emergency medical treatment and active labor act
SCOTUS Ruling on Emergency Abortion Care Called 'Dangerous Preview for What Could Come'
"If Trump is elected again, he will appoint even more justices who could uphold future abortion bans and endanger our fundamental freedoms for decades."
Reproductive rights advocates across the United States on Thursday were "hardly celebrating" the Supreme Court's one-sentence decision in a case regarding whether emergency departments can provide abortion care to people who have urgent pregnancy complications, and the court left open the possibility that such care could ultimately be banned.
In Moyle v. United States and Idaho v. United States, Idaho officials asked the court to intervene in an earlier decision by the U.S. Court of Appeals for the Ninth Circuit, which temporarily blocked the state's near-total abortion ban after the Biden administration argued it violated the Emergency Medical Treatment and Labor Act (EMTALA).
EMTALA requires hospital emergency departments that accept Medicare to provide "necessary stabilizing treatment" to all patients, and the Biden administration argued abortion care is included in that requirement and that federal law should override Idaho's abortion ban.
But a day after a draft decision was mistakenly posted on the Supreme Court's website, the release of the ruling confirmed that the court had dismissed the case without ruling on its merits and was sending it back to the lower courts.
The decision temporarily restores Idaho medical providers' ability to provide emergency abortions, but as the Center for Reproductive Rights (CRR) said, "it still leaves millions of people in states with abortion bans vulnerable."
"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," said the organization. "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."
Nancy Northrup, CRR's president and CEO, explained that the court had "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."
"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential health care, is a dangerous preview for what could come."
"The Supreme Court created this health care crisis by overturning Roe v. Wade and should have decided the issue," said Northrup. "Women with dire pregnancy complications and the hospital staff who care for them need clarity right now."
Two of the court's liberal members, Justices Ketanji Brown Jackson and Elena Kagan, agreed with Northrup and other advocates in a dissenting opinion that the panel should have ruled on the merits of the case.
Kagan wrote that EMTALA "unambiguously requires" hospitals to provide emergency treatment including abortion care, while Jackson said Idaho's ban on nearly all abortions created a "monthslong catastrophe" when it was in effect.
"Idaho physicians were forced to step back and watch as their patients suffered, or arrange for their patients to be airlifted out," Jackson wrote of the state's law, which bans abortions expect in cases of rape, incest, certain nonviable pregnancies, and those in which a pregnant patient's life is at risk. "There is simply no good reason not to resolve this conflict now."
"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," Jackson continued.
Right-wing Justice Samuel Alito also objected to the court's refusal to rule on the case's merits, but said Idaho's ban should apply to abortion care, arguing that EMTALA requires hospitals "to treat, not abort, an 'unborn child.'"
The American Civil Liberties Union (ACLU) said Alito's dissent, joined by Justices Neil Gorsuch and Clarence Thomas, "will embolden those who are pursuing a strategy to give legal rights to embryos and fetuses that will override the rights of the pregnant person and ban not only abortion, but other forms of reproductive health care like fertility treatment and birth control as well."
With the official release of the ruling, said Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project, "it is now clear that the Supreme Court had the opportunity to hold once and for all that every pregnant person in this country is entitled to the emergency care they need to protect their health and lives, and it failed to do so."
"The court's refusal to clearly affirm the rights of all pregnant people to emergency abortion care, and put an unequivocal end to extremist attacks by anti-abortion politicians on this essential health care, is a dangerous preview for what could come," said Kolbi-Molinas. "This fight is far from over–anti-abortion politicians are trying to ban abortion in all 50 states, including in emergencies. These extremist politicians went all the way to the Supreme Court for the right to put doctors in jail for providing life-and health-saving emergency abortion care, and they will do it again, if we let them."
Since Roe v. Wade was overturned by the Supreme Court's right-wing majority in June 2022, a number of cases from states with abortion bans and restrictions have garnered national attention, with women speaking out about being denied abortion care when they were experiencing severe, sometimes life-threatening, complications or had learned their fetuses had fatal abnormalities.
Despite those cases, Indivisible co-executive director Leah Greenberg said Thursday's ruling leaves an "open question" on whether or not emergency rooms can "just let women die instead of treating them."
