What’s EMTALA, the patient protection law at the center of Supreme Court abortion arguments?

WASHINGTON — The Supreme Court will hear arguments Wednesday in a case that could determine whether doctors can perform abortions on pregnant women with medical emergencies in states that implement abortion bans.

The Justice Department has sued Idaho over its abortion law, which only allows a woman to have an abortion if her life — and not her health — is in danger. State law has raised questions about when a doctor is able to provide the stabilizing treatment required by federal law.

Federal law, the Emergency Medical Treatment and Active Labor Act (EMTALA), requires physicians to stabilize or treat any patient who presents to the emergency room.

Here’s a look at the history of EMTALA, what rights it offers patients, and how a Supreme Court ruling could change that.

Simply put, EMTALA requires the emergency room to offer a medical exam when you show up to them. The law applies to almost all emergency rooms — all rooms that accept Medicare funding.

These emergency departments are required to stabilize patients if there is a medical emergency before discharging or transferring them. And if the ER does not have the resources or staff to properly treat that patient, staff members must arrange a medical transfer to another hospital after confirming that the facility can accept the patient.

So, for example, if a pregnant woman shows up at the emergency room and is concerned that she is in labor, but there is no gynecologist on staff, the hospital staff cannot simply order the woman to go elsewhere.

Look at Chicago in the early 1980s.

Doctors at the city’s public hospital faced a huge problem: Thousands of patients, many of them black or Latino, arrived in very poor condition – and they were sent there by private hospitals in the city that refused to treat them. Most of them had no health insurance.

Chicago wasn’t alone. Doctors working in public hospitals across the country reported similar problems. Media reports, including that of a pregnant woman who delivered a stillborn baby after being turned away by two hospitals because she had no insurance, increased public pressure on politicians to act.

Congress drafted legislation, with Republican Senator David Durenberger of Minnesota saying at the time: “Americans, rich or poor, deserve access to quality health care. This issue of access should be the responsibility of government at the federal, state and local levels.”

Then-President Ronald Reagan, a Republican, signed the bill into law in 1986.

The hospital is under investigation by the Centers for Medicare and Medicaid Services. If they discover that the hospital violated a patient’s right to care, they could lose their Medicare funding, a vital source of revenue for most hospitals to keep their doors open.

Typically, however, the federal government issues fines when a hospital violates EMTALA. They can amount to hundreds of thousands of dollars.

Since the Supreme Court struck down the constitutional right to abortion, President Joe Biden, a Democrat, has repeatedly reminded hospitals that his administration considers abortion part of the stabilizing care EMTALA requires from the facilities.

The Biden administration says Idaho law prohibits emergency physicians from offering an abortion if a woman needs one in a medical emergency.

But the Idaho attorney general has pointed out that EMTALA also requires hospitals to consider the health of the “unborn child” in their treatment.

Anti-abortion advocates argue that state laws banning abortion can coexist with federal law requiring hospitals to stabilize pregnant patients in an emergency.

Prominent anti-abortion group Susan B. Anthony Pro-Life America called the Idaho lawsuit a “PR stunt” in a statement to The Associated Press on Tuesday.

“The EMTALA case is based on the false premise that pregnant women cannot receive emergency care under pro-life laws,” said Kelsey Pritchard, the group’s director of public affairs. “It is a clear fact that pregnant women can receive miscarriage care, ectopic care. pregnancy care and treatment in the event of a medical emergency in all 50 states.”

But many doctors say it’s not as clear-cut as anti-abortion advocates claim. Idaho state law banning abortion except for the mother’s life has left some doctors questioning whether a patient is close enough to death to treat.

In most other states, doctors are allowed to perform abortions to save a mother’s health. But if the Supreme Court rules in Idaho’s favor, it could invite other states to pass restrictions without that exemption.

In a statement released Monday, Jack Resneck, the former president of the American Medical Association, said the Idaho law forces doctors to deny patients proper treatment.

The state’s “dangerous standard cannot be applied to the real-world situations encountered every day in emergency rooms,” Resneck said. “There is no clear cutoff when each patient’s condition suddenly becomes ‘life-threatening,’ and deteriorating patients do not want their doctors to delay care.”