N.M. Delegation Files Amicus Brief Urging Ninth Circuit Court to Affirm that Federal Law Requires Hospitals to Provide Emergency Care, Including Abortion

After the Supreme Court dismissed Idaho v. United States, returning it to the Ninth Circuit Court, 259 Members of Congress ask the Ninth Circuit to affirm that federal law ensures abortion care qualifies as "emergency stabilizing care" under the Emergency Medical Treatment and Labor Act (EMTALA), and hospitals participating in Medicare must provide "emergency stabilizing treatment" to patients, including abortion care, when necessary.

The N.M Delegation joins the brief as New Mexico's highly impacted health system continues to serve patients from neighboring states with restrictions on reproductive health care.

"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."

WASHINGTON - U.S. Senators Martin Heinrich (D-N.M.) and Ben Ray Luján (D-N.M.) and U.S. Representatives Teresa Leger Fernández (D-N.M.), Melanie Stansbury (D-N.M.), and Gabe Vasquez (D-N.M.) submitted an amicus brief to the U.S. Court of Appeals for the Ninth Circuit in Moyle v. United States and Idaho v. United States, two consolidated cases concerning the Emergency Medical Treatment and Labor Act (EMTALA) under consideration by the en banc Ninth Circuit. EMTALA is a federal law that requires hospitals that receive Medicare funding to provide necessary "stabilizing treatment" to patients experiencing medical emergencies, which includes abortion care.

After the Dobbs decision in 2022, an anti-abortion law in Idaho went into effect, making 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 existing federal law 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. Idaho Republicans appealed that ruling to the Supreme Court.

In March, 258 lawmakers, including the N.M. Congressional Delegation, filed an amicus brief, asking the Supreme Court to affirm the district court decision. In June, the Supreme Court dismissed the case but without a ruling on the merits, sending the case back to the Ninth Circuit Court and reinstating the district court's injunction.

In their brief in support of the Justice Department, the lawmakers state "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 lawmakers continued in their amicus brief, "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 '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."

The lawmakers point to numerousreports of OB/GYNs leaving Idaho en masse since the state's abortion ban went into effect - Idaho has since lost fifty-five percent of its maternal-fetal medicine specialists, and three rural hospitals have shut down maternity services altogether.

"These are not hypothetical scenarios. Because Idaho's abortion ban contains no clear exceptions for the "emergency medical conditions" covered by EMTALA, it forces physicians 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 lawmakers, pointing to harrowingreports of pregnant women with severe health complications being denied necessary abortion care. The lawmakers' brief also 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 lawmakers make clear that alllaws passed by Congress are entitled to preemption - 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.

"EMTALA requires abortion when necessary to stabilize a patient with an emergency medical condition, Idaho's near-total abortion ban is preempted to the extent that it prevents doctors from providing that care," the lawmakers wrote. "This Court should reject Appellants' novel theory that EMTALA is not entitled to preemptive effect because it was enacted pursuant to Congress's spending power. Under the Supremacy Clause, all'the constitutional laws enacted by congress,' constitute 'the supreme Law of the Land,'. As the Supreme Court has repeatedly held, the principle of federal supremacy applies to laws passed pursuant to Congress's spending authority no less than it does to laws effectuating other enumerated powers."

"In sum, EMTALA plainly requires hospitals that participate in the Medicare program to provide abortion care when, in a doctor's medical judgment, it constitutes the 'ecessary stabilizing treatment' for a patient's 'emergency medical condition.'"

The amicus brief was led by U.S. Senators Chuck Schumer (D-N.Y.), Patty Murray (D-Wash.), Ron Wyden (D-Ore.), Dick Durbin (D-Ill.), and U.S. Representatives Hakeem Jeffries (D-N.Y.), Katherine Clark (D-Mass.), Frank Pallone (D-N.J.), Richard Neal (D-Mass.), Jerry Nadler (D-N.Y.), Diana DeGette (D-Colo.), and Barbara Lee (D-Calif.).

The lawmakers' amicus brief to the Supreme Court can be read in full here.

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