Document ID: ./input/supremecourt_opinions/opinions/23pdf/23-726_6jgm.pdf
Page Number: 33

10 

MOYLE v. UNITED STATES 

ALITO, J., dissenting 

signed EMTALA into law if it did what he “steadfastly op-
pose[d].”  Ibid. 

C 
Desperate to find some crumb of support for its interpre-
tation,  the  Government  scrapes  together  a  handful  of
sources that it says evidence a general understanding that
EMTALA  requires  hospitals  to  perform  health-related
abortions prohibited by Idaho law.  None of these sources 
stands for that proposition.

First, the Government searched a vast database of HHS 
enforcement  decisions  and  located  six  occurring  between
2010 and 2023 that it finds helpful.  It is not obvious why 
those enforcement decisions—which postdate EMTALA by
more  than  20  years—shed  light  on  its  original  meaning.
And it is even less clear why they justify the Government’s 
claim that EMTALA preempts Idaho law.  Five of the six 
cases  involved  ectopic  pregnancies,  which  the  Idaho  law 
does not cover.  See Idaho Code Ann. §18–604(1)(c) (exclud-
ing  ectopic  pregnancies  from  the  definition  of  “abortion”).
In the remaining case, the hospital was faulted, not for fail-
ing to perform an abortion, but for discharging a sick preg-
nant woman without calling for an ambulance to transport 
her to another hospital.12 

The Government also seizes upon a provision in the Af-
fordable Care Act stating that “[n]othing in this Act shall 
be  construed  to  relieve  any  health  care  provider  from 
providing emergency services as required by State or Fed-

—————— 

12 Additionally, it is doubtful that Idaho law would have prevented an
abortion in this suit.  The woman was diagnosed with “[i]nevitable abor-
tion.”    Centers  for  Medicare  and  Medicaid  Services,  Hospital  Surveys 
With  2567  Statement  of  Deficiencies—2024Q1  (2010–2016  file)  Row
16,961.    But  Idaho  law  does  not  apply  to  “non-viable  pregnancies  . . . 
where  the unborn  child  is no  longer  developing.”    Planned  Parenthood 
Great  Northwest  v.  State,  171  Idaho  374,  445,  522  P. 3d  1132,  1203 
(2023); see also Idaho Code Ann. §§18–604(1), (11).