Medical Emergencies & Access to Abortion Care

Signed into law in 1986, the Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals that receive Medicare funds to treat and stabilize anyone who presents with an emergency medical condition, regardless of their ability to pay and regardless of the type of care required. If the hospital is not equipped to provide treatment, it must arrange a transfer. EMTALA requires hospitals to offer abortion care if needed to stabilize a pregnant person in an emergent situation, and the US Department of Health and Human Services (HHS) offers several resources for providers.

Since the Dobbs decision, there has been litigation focused on whether EMTALA’s requirements to provide stabilizing care supersede state abortion bans. Most recently, the US Department of Justice dropped an ongoing lawsuit challenging Idaho’s near-total abortion ban. The suit, originally filed by the Biden administration, claimed that Idaho’s law violated EMTALA.

In response to the Justice Department's decision, Idaho’s largest hospital system, St. Luke’s, sought a temporary restraining order to block enforcement of Idaho's abortion ban in emergency situations. A judge granted a temporary restraining order that applies only to St. Luke’s and not other facilities in the state.

In addition to the Idaho case, there are other EMTALA cases pending and described below. SMFM will continue to monitor and provide updates on these cases as they progress.

SMFM members with questions regarding EMTALA should consult with counsel or contact the Abortion Defense Network, a coalition of attorneys and legal organizations that can provide legal advice, resources, and assistance in evaluating a range of legal issues for providers in a post-Roe landscape.

Case Updates and SMFM Judicial Advocacy

SMFM has provided expert input in court filings supporting efforts to protect clinicians’ ability to provide necessary and life-saving health care to patients experiencing obstetric emergencies. Learn more about this work below.

Catholic Medical Association v. HHS

In January 2025, the Alliance Defending Freedom and the Catholic Medical Association filed a federal lawsuit against HHS arguing that abortion care is not covered under EMTALA and that providers cannot be compelled to provide abortion care, even in emergency situations.

Idaho

On March 6, 2025, the US Department of Justice reversed its position and ended its challenge to Idaho’s abortion ban. Additional details above.

On June 27, 2024, the US Supreme Court dismissed the Idaho EMTALA case as improvidently granted. The decision sent the case back to the lower court for further argument. SMFM promptly released a statement on the ruling.

In advance of oral arguments heard by the US Supreme Court on April 24, 2024, SMFM joined partners in an amicus brief and public statement urging the court to maintain EMTALA protections. SMFM members and staff also attended a rally in front of the Supreme Court during oral arguments.

In August 2022, the US Department of Justice filed a lawsuit challenging Idaho's abortion law, claiming that state law conflicts with and is preempted by EMTALA. SMFM joined the American College of Obstetricians and Gynecologists (ACOG), the American College of Emergency Physicians (ACEP), and several other medical societies to file an amicus brief that detailed the life-saving nature of abortion care.

Texas

In October 2024, the US Supreme Court denied the Biden Administration's petition to hear the Texas case, thereby leaving the lower court’s ruling intact.

In August 2022, a federal judge agreed with the State of Texas and temporarily blocked the HHS EMTALA guidance. HHS appealed the ruling, and again, SMFM joined partner organizations in filing an amicus brief detailing how Texas and the lower court misunderstood EMTALA and the realities of emergency medical care.

In July 2022, Texas filed a lawsuit against HHS asserting that the July 2022 HHS EMTALA guidance did not provide a basis for the federal government to compel clinicians to offer abortion care. In response, SMFM joined ACOG, ACEP, and the American Medical Association to file an amicus brief explaining the importance of the federal law requiring clinicians to provide stabilizing medical care, including abortion care, to patients experiencing medical emergencies.

Federal Agency Activities

The Centers for Medicare and Medicaid Services (CMS) continues to provide guidance on EMTALA including a 2022 letter from Secretary Becerra reaffirming that EMTALA requires clinicians to offer necessary stabilizing care for patients suffering emergency medical conditions, including abortion care. Some portions of this guidance are now unenforceable in Texas and for members of certain anti-abortion organizations due to a court injunction. 
In May 2024, HHS launched a new online portal to make it easier for individuals to file an EMTALA complaint if they believe a patient was denied stabilizing treatment at a Medicare-funded facility. The new web resource aims to both educate consumers about EMTALA’s protections and ease the filing process. Complaints can be filed anonymously using the form.