Mini Timmaraju, president and CEO of Reproductive Freedom for All, said the ruling should "serve as a reminder of what's at stake this November."
"While the Biden administration is fighting tooth and nail to ensure people can get the emergency abortion care they need, anti-abortion extremists will continue to do whatever they can to stop them," said Timmaraju. "We must secure reproductive freedom majorities in Congress and send President Biden back to the White House to restore the federal right to abortion and expand access for all."
Judicial reform group Stand Up America pointed to the Supreme Court Voter campaign it launched Monday, aiming to mobilize voters "on the impact the next president will have on the future of the U.S. Supreme Court."
"The Roberts court's decision to take up Idaho v. United States endangered the lives of pregnant Americans and did irreparable harm," said Stand Up America executive director Christina Harvey. "By staying the lower court's decision, the Supreme Court allowed Idaho's extreme abortion ban to take effect while it considered the case. In the meantime, for months, the lives of women in Idaho were callously put at risk, with multiple patients having to be medevacked out of the state to receive care.
"By overturning Roe, the MAGA majority on the Court opened the door to extreme abortion bans like the one in Idaho," she added. "If Trump is elected again, he will appoint even more justices who could uphold future abortion bans and endanger our fundamental freedoms for decades."
On Dobbs Anniversary, Advocates Mark 'Two Years of Outrage' and Rally for Abortion Rights
"Women shouldn't have to wait to see if the Supreme Court will decide if they can get life-saving healthcare in all states," said one campaigner of a pending ruling on emergency abortion care.
Exactly two years after the right-wing majority on the U.S. Supreme Court cleared the way for nearly half of U.S. states so far to ban or severely restrict abortion care, reproductive justice advocates convened in Washington, D.C. on Monday to mark the anniversary and speak out ahead of another ruling that could have deadly consequences for pregnant people across the country.
As the country marks two years since the Dobbs v. Jackson Women's Health Organization decision, which overturned the 1973 ruling that affirmed Americans have the constitutional right to obtain abortions, advocates expressed a need to acknowledge the harm caused by Dobbs while also looking ahead to the pro-forced pregnancy movement's desire to further restrict reproductive rights.
"Women shouldn't have to wait to see if the Supreme Court will decide if they can get lifesaving healthcare in all states. This is a direct result of the disastrous Dobbs decision two years ago," said Margaret Viggiani, a campaigner who joined the National Mobilization for Reproductive Justice Monday at the rally and press conference in the nation's capital.
The decision expected by the end of the month is Idaho and Moyle, et al. v. United States, which stems from Idaho's near-total ban on abortion care. In August 2022, a federal judge barred the state from enforcing the ban due to its conflict with the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospital emergency departments that accept Medicare to provide treatment to any patient with an emergency medical condition, including people facing pregnancy complications who need abortions.
Since the Dobbs decision was handed down two years ago, the real-world implications of abortion bans have become clear to many Americans as advocates have shared the stories of women like Kate Cox, who was forced to flee Texas to obtain abortion care when she learned her fetus had a fatal condition; Anya Cook and Shanae Smith-Cunningham, who faced the dangerous condition preterm prelabor rupture of the membranes (PPROM) but were unable to receive the standard of care recognized by obstetricians under Florida's 15-week abortion ban; and Amanda Zurawski, who was forced to become "sick enough" from a rapidly spreading infection before doctors would provide an abortion in Texas.
The life-threatening experiences of those women and others, said Human Rights Watch on Monday, exemplify "two years of outrage" since Roe v. Wade was overturned.
"The Supreme Court's revocation of national protections for abortion access, and the restrictive state laws that followed, means the United States is violating the rights to life, health, privacy, nondiscrimination, and freedom from cruel, inhuman, or degrading treatment, among others," said the global organization. "Access to legal abortion is essential to achieve gender equality. Every year, more leaders, legislatures, and courts abroad understand this. U.S. states should repeal restrictions on abortion, enshrine access to abortion in state constitutions, and advance the global trend of recognizing women's autonomy."
Last month, polling from the Pew Research Center suggested the stories of Zurawski, Cox, and other women have struck a chord with many Americans; more than 60% said they believed abortion should be legal in all or most cases, a four-percentage-point jump from 2021.
