Spanberger Joins 257 of Her Colleagues in Asking the U.S. Supreme Court to Affirm District Court Decision that Under EMTALA, Hospitals Participating in Medicare Must Provide Emergency Stabilizing Treatment — Including Abortion Care

WASHINGTON, D.C. — U.S. Representative Abigail Spanberger yesterday joined 257 of her colleagues in filing an amicus brief to the U.S. Supreme Court in Moyle v. United States and Idaho v. United States, two consolidated cases concerning the Emergency Medical Treatment and Active Labor Act (EMTALA) that the Supreme Court will hear this April.

EMTALA is a federal law that requires hospitals that receive Medicare funding to provide necessary “stabilizing treatment” to patients experiencing medical emergencies, which can include abortion care. Hospitals that violate the law can face consequences including fines and exclusion from further Medicare funding.

After the Supreme Court overturned Roe v. Wade in 2022, an anti-abortion law in Idaho went into effect that makes it a felony for a doctor to terminate a patient’s pregnancy unless it is “necessary” to prevent the patient’s death. The United States sued the State of Idaho, arguing that the state’s law is preempted by EMTALA in those circumstances in which abortion may not be necessary to prevent imminent death, but still constitutes the necessary stabilizing treatment for a patient’s emergency medical condition. The district court agreed; it held that in those limited, but critically important situations, EMTALA requires Medicare-participating hospitals to provide abortion as an emergency medical treatment.

In their brief in support of the U.S. Department of Justice, the lawmakers ask the Supreme Court to uphold the district court’s ruling. They argue that the congressional intent, text, and history of EMTALA make clear that covered hospitals must provide abortion care when it is the necessary stabilizing treatment for a patient’s emergency medical condition, and that EMTALA preempts Idaho’s abortion ban in emergency situations that present a serious threat to a patient’s health.

“The 99th Congress passed EMTALA to ensure that every person who visits a Medicare-funded hospital with an ‘emergency medical condition’ is offered stabilizing treatment,” wrote Spanberger and her colleagues. “Congress chose broad language for that mandate, requiring hospitals that participate in the Medicare program to provide ‘such treatment as may be required to stabilize the medical condition.’ That text — untouched by Congress for the past three decades — makes clear that in situations in which a doctor determines that abortion constitutes the ‘necessary stabilizing treatment’ for a pregnant patient… federal law requires the hospital to offer it. Yet Idaho has made providing that care a felony, in direct contravention of EMTALA’s mandate that it be offered.”

They continued, “respecting the supremacy of federal law is about more than just protecting our system of government; it is about protecting people’s lives. If this Court allows Idaho’s near-total abortion ban to supersede federal law, pregnant patients in Idaho will continue to be denied appropriate medical treatment, placing them at heightened risk for medical complications and severe adverse health outcomes.”

“These are not hypothetical scenarios. Because Idaho’s abortion ban contains no clear exceptions for the ‘emergency medical conditions’ covered by EMTALA, physicians are forced to wait until their patients are on the verge of death before providing abortion care. The result in other states with similar laws has been ‘significant maternal morbidity,’” wrote the Members, pointing to harrowing reports of pregnant women with severe health complications being denied necessary abortion care. “Federal law does not allow Idaho to endanger the lives of its residents in this way.”

Spanberger and her fellow lawmakers concluded by asking the U.S. Supreme Court to affirm the district court’s decision, writing: “Petitioners and their amici offer remarkably little argument about the Idaho law itself to refute that point. Instead, they assert that EMTALA is not entitled to preemptive effect because it was enacted pursuant to Congress’s spending power. This Court should reject that argument, as it has many times before. Under the Supremacy Clause, all ‘the Constitutional laws enacted by Congress’ constitute ‘the supreme Law of the Land.’ As this Court has repeatedly held, the principle of federal supremacy applies to laws, like EMTALA, enacted pursuant to Congress’s spending authority no less than it does to laws effectuating other enumerated powers.”

The amicus brief was led in the U.S. Senate by U.S. Senators Chuck Schumer (D-NY), Patty Murray (D-WA), Ron Wyden (D-OR), and Dick Durbin (D-IL) — and in the U.S. House, the amicus brief was led by U.S. Representatives Hakeem Jeffries (D-NY-08), Katherine Clark (D-MA-05), Frank Pallone (D-NJ-06), Richard Neal (D-MA-01), Jerry Nadler (D-NY-12), Diana DeGette (D-CO-01), and Susie Lee (D-NV-03).

Click here to read the full amicus brief.

###