The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted in 1986 to address the widespread practice of hospitals refusing to provide emergency medical care to uninsured, Black, or otherwise undesirable patients. It ensures that anyone with a medical emergency, regardless of their circumstances, will receive emergency care at a hospital emergency department.
EMTALA relies on emergency department physicians to determine, according to evidence-based standards, whether a medical emergency exists and how to handle it. The law also protects pregnant people experiencing labor, as hospitals had refused care for these people, and they and their newborns suffered grave injuries—and some died—as a result.
On April 24, the U.S. Supreme Court will hear arguments in a case that challenges EMTALA’s universal access rule. Idaho claims that its laws criminalizing abortion, with only an exception to save the life of the pregnant person, are not preempted by EMTALA. This case arises from the Supreme Court’s June 24, 2022, decision to overturn Roe v. Wade in Dobbs v. Jackson Women’s Health Organization.
The Dobbs decision has created a wildly uneven legal landscape across the states, with some states criminalizing abortion at the moment Roe was overturned and others enacting new laws restricting abortion access. In response to this widespread legal uncertainty, the Department of Health and Human Services issued guidance clarifying that, under EMTALA, hospitals are responsible for treating medical emergencies, including providing an abortion if that is the standard of care for a patient’s condition.
Idaho and other abortion-restrictive states claim they do not need to follow EMTALA when it comes to abortion. However, EMTALA is a national law that has had bipartisan support and exists for important reasons. Carve-outs would not stop with abortion care. EMTALA is a unique law protecting a right to emergency care in the U.S. If the Court allows states like Idaho to chip away at the protection it offers, it would be undermined for all Americans.
Healthcare providers are now afraid of states’ restrictive laws and whether they might lose their licenses, be criminally charged, or face steep fines for providing care that, in their learned view, is medically necessary. As a result, people needing emergency care are suffering. The media regularly publish stories about people being turned away while enduring obvious emergencies related to their pregnancies. In fact, patients like Jane Doe and others are suing over such harms. And the dangers extend beyond pregnancy. Some people with cancer, for example, are being denied necessary care after Dobbs.
The Supreme Court’s decision in this case will have a profound impact on the availability of emergency medical care in the United States. If the Court allows states to create exceptions to EMTALA, it would undermine this vital law and endanger universal access to care for all Americans.