At the rally in Washington on Monday, reproductive rights advocates joined union members in calling on the American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) to convene a national labor conference for reproductive justice, arguing that the largest federation of unions in the U.S. "is in the most powerful position to mobilize thousands of workers in defense of this fundamental right."
With 1 in 3 women of reproductive age in the U.S. now living in states with abortion bans, Reproductive Justice Maryland executive director Jakeya Johnson said at the rally that the Dobbs decision has "disproportionately impacted those who are marginalized and struggling to make ends meet."
"Today we're here to say, enough is enough," said Johnson. "The power of our collective voices cannot be underestimated. When labor and reproductive justice movements join forces, we are unstoppable. We're a force for change, and our strength lies in our numbers."
Meanwhile, groups including Reproductive Freedom for All, the Center for Reproductive Rights, the National Women's Law Center, and Planned Parenthood Federation of America marked the Dobbs anniversary by launching their Abortion Access Now campaign, pledging a $100 million investment to advance abortion rights and access through lobbying, grassroots organizing, public education, and other communications strategies.
"We envision a future where abortion, and all sexual and reproductive healthcare, is not only legal but also accessible, affordable, and free from stigma or fear," said the campaign. "This campaign is committed to building and leading a broad, inclusive vision for abortion access, ensuring everyone can make fundamental decisions about their health and bodies with dignity and support. Together, we will secure the freedom to control our own bodies and care for ourselves, our families, and our communities."
A separate campaign launched by the judicial reform group Stand Up America similarly marked the Dobbs anniversary and focused on warning U.S. voters that a victory by presumptive Republican presidential nominee Donald Trump in November would "ensure MAGA control of the [U.S. Supreme] Court for decades to come," with an impact on abortion rights and other crucial issues.
"We can't let that happen," said executive director Christina Harvey.
'All States Will Be Impacted' by US Supreme Court's Idaho Abortion Case
"At its core, this Supreme Court decision will reflect who we are becoming as a society."
Less than a month after a key abortion pill hearing, the right-wing U.S. Supreme Court on Wednesday heard arguments for another major reproductive rights case—one out of Idaho that could impact healthcare for pregnant women and people across the country.
Idaho is among the over 20 states that have tightened restrictions on abortion since the high court's right-wing majority reversedRoe v. Wade nearly two years ago with Dobbs v. Jackson Women's Health Organization. Since August 2022, abortions have been banned in the state except for reported cases of rape or incest or when "necessary to prevent the death" of the pregnant person.
"If the court does not uphold emergency abortion care protections, this ruling will have devastating consequences for pregnant people."
Before Idaho's near-total ban on abortion took effect, U.S. District Judge B. Lynn Winmill barred enforcement of it to the extent that it conflicts with the Emergency Medical Treatment and Labor Act (EMTALA), a 1986 federal law requiring emergency departments that accept Medicare to provide "necessary stabilizing treatment" to any patient with an emergency medical condition.
The Biden administration argues that such care includes abortion; Idaho's Republican policymakers—backed by the far-right Christian Alliance Defending Freedom—disagree. The U.S. Supreme Court in January paused Winmill's order and agreed to hear arguments in Moyle v. United States and Idaho v. United States.
As The New York Timesreported Wednesday:
In a lively argument, questions by the justices suggested a divide along ideological lines, as well as a possible split by gender on the court. Justice Amy Coney Barrett, a conservative, appeared skeptical that Idaho's law, which bars doctors from providing abortions unless a woman's life is in danger or in specific nonviable pregnancies, superseded the federal law.
The argument also raised a broader question about whether some of the conservative justices, particularly Justice Samuel A. Alito Jr., may be prepared to embrace language of fetal personhood, that is, the notion that a fetus would have the same rights as a pregnant woman.
Also noting Barrett's apparent alignment with the three liberal women on the court, Law Dork's Chris Geidner predicted "it comes down to" Chief Justice John Roberts and fellow right-winger Brett Kavanaugh.
