Attorney General Bonta: We Must Protect EMTALA and Ensure Access to Emergency Care for All Americans

OAKLAND - California Attorney General Rob Bonta today co-led a coalition of 24 attorneys general in filing an amicus brief before the en banc court of the Ninth Circuit, supporting the Biden administration's challenge to Idaho's near-total ban on abortion. In an amicus brief filed in United States of America v. Idaho, the multistate coalition supports the U.S. government's argument that the Emergency Medical Treatment and Labor Act (EMTALA), a federal law, requires hospitals to provide necessary abortion care to pregnant people experiencing medical emergencies. The coalition further argues that Idaho's ban not only endangers the lives and health of pregnant individuals in the state but would have serious repercussions on the health systems of other states, and urges the Court to uphold the lower court's preliminary order prohibiting enforcement of Idaho's ban to the extent it conflicts with EMTALA.

"EMTALA ensures that no one is denied access to emergency medical care, including abortion care, and this federal law is more imperative than ever following the overturn of Roe v. Wade," said Attorney General Bonta. "That's why I, alongside attorneys general nationwide, are reaffirming our unwavering commitment to safeguarding access to emergency medical care for all Americans with today's amicus brief. Abortion care is healthcare, and at the California Department of Justice, we will pursue every legal avenue to protect EMTALA and ensure that medical decisions remain between patients and their doctors."

Every hospital in the United States that operates an emergency department and participates in Medicare is subject to EMTALA. Under the law, emergency departments are required to provide all patients who have an emergency medical condition with the treatment required to stabilize their condition. EMTALA's requirement extends to abortion care, which is sometimes necessary to stabilize a pregnant individual experiencing an emergency medical condition. Under Idaho's radical abortion ban, which came into effect after the U.S. Supreme Court's June 2022 decision overturning Roe v. Wade, healthcare providers face criminal prosecution and loss of their license for providing this medically necessary care.

In today's amicus brief, the multistate coalition supports the federal government's case arguing that:

• Decades of federal guidance and court precedent have held that stabilizing treatment under EMTALA includes emergency abortion care, and states have relied on that determination to protect their residents' health and safety.
• Preventing medical providers from performing abortions needed to treat emergency medical conditions threatens the health and lives of pregnant patients. Many pregnancy and miscarriage complications are emergency medical conditions requiring time-sensitive stabilizing treatment that can include abortion. In an emergency, any failure to provide, or delays in providing, necessary abortion care can put at risk the pregnant patient's life or health.
• If Idaho hospitals do not provide the emergency abortion care required by EMTALA, patients, if they have time, will be forced to turn to out-of-state hospitals and providers, adding strain to other states' emergency departments that are already struggling with overcrowding, long wait times, and staff shortages. The added strain will cause more delays and threaten the safety and health of all patients who need emergency care.

Last month, California sued Providence St. Joseph Hospital, enforcing the crucial right to emergency abortion care under California state law, while the scope of federal protections for such care under EMTALA is litigated in the federal courts. As litigation about EMTALA proceeds, states like California rely on their own state laws to protect pregnant patients.

Today's amicus brief was led by the attorneys general of California and New York, who were joined by the attorneys general of Arizona, Colorado, Connecticut, Delaware, Hawai'i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, Wisconsin, and the District of Columbia.

A copy of the brief is available here.