Case before justices today could set stage for emergency abortions in states banning them

The Supreme Court will hear arguments today in a case that could determine whether doctors can provide abortions to pregnant women with medical emergencies in states that enact abortion bans.

The Justice Department has sued Idaho over its abortion law, which allows a woman to get an abortion only when her life — not her health — is at risk. The state law has raised questions about when a doctor is able to provide the stabilizing treatment that federal law requires.

The federal law, called the Emergency Medical Treatment and Active Labor Act, or EMTALA, requires doctors to stabilize or treat any patient who shows up at an emergency room.

Here's a look at the history of EMTALA, what rights it provides patients and how a Supreme Court ruling might change that.

ER stipulations

Simply put, EMTALA requires emergency rooms to offer a medical exam if you turn up at their facility. The law applies to nearly all emergency rooms — any that accept Medicare funding.

Those emergency rooms are required to stabilize patients if they do have a medical emergency before discharging or transferring them. And if the ER doesn't have the resources or staff to properly treat that patient, staff members are required to arrange a medical transfer to another hospital, after they've confirmed the facility can accept the patient.

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

Why was it created?

Look to Chicago in the early 1980s.

Doctors at the city's public hospital were confronting a huge problem: Thousands of patients, many of them Black or Latino, were arriving in very bad condition — and they were sent there by private hospitals in the city that refused to treat them. Most of them did not have health insurance.

Chicago wasn't alone. Doctors working in public hospitals around the country reported similar issues. Media reports, including one of a pregnant woman who delivered a stillborn baby after being turned away by two hospitals because she didn't have insurance, intensified public pressure on politicians to act.

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

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

Patient rights

The hospital is investigated by the Centers for Medicare and Medicaid Services. If they find the hospital violated a patient's right to care, they can lose their Medicare funding, a vital source of revenue for most hospitals to keep their doors open.

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

Controversial times

Since the Supreme Court overturned the constitutional right to an abortion, President Joe Biden, who is looking at abortion rights as a key issue in his reelection bid, has repeatedly reminded hospitals that his administration considers an abortion part of the stabilizing care that EMTALA requires facilities to provide.

The Biden administration argues that Idaho's law prevents ER doctors from offering an abortion if a woman needs one in a medical emergency.

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