Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 25.0

2 

MOYLE v. UNITED STATES 

ALITO, J., dissenting 

States  enacted  new  laws  restricting  the  performance  of
abortions.  To  protect  both  “maternal  health  and  safety” 
and  “ ‘the  life  of  preborn  children,’ ”  Planned  Parenthood 
Great  Northwest  v.  State,  171  Idaho  374,  438,  522  P. 3d 
1132,  1196  (2023)  (quoting  Idaho  Code  Ann.  §18–601), 
Idaho’s law permits an abortion only when  “necessary to 
prevent  the  death  of  the  pregnant  woman,”  §18– 
622(2)(a)(i).

Shortly before Idaho’s law took effect, President Biden in-
structed  members  of  his  administration  to  find  ways  to
limit  Dobbs’s  reach.  Protecting  Access  to  Reproductive
Healthcare Services, Exec. Order No. 14076, 87 Fed. Reg.
42053 (2022).  In response, Government lawyers hit upon
the  novel  argument  that,  under  EMTALA,  all  Medicare-
funded hospitals—that is, the vast majority of hospitals1— 
must perform abortions on request when the “health” of a 
pregnant woman is in serious jeopardy.  §1395dd(e)(1)(A)(i).
In  the  Government’s  view,  EMTALA  trumps  laws  like 
Idaho’s,  which  allow  abortions  only  to  preserve  the  life  of 
the pregnant woman.  See Dept. of Health & Human Servs.
(HHS), Reinforcement of EMTALA Obligations Specific to
Patients Who Are Pregnant or Are Experiencing Pregnancy 
Loss 1 (QSO–22–22–Hospitals, July 11, 2022).  The Govern-
ment sued Idaho on this preemption theory and obtained a 
preliminary injunction against enforcement of the state law 
“to the extent it conflicts with EMTALA.”  623 F. Supp. 3d 
1097, 1117 (Idaho 2022). 

The Government’s preemption theory is plainly unsound.
from  requiring  hospitals  to  perform  abortions, 
Far 
EMTALA’s  text  unambiguously  demands  that  Medicare-
funded  hospitals  protect  the  health  of  both  a  pregnant 
woman  and  her  “unborn  child.”  §1395dd(e)(1)(A)(i).  And 
—————— 

1 For  instance,  the  American  Hospital  Association  (AHA)  calculates 
that 96% of hospitals have at least 50% of their inpatient days paid by
Medicare  and  Medicaid.    AHA,  Fact  Sheet:  Majority  of  Hospital  Pay-
ments Dependent on Medicare or Medicaid (Mar. 2024).