It is unconscionable that the Biden administration is trying to turn EMTALA into a weapon in its quest to push ever more abortion on the American public.
It is unconscionable that the Biden administration is trying to turn EMTALA into a weapon in its quest to push ever more abortion on the American public.
T he Supreme Court will soon hear a case about a federal law that may be obscure to most people but is a vivid reality to me — the Emergency Medical Treatment and Active Labor Act (EMTALA). The 1986 law was designed to save patients, especially laboring mothers and their unborn babies, from being turned away from the emergency rooms of private hospitals because they were uninsured or indigent. It was bipartisan and pro-life in the broadest sense of the term.
Today, the Biden administration is seeking to use EMTALA to override pro-life laws in some 20 states and mandate abortion in emergency rooms across the country. In fact, nothing in the text of EMTALA requires any particular treatment except life-saving care for both mothers and their children.
In the early Nineties, I did my medical-school training at a busy urban public hospital. Its labor and delivery floor was so packed that women labored in the hallways in long rows and sometimes delivered there, too. To the uninitiated it was a scene from a dystopic movie; the women, mostly indigent Latin Americans and Haitians, did not generally have the benefit of epidurals. Still, we provided good care, and moms and dads and exhausted doctors and nurses celebrated the joy of new babies making their first cry. It was women like these that EMTALA was intended to help.
And its impact was huge. Before that law, uninsured, indigent mothers who showed up at their local private hospital in active labor were often turned away at the door and told to go to our public hospital. The private hospital would not take on the cost of delivery. The trip across town and the delay often resulted in serious, even deadly, complications, including a precipitous birth in the back seat of a car.
When I went to work on the labor floor, EMTALA had just changed all that. The law mandates that the staff of a hospital emergency room must evaluate any patient who arrives at their door and determine whether an emergency condition exists. If it does, the hospital’s doctors must stabilize the patient, regardless of the patient’s ability to pay. Only then can the private hospital transfer the patient, or the patient and her child if she is pregnant or delivers under their care, to a publicly funded hospital tasked with caring for the indigent or uninsured.
In 2022, President Biden’s Department of Justice filed suit against Idaho, claiming that the state’s pro-life law, which limits abortion with some exceptions including to save the life of the mother, conflicts with its own novel interpretation of EMTALA. According to Biden’s DOJ, EMTALA creates an abortion mandate in any hospital emergency room that accepts Medicare. In this way, the Biden administration intends to steamroll pro-life state laws across the country and impose its radical abortion policy.
But the Idaho law specifically permits emergency medical interventions that result in the death of an unborn child when “necessary to prevent the death” of the mother. Far from presenting a conflict with EMTALA, Idaho’s law dovetails perfectly with any honest reading of it and its original intent.
Emergency treatment of a mother and her unborn child is altogether different from elective abortion. The Justice Department suit purposely conflates medical and surgical interventions necessary to save a mother’s life with elective abortion. It mentions several scenarios: ectopic pregnancy, severe preeclampsia, or a pregnancy complication causing hemorrhage or sepsis. The emergency treatment for these conditions may include delivering a baby, even if there is no chance that the baby will survive, but no medical professional would call this abortion or consider it such. The Idaho law is specific on this point: “Medical treatment provided to a pregnant woman . . . that results in the . . . death of, or injury to, the unborn child” will not violate the law.
EMTALA is a good law — a lifesaving law, particularly for the vulnerable. It has saved countless laboring women from being turned away from their nearest emergency room. It has saved countless babies from being born in unsafe circumstances. It is unconscionable that the Biden administration is trying to turn this good law into just one more weapon in its relentless quest to push ever more abortion on the American public.