Supreme Court Refuses to Say Whether EMTALA Requires Hospitals to Provide Stabilizing Abortions

06.27.24 (PRESS RELEASE) — Just one day after accidentally posting the unfinished opinion to their website, the U.S. Supreme Court ruled today to reinstate a lower court injunction that blocked Idaho’s abortion ban to the extent it is in conflict with the Emergency Medical Treatment & Labor Act (EMTALA)—a longstanding federal law requiring hospitals to provide stabilizing treatment to all patients with emergency medical conditions.

However, even with this injunction still in place, hospitals in the fourteen states that completely ban abortion, as well as many others with bans and restrictions, have shown they are afraid to provide emergency abortions due to the risk of severe criminal penalties under their states’ vague and confusing abortion bans. While today’s ruling does not eliminate the bare minimum of federal protections for pregnant people needing emergency abortion care, it still leaves millions of people in states with abortion bans vulnerable. For patients needing abortion care in those states, they will continue to largely rely on their state’s medical exceptions, which often do not work in practice, as we are seeing play out in states across the country, including in the experiences of dozens of patients represented by the Center for Reproductive Rights.

“We are relieved for the moment, but hardly celebrating. The Court kicked the can down the road on whether states with abortion bans can override the federal law requirement that hospitals must provide abortion care to patients in the throes of life-threatening pregnancy complications,” said Nancy Northup, president and CEO of the Center for Reproductive Rights. “The Supreme Court created this health care crisis by overturning Roe v. Wade and should have decided the issue. Women with dire pregnancy complications and the hospital staff who care for them need clarity right now.”

As Justice Ketanji Brown Jackson wrote in her concurrence, “Today’s decision is not a victory for pregnant patients in Idaho. It is delay. While this court dawdles and the country waits, pregnant people experiencing emergency medical conditions remain in a precarious position, as their doctors are kept in the dark about what the law requires.”

Earlier this year, The Center for Reproductive Rights filed an amicus brief in this case in the Supreme Court on behalf of patients who were denied critical care for pregnancy complications. In the opinion, Justice Jackson specifically names this brief as evidence of why State medical exceptions are not enough to protect pregnant people.

A case out of Texas raising the same issues, or this same case, may be back before the Supreme Court as early as next term.

The case advanced to the Supreme Court after the Department of Justice (DOJ) argued that Idaho’s total abortion ban conflicted with EMTALA. While a lower court agreed with DOJ in August 2022 and blocked the ban as it applies to patients who fall under EMTALA, the Supreme Court lifted that injunction in January 2024 and reinstated the abortion ban in full while they proceeded with the full hearing.

Fourteen states currently have total abortion bans, and many others ban abortion as early as six weeks of pregnancy. While most of those bans have very narrow exceptions for the life of the pregnant patient, the exceptions are not workable in practice. Doctors are unclear who qualifies for the exceptions, and they are terrified to provide any abortions as they face years in prison for violating the bans. The Center has filed lawsuits in Idaho, Texas, Tennessee, and North Dakota on behalf of physicians and women denied abortions despite severe pregnancy complications.  

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