Texas Sues Biden Administration: How EMTALA Prevents 'Patient Dumping' in a Post-Roe World

[niyad]

Texas Sues Biden Administration: How EMTALA Prevents ‘Patient Dumping’ in a Post-Roe World
7/27/2022 by Aziza Ahmed
By challenging EMTALA, Texas is signaling that it is okay with patient dumping—especially when those patients are pregnant.

Abortion rights demonstrators gather near the State Capitol in Austin, Texas, June 25, 2022. (Suzanne Cordiero / AFP via Getty Images)

In the weeks following Dobbs v. Jackson Women’s Health Organization, the case overturning Roe v. Wade and the constitutional right to abortion, the worst fears of reproductive advocates became reality. Trigger bans outlawing abortion services went into effect around the country. Some of these bans did not contain exceptions for “life” or “health.” And, even where there were exceptions, physicians expressed confusion about how to interpret them. How close does a woman need to be to death before an abortion would be legal? At least one study has already shown an uptick in maternal morbidity as physicians struggled with when to intervene in a woman’s miscarriage. Many anecdotal and journalistic accounts of women suffering poor care in the context of an abortion or miscarriage are now circulating, with more stories expected to surface in the coming days, months and years.

In response to this crisis, one of the measures taken by the Biden administration was to highlight the role of the Emergency Medical Treatment and Labor Act (EMTALA). This law, passed by the Reagan administration, states that any hospital that received Medicare funds must screen and stabilize patients for emergency medical conditions regardless of whether or not a patient could pay. The law was enacted, at least in part, to prevent “patient dumping”—leaving patients without care at the door of the hospital. EMTALA has implications for the current abortion landscape because patients who have attempted abortion or who are facing a life or health threatening problem with regard to their pregnancy may show up at an emergency room. Following Dobbs, Health and Human Services (HHS) clarified that if a physician believes a pregnant patient has an emergency medical condition, as defined by EMTALA and that an abortion is necessary, the physician should provide that treatment even where state law contravenes. For example, if a pregnant person goes to a hospital emergency room with an ectopic pregnancy, they will likely need an immediate abortion. But if a state law does not allow abortions even when the mother’s health or life are at risk, HHS suggests that the physician act to give the person the care they need and the physician would be protected by EMTALA.

In issuing this guidance, HHS was doing what they should be doing—protecting the lives and health of pregnant Americans in the context of institutional failure to protect pregnant people at the highest levels. But they are facing opposition. In keeping with the hard line taken by Texas on abortion, Attorney General Ken Paxton filed a suit challenging this EMTALA guidance. The suit argues that the “practice of medicine or the manner in which medical services are provided” cannot be dictated by the federal government. The suit also argues that EMTALA does not preempt state or local law. The suggestion that it is the Texas abortion ban that is making it possible for providers to make the best care is patently false as it is tying the hands of providers and putting patients at risk.

While it is not surprising that Texas challenged EMTALA, from the perspective of caring for pregnant people in Texas, the challenge is a signal that they continue to be willing to sacrifice emergency care for pregnant patients. And as this back and forth continues, both physicians and patients are left in the crosshairs. As the HHS guidance suggests, physicians can use EMTALA as a defense to a state enforcement action or they could bring a federal suit, but this requires a great deal from physicians who are focused on providing services—often life-saving services—in the emergency room setting. Patients who find themselves in this situation, often scared for their own health and life, may now find that their providers are too afraid to give them the care that their best medical judgement suggests.

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https://msmagazine.com/2022/07/27/emergency-medical-treatment-labor-act-emtala-hhs-texas-biden-abortion/

[Timeflyer]

1. Vote out all forced birthers!

So Texas state law does not preempt state or local law? The arrogant power-mad reThugs--if women don't get out and vote like their lives depend on it, we're lost. All the DU people citing reThug death panels are exactly right--women are going to die, or be permanently maimed, by health care decisions these smug morons make at a distance. May they all rot.