Maine advocates say latest abortion case underscores importance of state-level protections

Supporters of abortion rights packed the halls of the Maine State House on Jan. 22, which also marked the the 51st anniversary of the Roe v. Wade ruling. (Emma Davis/ Maine Morning Star)

The U.S. Supreme Court has taken up another closely-watched abortion case, this one about whether a federal law protects emergency abortion care even in states with strict bans on the procedure. While abortion is legal in Maine, advocates say the case highlights the importance of having strong safeguards for reproductive health care services. 

Last week, the Supreme Court heard oral arguments on the case, which hinges on the Emergency Medical Treatment and Labor Act, or EMTALA, a law that requires hospitals that receive federal funding to treat patients who come to an emergency room regardless of their ability to pay. 

In July 2022, the Centers for Medicare and Medicaid Services issued an advisory on EMTALA stating that if a doctor believes a pregnant patient is experiencing a medical emergency and abortion is the treatment needed to stabilize them, “the physician must provide that treatment.” 

“When a state law prohibits abortion and does not include an exception for the life of the pregnant person — or draws the exception more narrowly than EMTALA’s emergency medical condition definition — that state law is preempted,” the guidance continued. However, due to a court ruling, that advisory is not enforceable in Texas. 

The case the Supreme Court took up last week, though, centers around a near-total abortion ban passed by Idaho after the fall of Roe v. Wade. The Biden administration sued Idaho over its law, arguing it is too restrictive because the statute allows abortion only to prevent a pregnant person’s death whereas EMTALA mandates that doctors give patients necessary stabilizing treatment in emergency settings when a person’s well-being is at risk. 

The justices — who nearly two years ago overturned federal abortion rights — appeared split on this most recent abortion case during arguments last week. 

State advocates, such as Planned Parenthood Maine Action Fund, are watching the case closely and say that the threats to emergency abortion treatment posed by Idaho’s law make the reproductive health protections Maine has passed all the more important.  

“What this EMTALA case highlights for Maine is that the laws we do have, including LD 1619, which passed last session and decriminalized abortion care in our state, are critical measures to safeguarding access to care by ensuring providers can offer the right care for their patients without fear of criminal prosecution,” said Lisa Margulies, vice president of public affairs at Planned Parenthood Maine Action Fund. 

However, Margulies said state lawmakers could take additional action to safeguard abortion rights in Maine.

Specifically, she referenced a bill considered this past legislative session, LD 780, which would have put a referendum on the ballot in November asking voters if they favor amending the Constitution of Maine to declare that “every person has a right to personal reproductive autonomy.” 

If passed, the amendment would have barred Maine from interfering with that right unless justified by a compelling state interest and done in the least restrictive way possible. 

Although the bill received support from a majority of lawmakers, with blanket opposition from Republicans, it failed to reach the two-thirds threshold needed to put the question to voters.

The threat to reproductive health care at the national level — and the opposition to abortion from some local politicians — shows why the constitutional amendment is needed, Margulies said. 

“Mainers are paying attention to how their lawmakers in Augusta voted on LD 780 this session, and … we will continue to fight to protect our rights and elect true reproductive rights champions to represent Maine values in the Legislature,” she said. 

In Idaho, Margulies noted that there has been a reported increase in air transfers of patients to other states because of the lack of protections for emergency abortion care. 

“Lawmakers unqualified to make emergency medical decisions want the court to ignore nearly 40 years of federal law and protections for people in life threatening situations simply because they believe it’s their role to second guess providers’ judgment of who needs that care,” Margulies said. “They’re willing to endanger patients’ well-being and safety.” 

Another possible impact of the case is how religiously-affiliated hospitals would respond if the Supreme Court decides EMTALA doesn’t protect abortion care in emergency settings. 

In Maine, the answer is murky. The Attorney General’s Office said in an email that it “cannot speculate on how a future Supreme Court ruling might impact EMTALA’s application in Maine” and Planned Parenthood Action Fund stated that the immediate impact of the court’s decision on religious medical institutions is difficult to know. 

Maine Morning Star reached out to the state’s Catholic medical centers — St. Joseph Healthcare in Bangor, St. Mary’s Regional Medical Center in Lewiston and Northern Light Mercy Hospital in Portland — with questions about their current abortion services and whether the EMTALA decision will impact the reproductive health care offered at those institutions. 

Only Northern Light responded, with a spokesperson saying that the hospital’s focus is “ensuring that all women have access to the care they need to live long, healthy lives. Maine law has not changed and the services we offer will remain the same.”

However, the spokesperson declined multiple requests to specify what sort of abortion care is provided by the hospital.

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