Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 38.0

Cite as:  603 U. S. ____ (2024) 

15 

ALITO, J., dissenting 

other than those intended by Congress.16  The Government 
has  not identified  any decision  holding  that  a  federal law 
enacted under the Spending Clause preempts a state crim-
inal law or public health regulation.

For  present  purposes,  it  is  not  necessary  to  decide
whether the Legislature’s theory is correct.  At a minimum, 
however,  it  provides  yet  another  reason  to  be  wary  about
interpreting EMTALA to displace the core powers of a non-
consenting  State  without  unmistakable  clarity  regarding
the meaning of the federal law. 

* 

* 

* 

In  sum,  the  Government’s  new 

interpretation  of 
EMTALA  is  refuted  by  the  statutory  text,  the  context  in 
which the law was enacted, and the rules of interpretation
that we apply to Spending Clause legislation.  We should 
reject the Government’s interpretation and put that matter 
to rest.17 

—————— 

16 See Philpott v. Essex County Welfare Bd., 409 U. S. 413, 415 (1973) 
(attachment of Social Security benefits); Bennett v. Arkansas, 485 U. S. 
395, 398 (1988) (per curiam) (same); Lawrence County v. Lead-Deadwood 
School Dist. No. 40–1, 469 U. S. 256, 271 (1985) (use of federal payments
in lieu of taxes made to municipalities with federal facilities). 

17 JUSTICE SOTOMAYOR, JUSTICE KAGAN, and JUSTICE JACKSON endorse 
the  Government’s  interpretation  of  EMTALA  but  barely  bother  to  ex-
plain why they think the interpretation is correct.  JUSTICE KAGAN’s opin-
ion,  which  JUSTICE SOTOMAYOR  and  JUSTICE  JACKSON  join,  argues  that
“EMTALA unambiguously requires that a Medicare-funded hospital pro-
vide whatever medical treatment is necessary to stabilize a health emer-
gency” and in some cases this may require an abortion.  Ante, at 4 (con-
JUSTICE  KAGAN  conveniently  fails  to  note  that 
curring  opinion). 
EMTALA defines the term “emergency medical condition” and that this 
definition  includes  any  condition  that  is  sufficiently  serious  to  “plac[e] 
. . . the health of [a pregnant] woman or her unborn child . . . in serious 
jeopardy.”  §1395dd(e)(1)(A)(i).  Therefore, as I have already explained, 
EMTALA demands that a covered hospital stabilize any sufficiently se-
rious threat to the health of an “unborn child.” 

Not only is JUSTICE KAGAN’s analysis of the statutory language faulty, 
but she fails to say anything about the special rules of interpretation that