When President Ronald Reagan acted in 1986 to ensure that Americans couldn’t be denied care at emergency rooms, no one in their right mind thought they were creating a national abortion mandate. Yet that is the far-fetched claim Biden administration officials made Wednesday before the U.S. Supreme Court. In the case, Biden v. Idaho, the administration is seeking to override Idaho’s pro-life law and force emergency room doctors to perform abortions that are otherwise illegal in the state. Such an outcome, if granted, would allow the federal government to impose a national abortion mandate in the emergency rooms of all 50 states.
This case centers on Idaho’s Defense of Life Act. Like many pro-life state laws, Idaho’s law protects women and their unborn children, prohibiting abortion except when necessary to save the life of the mother. Some have mischaracterized this law as somehow leaving women medically vulnerable. But the truth is that it allows abortion when a woman faces a whole range of life-threatening conditions—including ectopic pregnancies and pre-eclampsia. Indeed, Biden officials have failed to identify a single case of Idaho’s law denying an abortion necessary to save the mother’s life. Yet the administration wants to impose its will on Idaho and turn emergency rooms into abortion clinics.
To do so, it is peddling a highly contorted and novel interpretation of the Emergency Medical Treatment and Active Labor Act (EMTALA). My organization, Alliance Defending Freedom, and the law firm Cooper & Kirk are assisting Idaho in defending its law before the Supreme Court. So, what does EMTALA actually say? For starters, it says nothing about abortion. It requires hospital emergency rooms to provide stabilizing care to patients in emergency situations, regardless of their ability to pay. And it does so without dictating medical standards or specific procedures. Those are, and always have been, explicitly left to the states.
The Medicare Act, which includes EMTALA, says that it ‘shall [not] be construed’ to interfere with ‘the practice of medicine or the manner in which medical services are provided.’ EMTALA recognizes that our nation of 50 states has wide diversity in medical regulations, on issues ranging from abortion to medical marijuana to organ transplants. No court has ever read the statute otherwise. Indeed, the United States has never interpreted EMTALA this way, until now. If anything, EMTALA is a pro-life law because it recognizes the importance of preserving both born and unborn life. Under EMTALA, emergency rooms are required to provide care to pregnant mothers and their ‘unborn child[ren],’ which are mentioned four times in the law. The goal of emergency care, after all, is to preserve life—not end it.
EMTALA is entirely consistent with Idaho’s Defense of Life Act. Twisting it to force Idaho emergency rooms to perform abortions, in violation of state law, is a lawless power grab by the administration. The underlying reality is that the Biden administration has refused to accept the fact that we are living in a post-Roe era, in which states now have the right to protect life. Ever since Roe was overturned, the administration has tried to undercut pro-life laws that reflect the will of the states and re-impose abortion on demand nationally.
It has issued sweeping mandates seeking to transform pharmacies into abortion drug dispensaries. It has denied conscience rights to doctors and hospitals who don’t want to be complicit in abortion. And it has loosened basic safeguards to allow dangerous abortion drugs to be shipped cross-country, threatening women’s health and safety and making it next to impossible for states to enforce their pro-life laws. This administration has proved willing to twist any federal law on the way to resurrecting a national abortion economy.
The Supreme Court has an opportunity in this case to reaffirm the true meaning of EMTALA and strengthen our federal system of government. The Court should uphold Idaho’s law and rebuke the administration for its lawlessness.
