Senators Carper and Coons, Congresswoman Blunt Rochester, bicameral colleagues file amicus brief urging Supreme Court to affirm that hospitals are required to provide emergency stabilizing care, including abortion care

WASHINGTON – U.S. Senators Tom Carper and Chris Coons and Congresswoman Lisa Blunt Rochester (all D-Del.) joined 255 Members of Congress in submitting 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. The Emergency Medical Treatment and Active Labor Act 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. 

After the Dobbs v. Jackson Women's Health Organization decision in 2022, a draconian anti-abortion law went into effect in Idaho 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 in federal court, 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, ruling EMTALA requires Medicare-participating hospitals to provide abortion as an emergency medical treatment.

In their brief in support of the U.S. Justice Department, 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.

“[T]he 99th Congress passed EMTALA to ensure that every person who visits a Medicare-funded hospital with an ‘emergency medical condition’ is offered stabilizing treatment,” the Members wrote. “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 ‘[n]ecessary 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.”

The Members noted that in this case, “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. And health care providers, forced to let Idaho’s abortion law take precedence over their medical judgment about their patients’ best interests, will continue their exile from Idaho, creating maternity-care ‘deserts’ all over the state.” The Members point to numerous reports of OB-GYNs leaving Idaho en masse since the state’s abortion ban went into effect. Idaho has since lost 55% of its maternal-fetal medicine specialists and three rural hospitals have shut down maternity services altogether.

“These are not hypothetical scenarios,” the Members continued. “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,’” with 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.”

In their brief, the members also clarify that the references to “unborn child” in EMTALA were intended to expand hospitals’ obligations with respect to providing stabilizing treatment, not to limit them or take away the obligation to provide abortion care in certain circumstances.

The Members’ brief counters an argument from Idaho and its amici that the Supremacy Clause does not apply in this case because EMTALA was passed using Spending Clause authority, and therefore acts only as a condition on Medicare funding. The members make clear that all laws passed by Congress are entitled to the same preemptive effect under the Supremacy Clause – regardless of their source of constitutional authority – and states cannot pass laws that make it impossible for private parties to accept federal funding, inhibiting the purpose of the federal law. 

The lawmakers conclude by asking the Supreme Court to affirm the district court’s decision that EMTALA requires Medicare-participating hospitals to provide abortion care when it is necessary as emergency medical treatment.

In addition to Senators Coons and Carper, the brief was signed by 47 other U.S. Senators, including Chuck Schumer (D-N.Y.), Patty Murray (D-Wash.), Ron Wyden (D-Ore.), Dick Durbin (D-Ill.), Bernie Sanders (I-Vt.), Richard Blumenthal (D-Conn.), Tammy Baldwin (D-Wis.), Michael Bennet (D-Colo.), Cory Booker (D-N.J.), Sherrod Brown (D-Ohio), Laphonza Butler (D-Calif.), Maria Cantwell (D-Wash.), Ben Cardin (D-Md.), Bob Casey (D-Pa.), Catherine Cortez Masto (D-Nev.), Tammy Duckworth (D-Ill.), John Fetterman (D-Pa.), Kirsten Gillibrand (D-N.Y.), Maggie Hassan (D-N.H.), Martin Heinrich (D-N.M.), John Hickenlooper (D-Colo.), Mazie Hirono (D-Hawaii), Tim Kaine (D-Va.), Mark Kelly (D-Ariz.), Angus King (I-Maine), Amy Klobuchar (D-Minn.), Ben Ray Luján (D-N.M.), Ed Markey (D-Mass.), Bob Menendez (D-N.J.), Jeff Merkley (D-Ore.), Chris Murphy (D-Conn.), Alex Padilla (D-Calif.), Gary Peters (D-Mich.), Jack Reed (D-R.I.), Jacky Rosen (D-Nev.), Brian Schatz (D-Hawaii), Jeanne Shaheen (D-N.H.), Kyrsten Sinema (I-Ariz.), Tina Smith (D-Minn.), Debbie Stabenow (D-Mich.), Jon Tester (D-Mont.), Chris Van Hollen (D-Md.), Mark Warner (D-Va.), Raphael Warnock (D-Ga.), Elizabeth Warren (D-Mass.), Peter Welch (D-Vt.), and Sheldon Whitehouse (D-R.I.)

The brief was signed by 209 Representatives in the U.S. House, including Congresswoman Blunt Rochester.

The full text of the amicus brief can be found here.