Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 19

4 

MOYLE v. UNITED STATES 

Opinion of JACKSON, J. 

have changed their tune about the exact types of medical 
care that fall in the gap between state and federal law, but 
the fundamentals of this dispute remain the same. 

II 
Most importantly, as JUSTICE KAGAN observes, the con-
flict between the state and federal law—as they are actually 
being interpreted and applied on the ground—is both sub-
stantial  and  significant.  Ante,  at  4–6.  It  is  a  clash  that 
clearly  exists  despite  the  attempt  by  Idaho’s  counsel  to 
muddy the waters concerning the scope of the State’s law. 
The textual conflict is plain.  EMTALA requires stabiliz-
ing  treatment  if  a  patient  has  an acute  medical  condition
that is so severe “that the absence of immediate medical at-
tention could be reasonably expected to” either result in a 
serious  health  risk,  or  seriously  threaten  bodily  functions 
or  organs.  42  U. S. C.  §§1395dd(b)(1),  (e)(1)(A).    In  such 
cases, EMTALA requires hospitals “to provide such medical 
treatment of the condition as may be necessary to assure,
within reasonable medical probability, that no material de-
. . .  occur.” 
terioration  of  the  condition  is  likely  to 
§1395dd(e)(3)(A).  Idaho’s  broad  criminalization  of  abor-
tion—unless the treating physician believes that the abor-
tion  is  “necessary  to  prevent  the  [patient’s]  death,”  Idaho 
Code  Ann.  §18–622(2)(a)(i)—conflicts  with  the  text  of 
EMTALA.  Put simply, under federal law, a hospital must 
provide an emergency abortion that is reasonably necessary 
to  preserve  a  patient’s  health  within  the  meaning  of
EMTALA.  But, under Idaho law, a doctor cannot provide
this  care  (required  by  federal  law)  without  committing  a 
criminal act. 

From the beginning of this litigation, the United States
has emphasized the host of emergency medical conditions 
that  require  stabilizing  abortions—even  when  the  proce-
dure is not necessarily life saving.  That list includes pre-
eclampsia,  preterm  premature  rupture  of  the  membranes