Moyle v. United States

Today, the Supreme Court dismissed as improvidently granted the writs of certiorari in Moyle v. United States, a case that was poised to determine whether the federal Emergency Medical Treatment and Labor Act (EMTALA) preempts Idaho’s Defense of Law Act, which criminalizes abortion only with an exception when “necessary to prevent the death of the pregnant person.” At the heart of this consolidated case was the troubling question of just how dire a pregnant person’s medical emergency needs to be to receive abortion care in Idaho and states with similarly restrictive bans. Unfortunately, this question remains unanswered for now.

What You Need to Know

• Question Before the Court: To what extent does Idaho’s Defense of Life Act conflict with the federal EMTALA and to the extent that a conflict exists, does EMTALA preempt the state’s abortion ban?
• What Happened at the Oral Argument: The justices sought clarity from advocates for both sides on the scope of the conflict between the two laws, seeking to understand the amount of “daylight” between the two. Idaho maintained that the scenarios brought up in the federal government’s briefs would all be covered under the state’s “necessary to prevent” death exception whereas the federal government, and many amicus briefs from physicians and medical experts, disagreed. In a particularly animated exchange with Solicitor General Prelogar, Justice Alito advanced a dangerous line of argument regarding language within EMTALA to advance the cause of fetal personhood. EMTALA includes language that requires stabilizing care also be provided to an “unborn child,” which Justice Alito seemed to suggest would prompt a weighing of fetal interests versus a pregnant person’s interests by a physician. The Solicitor General responded that the law was designed to require hospitals to provide care in situations where the pregnant person’s health was not in danger but their pregnancy was in peril, creating an obligation of care flowing through the pregnant person, not in contrast to their own health.
• What Did the Court Decide: In a very brief per curiam decision, the Court dismissed the writs of certiorari granted in this consolidated case as improvidently granted and vacated the stays previously put in place by the Court. But beyond the brief order lies clear disagreement among the justices on how the Court handled this case and what the future holds for EMTALA. Justices Kagan and Barrett each wrote concurring opinions, the former because Idaho’s arguments never justified emergency relief or early consideration and the latter because “the shape of these cases has substantially shifted” since cert was granted. Justice Jackson, concurring in part and dissenting in part, noted that the Court had already inserted itself into the ongoing litigation to the detriment of pregnant Idahoans experiencing medical emergencies and their doctors and that three days after the petition in this case was granted, the Fifth Circuit affirmed a similar case in which the federal government was enjoined from enforcing EMTALA’s requirements in Texas. And then there was Justice Alito, writing in dissent, picking up and advancing the dangerous theories he advanced during oral argument in regards to fetal personhood.
• What to Make of the Result: In the end, the Court kicked the can down the road on the question of whether EMTALA preempts state abortion bans when it comes to care for pregnant people experiencing a medical emergency and in need of stabilizing care that includes abortion care. While Idahoans now arguably have the benefit of EMTALA while litigation proceeds in the lower courts, Texans do not because of the Fifth Circuit injunction still in place there. Time is of the essence when patients present requiring critical care, and the Court today chose to delay, past the elections and extending the uncertainty they created.