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Last June, the Supreme Court dismissed a case that would have determined whether emergency abortion care is protected under a federal law known as the Emergency Medical Treatment and Labor Act or EMTALA. At issue: an Idaho law that prohibits pregnant women from receiving abortions even if their health is in danger. That law conflicts with the federal guarantees in EMTALA, in instances where a woman’s necessary stabilizing emergency care requires an abortion. The High Court sent this case and a related one back to the US Court of Appeals for the Ninth Circuit, action that has already led to a risk for pregnant women.
A group of 134 nationally recognized public health deans and scholars, together with the American Public Health Association, the Robert Wood Johnson Foundation, the Network for Public Health Law, and the American Medical Women’s Association filed a public health amicus brief on Oct. 22 with the court urging it to uphold EMTALA. The brief argues that EMTALA provides critical health protections for women at all stages of pregnancy, even in rare cases in which abortion may be necessary stabilizing treatment.
“Many conditions can occur in pregnancy that can threaten the mother’s life or health,” said Lynn Goldman, the Michael and Lori Milken Dean of the Milken Institute School of Public Health at the George Washington University. “The Court must preserve EMTALA’s protections so that abortions and other stabilizing care can be performed in an emergency department,” said Goldman, who is one of the amici.
The brief also presents new evidence about EMTALA’s special added protections during the labor and delivery phase, showing that, far from diminishing the law’s safeguards during pregnancy, EMTALA expands those protections when the emergency presents risks during the actual labor and delivery period for both the pregnant woman and her unborn child.
The amici argue that these special protections were added by Congress at a time when Roe v Wade was the law of the land. They go on to say that these crucial safeguards do not reduce EMTALA’s requirement to protect women throughout pregnancy, but instead enhance its protections during labor and delivery. Nothing in the statutory protections for labor and delivery subordinates the health of pregnant women to fetal health, they argue.
The brief further argues that EMTALA’s protections would not turn hospital emergency departments into “abortion enclaves” as the defendants claim, because of EMTALA’s powerful but very narrow reach and because of the extraordinary conditions under which emergency departments operate that necessarily limit their services to true medical emergencies.
EMTALA was enacted in 1986 to guarantee that people who seek emergency care from Medicare-participating hospitals can obtain screening and stabilization care for conditions that affect life or health. It is a basic health care right guaranteed to all people.
"Every individual, including pregnant women, deserves access to vital emergency care. EMTALA ensures this access to necessary emergency medical treatment across the nation,” said Georges C. Benjamin, MD, Executive Director of the American Public Health Association. “Any limitation on these emergency care protections would leave countless people at risk.”
The public health amicus brief urges the Court to recognize that EMTALA takes precedence over state laws like the one enacted in Idaho. It goes on to say that the Idaho law and others like it impose a chilling effect on a vast range of emergency care for pregnant women. The harm is not theoretical, as the brief points out that women are currently being turned away or denied potentially life-saving care.
The brief can be accessed online here.
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The amici are represented by attorneys Thomas Barker, Kian Azimpoor, Andrew London and Jack C. Smith of Foley Hoag LLP.
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The American Public Health Association champions optimal, equitable health and well-being for all. With our broad-based member community and 150-year perspective, we influence federal policy to improve the public’s health. Learn more at www.apha.org.