Overview
On March 28, 2024, the National Women’s Law Center filed an amicus brief, co-authored by Cohen Milstein, with the Supreme Court of the United States, addressing Moyle v. U.S.A. (No. 23-726) and Idaho v. U.S.A. (23-727) and the Emergency Medical Treatment and Labor Act (EMTALA).
This brief is also submitted on behalf of In Our Own Voice: National Black Women’s Reproductive Justice Agenda, National Asian Pacific American Women’s Forum, and National Latina Institute for Reproductive Justice, as well as 98 organizations. Like the NWLC, these organizations are committed to equitable and adequate healthcare access for everyone who is pregnant or can become pregnant.
The amicus brief addresses two concerns: 1) Whether SCOTUS will interpret the law to permit women and pregnant people to be singled out for disfavored treatment when it comes to federal protections. 2) Whether states can make exceptions to federal laws they disagree with.
Introduction & Summary of the Argument
The Emergency Medical Treatment and Labor Act (EMTALA) is a life raft for people who have systematically been denied medical care.
Recognizing the cruelty of denying medical treatment to patients in crisis, Congress created EMTALA to ensure that Medicare funded hospitals would, at the very least, provide “necessary stabilizing treatment” for “any” patient with an “emergency medical condition,” regardless of the patient’s ability to pay. 42 U.S.C. § 1395dd(b). In 1989, Congress amended the statute to clarify and extend protections for pregnant people. The plain text of EMTALA now requires that emergency departments stabilize pregnant patients in labor, pregnant patients who have emergency conditions unrelated to labor, and patients who need emergency treatment to prevent pregnancy loss. Because more than half of pregnant people seek emergency department treatment at some point during their pregnancy, and up to 15% suffer a life-threatening condition during the first trimester, EMTALA’s safeguards are critical for everyone who can become pregnant in the United States.
The importance of EMTALA has only increased as this country reckons with a maternal health crisis. While structural barricades to quality prenatal care were erected long ago—particularly for pregnant patients in Black and Indigenous communities—rates of severe and fatal pregnancy complications in the United States are rising. The crisis has now reached fever pitch: The United States’ maternal mortality rate is ten times that of other high-income countries. And while the risk of pregnancy-related death is unacceptably high across demographic groups, it is worst for Black women, who are three times as likely to die as white women, and Indigenous women, who are twice as likely to die as white women.
In the wake of Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022), Idaho raises the novel theory that it has the power to carve protections for pregnant people out of federal law. Accepting Idaho’s reading of EMTALA—which distorts the statutory text beyond reason and recognition—would deepen the United States’ maternal health crisis, particularly for Black, Indigenous, immigrant, rural, and low-income communities. It would decimate treatment options for patients experiencing pregnancy-related emergencies and accelerate the exodus of healthcare providers from areas that are already considered pregnancy-care deserts, making even routine pregnancy care harder to find.
Amici urge the Court to reject Petitioners’ atextual reading of EMTALA and prevent the catastrophic consequences that would flow from it.