BACKGROUND – UNITED STATES V. STATE OF IDAHO

For nearly four decades, EMTALA has provided the foundation for the emergency care safety net and has been supported by lawmakers of diverse ideological perspectives. The American public trusts physicians to provide emergency care consistent with EMTALA and medical guidelines. Despite this, a range of state efforts would criminalize doctors who provide abortion even in such emergency circumstances, leaving physicians and their patients in an untenable and unsafe position.

The Biden Administration challenged one such effort – Idaho’s abortion ban – in federal court, arguing that its lack of a health exception unlawfully conflicts with federal protections under EMTALA.

On August 15, 2022, 10 of the nation’s leading professional organizations of physicians and public health experts, including the leading professional societies of emergency physicians and obstetrician-gynecologists, submitted a brief in the U.S. District Court for the District of Idaho in support of the U.S. Department of Justice’s challenge. The brief underscores the law’s clear conflict with EMTALA. The case is United States v. State of Idaho.

The brief explains some of the contexts in which the conflict with federal law arises. For example, the brief describes “contexts where a patient’s pregnancy is presenting urgent risks to the pregnant patient’s life or health but where the Idaho Law would prevent medically indicated care that includes terminating the pregnancy. Read the release here.

On August 26, 2022 a federal court in Idaho enjoined Idaho’s abortion law to the extent it conflicts with the Emergency Medical Treatment & Active Labor Act (EMTALA). The court agreed with the medical community that “Idaho’s criminal abortion law will undoubtedly deter physicians from providing abortions in some emergency situations,” subjecting “women in medical crisis to periods of serious physical and emotional trauma as they wait to get nearer and nearer to death.”

In September of 2023, the U.S. Ninth Circuit Court of Appeals granted the Idaho Legislature’s appeal. On September 29, 2023, a panel of three Trump-appointed judges stayed the injunction of Idaho’s abortion law as it applies to emergency care. On October 10, 2023, the Ninth Circuit agreed to reconsider the case.

The case reached the U.S. Supreme Court, where in March 2024, a broad coalition of major medical organizations, physicians, people who have been denied critical health-and life-saving emergency abortion care, former HHS officials, Members of Congress, states, cities, counties, prosecutors, public health experts, legal scholars, businesses, advocates for disability rights and survivors of intimate partner violence, abortion funds, and over 100 gender justice, reproductive rights and justice, civil rights, and labor organizations filed 27 amicus briefs with the Supreme Court in support of the federal government’s challenge to Idaho’s statute, emphasizing the essential nature of stabilizing emergency care for all, regardless of state laws.

However, on June 27, 2024, the U.S. Supreme Court dismissed the case without ruling on the merits, admitting that it should not have taken the case when it did, and sent the case back to the 9th U.S. Circuit Court of Appeals, refusing to provide needed clarity about whether state abortion bans will be allowed to override longstanding federal emergency medical care requirements.

On October 23, 2024, experts filed 16 amicus briefs supporting federal protections for emergency abortion care following the U.S. Supreme Court’s decision to send Moyle v. United States back to a lower appeals court. We represented a coalition of doctors and health care providers in filing a friend-of-the-court brief to the 9th Circuit Court of Appeals.

BACKGROUND – STATE OF TEXAS V. BECERRA

In the weeks following the Dobbs decision, the U.S. Department of Health and Human Services (HHS) issued a guidance statement reminding hospitals and their medical providers that when abortion is necessary to stabilize a patient’s medical emergency, EMTALA requires that it be offered.

The guidance was immediately attacked by Texas Attorney General Ken Paxton and two interest groups, who filed suit in federal court in Texas to invalidate the guidance.

On August 17, 2022, ten of the nation’s leading professional organizations of physicians and public health experts, including the professional societies of emergency physicians and obstetrician-gynecologists, submitted a brief in support of the HHS EMTALA guidance. This brief explains how Texas’s challenge misunderstands both federal law and the on-the-ground practice of emergency medicine. It affirms that forcing physicians to decide between obeying state law and obeying EMTALA would harm physicians and the public interest and urges the court to reject Texas’s motion to enjoin the guidance. The case is State of Texas v. Becerra. Read the release here.

On August 25, 2022 a federal court in Texas endorsed Governor Ken Paxton’s attack on EMTALA, preliminarily enjoining the Biden administration’s guidance interpreting the law in Texas. The u.S. Department of Justice appealed that decision in October of 2022.

On May 8, 2023, a similar coalition of the nation’s leading professional organizations of physicians and public health experts, including the professional societies of emergency physicians and obstetrician-gynecologists, submitted a brief in support of the Biden administration in the U.S. Court of Appeals for the Fifth Circuit.

On January 2, 2024, the U.S. Court of Appeals for the Fifth Circuit affirmed the district court’s ruling in Texas v. Becerra that Texas can ban emergency abortions in spite of a EMTALA.