho Attorney General Raul Labrador told the Supreme Court in a brief.

In Texas, opponents of the federal guidance said state law already allows abortions to save the life of the mother but that the federal guidance went too far, calling for abortions when an emergency condition is not present and eliminating obligations to treat the unborn child.

In the Texas case, a federal appeals court based in New Orleans affirmed a previous ruling by U.S. District Judge James Wesley Hendrix, who wrote that adopting the administration’s view would force physicians to place the health of a pregnant person over that of the fetus or embryo even though EMTALA “is silent as to abortion.”

The Associated Press contributed to this report.