"Already, we see women miscarrying and giving birth to stillborn infants in restrooms and in their cars after hospitals have turned them away, and medical professionals put in impossible positions by extremist lawmakers," said MomsRising executive director and CEO Kristin Rowe-Finkbeiner, citing Associated Pressreporting from last week.
"Of all the horrors SCOTUS unleashed with its appalling, dangerous, massively unpopular ruling overturning Roe v. Wade, the threat that pregnant people—most of whom are moms—will be denied emergency medical care is among the worst," she asserted. "An adverse ruling in this case will mean emergency rooms can deny urgently needed care to people experiencing serious pregnancy complications that can destroy their health, end their fertility, and take their lives."
Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project, similarly stressed that under a decision that favors the Idaho GOP, "pregnant people will suffer severe, life-altering health consequences, and even death."
"We're already seeing the devastating impact of this case play out in Idaho, where medical evacuations to transport patients to other states for the care they need have dramatically spiked since the Supreme Court allowed state politicians to block emergency abortion care," she noted.
The has also been an exodus of healthcare providers. Pointing out that those who violate Idaho's ban face five years in prison, The Guardianreported Wednesday that "between 2022, when Roe was overturned, and 2023, about 50 OB-GYNs moved out of the state."
As Republican lawmakers in various states have ramped up attacks on reproductive freedom since Dobbs, states that still allow abortions have seen an influx of "healthcare refugees." A Planned Parenthood spokesperson confirmed in January that about 30% of its abortion patients in Nevada—which borders Idaho—are from other states.
"With several of Nevada's bordering states enforcing abortion bans, pushing many people seeking care to our state, we've seen firsthand the devastation that anti-abortion policies are already wreaking,"
Reproductive Freedom for All director of Nevada campaigns Denise Lopez said Tuesday. "The Supreme Court must not allow us to spiral further into this healthcare crisis."
If the high court rules in favor of Idaho's Republican lawmakers, she warned, "all states will be impacted, even in places like Nevada with more than 4 in 5 voters supporting reproductive freedom."
Destiny Lopez, acting co-CEO of the Guttmacher Institute, declared that "at its core, this Supreme Court decision will reflect who we are becoming as a society: Are we okay with requiring pregnant individuals who face severe complications to suffer life-threatening health consequences rather than granting them access to abortion? Are we okay with forcing doctors to choose between violating federal law by not providing emergency abortion care or violating state law if they do?"
"If the court does not uphold emergency abortion care protections, this ruling will have devastating consequences for pregnant people—particularly Black and Brown folks, immigrants, people with lower incomes, those without health insurance, and LGBTQ+ communities—while further emboldening extremists," she emphasized.
Arguments in the case have sparked multiple demonstrations, from a weekend rally in Boise, Idaho to a Wednesday gathering outside the U.S. Supreme Court in Washington, D.C., where Women's March organized a die-in to highlight the potential consequences of the forthcoming ruling.
"It's a horrifying time to be someone who needs critical abortion care in America right now," said Women's March executive director Rachel O'Leary Carmona. "The GOP is chipping away at women's bodily autonomy and livelihoods one illegitimate court case at a time—from fast-tracking a case on the authorization of a medication that's been safely administered for decades last month, to now bringing the fate of emergency abortion care to a Supreme Court captured by their radical, anti-choice agenda."
"We know what these cases really are: They're part of a series of efforts by Christian nationalist politicians to do anything they can to control women's bodies and cut back women's decisions about their healthcare, their family planning, and their lives," she added.
Similar warnings about far-right Christian nationalist attacks on a range of rights have dominated political contests this cycle—including the race for the White House. In November, Democratic President Joe Biden, who supports access to abortion care, is set to face former Republican President Donald Trump, who brags about appointing three of the six justices who reversed Roe.
The case has renewed arguments for considering changes to the country's top court, which over the past few years has not only seen plummeting levels of public trust but also been rocked by repeated ethics scandals.
"Idaho's abortion ban is a direct consequence of the court's radical decision to overturn Roe v. Wade and allow partisan state legislatures to determine Americans' access to abortion care," said Stand Up America managing director of policy and political affairs Brett Edkins. "If the Supreme Court once again sides with anti-abortion extremists, it will be further proof that this court is radically out of touch with the American people and must be reformed."