Skip to content Skip to footer

US Supreme Court Considers Whether Hospitals Must Provide Emergency Abortions

“If these extreme politicians succeed, doctors will be forced to withhold critical care from their patients.”

Pro-abortion activists rally for "reproductive rights and emergency abortion care" outside the US Supreme Court as it hears arguments in the Moyle v. United States case, in Washington, DC, on April 24, 2024.

On Wednesday, the Supreme Court heard oral arguments in a decisive abortion rights case regarding whether hospitals are obligated to provide abortions in emergency situations under federal law, even in states where abortion is prohibited.

“Anti-abortion politicians have brought this case to the nation’s highest court to challenge long-standing federal protections for emergency care abortion care,” Alexa Kolbi-Molinas, deputy director of the ACLU Reproductive Freedom Project, said in a statement. “If these extreme politicians succeed, doctors will be forced to withhold critical care from their patients, and pregnant people will suffer severe, life-altering health consequences, and even death.”

In response to Dobbs, President Joe Biden released an executive order in July 2022 aimed at safeguarding access to reproductive health care. The Department of Health and Human Services (HHS) then issued a guidance clarifying that abortion services are encompassed within emergency medical care protected by the Emergency Medical Treatment and Active Labor Act (EMTALA). EMTALA, which was passed in 1986, stipulates that hospitals that receive federal funding are required to provide emergency services to all patients arriving at their facilities.

“Under the law, no matter where you live, women have the right to emergency care — including abortion care,” said HHS Secretary Xavier Becerra in July 2022. “Today, in no uncertain terms, we are reinforcing that we expect providers to continue offering these services, and that federal law preempts state abortion bans when needed for emergency care. Protecting both patients and providers is a top priority, particularly in this moment.”

Since the constitutional right to an abortion was reversed by Dobbs in 2022, 14 states have completely banned abortion, with Arizona on the verge of becoming the 15th. Additionally, numerous states, including Florida, have restricted abortion access as early as six weeks into pregnancy.

In August 2022, the Department of Justice (DOJ) filed a lawsuit claiming that Idaho’s Defense of Life Act was overridden by EMTALA under the Supremacy Clause of the United States Constitution, which stipulates that federal law takes precedence over state law in specific domains. A district court ruled in favor of the DOJ, determining that Idaho’s abortion ban violated EMTALA, and partially halted the implementation of the law. In September, a three-judge panel composed of Trump-appointed judges from the 9th U.S. Circuit Court of Appeals permitted Idaho to enforce its ban. However, in November, the full 9th Circuit overturned the panel’s decision, granting the DOJ’s request to halt the law while the appeal is ongoing.

“Federal law is clear: patients have the right to stabilizing hospital emergency room care no matter where they live,” Becerra said in a statement in August 2022. “Women should not have to be near death to get care. The Department of Health and Human Services will continue its work with the Department of Justice to enforce federal law protecting access to health care, including abortions.”

Idaho, represented by the Alliance Defending Freedom — an organization designated as a hate group by the Southern Poverty Law Center — appealed to the Supreme Court, aiming to overturn this decision and implement the full abortion ban. On January 5, the Court halted the lower-court order that blocked Idaho from enforcing its abortion ban, allowing the ban to be fully implemented while the Court reviews the state’s appeal.

While state abortion bans often include “exceptions” for life-threatening pregnancy complications, many hospitals have refused to provide abortion care in emergencies out of fear of being prosecuted. Not only has this resulted in patients being denied care, with at least one person being forced to miscarry in an emergency room restroom, it has also forced doctors to resort to unnecessary and risky procedures to avoid potential legal repercussions.

For example, Idaho’s Defense of Life Act lacks a provision allowing abortion as stabilizing care for an emergency medical condition. While it includes an exception solely to preserve the life of the pregnant person, physicians have expressed concerns that the state’s abortion ban is vaguely worded and makes it challenging to discern when medical intervention for abortion during an emergency is permissible without risking prosecution. Those prosecuted under the law could face imprisonment ranging from two to five years, along with the potential revocation or suspension of their medical license.

This has led to doctors refusing to help pregnant people experiencing medical emergencies, as well as doctors leaving the state to practice medicine elsewhere. In fact, a recent study reveals that Idaho has experienced a 22 percent decrease in its practicing obstetricians within the 15 months following the implementation of the state’s near-total abortion ban. Additionally, due to the “legal and political climate” in the state, at least one hospital has closed down its obstetric department entirely.

“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,” Kolbi-Molinas said. “This case once again highlights the extraordinary lengths extremist politicians will go to control our bodies, our lives, and our ability to get the health care we need.”

The Supreme Court’s ruling in this case is expected in June.

During the Supreme Court’s oral arguments, the Women’s March orchestrated a die-in protest outside the courthouse to bring attention to the devastating impacts the case could have on pregnant people across the country.

“It’s a horrifying time to be someone who needs critical abortion care in America right now,” Rachel O’Leary Carmona, executive director of Women’s March, said in a statement to Truthout. “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 health care, their family planning and their lives.”