Supreme Court poised to rule in case that could prevent pregnant women from receiving emergency, life-saving treatment

BOSTON - On June 24, 2024, on the two-year anniversary of the Dobbs decision which overturned Roe v. Wade, Massachusetts Governor Maura T. Healey stood with state officials, health care providers, insurers and advocates and signed an Executive Order protecting access to emergency abortion care in Massachusetts. The U.S. Supreme Court is poised to rule this week on Idaho v. United States and Moyle v. United States, which concern whether the Emergency Medical Treatment and Labor Act (EMTALA) requires emergency rooms to provide an abortion to save the life or health of a pregnant woman. The case originated from Idaho’s extreme, near-total abortion ban, which went into effect after the Dobbs decision.

“Two years ago, when the Supreme Court overturned Roe v. Wade, I pledged to the people of Massachusetts that we were going to protect and expand reproductive freedom. Working together with our Legislature and incredible health care providers and advocates, we’ve done just that,” said Governor Maura Healey. “But with continued attacks on women’s health and freedom across the country, and the Supreme Court poised to rule any day now in a case that could prevent pregnant women from receiving emergency, life-saving treatment, we must continue to act. That’s why I’m signing an Executive Order today affirming that Massachusetts patients will continue to receive emergency abortion care at our hospitals regardless of the Supreme Court’s ruling."

“When the Supreme Court overturned Roe v. Wade, Massachusetts jumped into action and protected access to safe and legal abortion care. When access to mifepristone was threatened, we jumped into action and stockpiled doses,” said Lieutenant Governor Kim Driscoll. “Now, with access to emergency abortion care on the line, we’re stepping up again to make sure there isn’t any doubt that pregnant women in Massachusetts can and will receive the emergency, life-saving care that they need.”

Executive Order
The Governor’s Executive Order reaffirms that Massachusetts law provides a right to prompt treatment in an emergency – including emergency abortion care – without discrimination on account of economic status or source of payment. It also reaffirms that Massachusetts state law protects the right to an abortion, protects providers and pharmacists from professional licensure consequences and out-of-state legal actions for providing reproductive health care services or gender-affirming health care services in Massachusetts, and protects patients from out-of-state legal actions when seeking those services.

DPH guidance
In accordance with the Executive Order, the Department of Public Health (DPH) issued guidance to hospitals that as a condition of licensure in Massachusetts, all hospitals must comply with all applicable state and federal statutes and regulations pertaining to hospitals, including EMTALA. DPH’s guidance also provides that the violation of any violation of EMTALA or related state statutes and regulations could result in not renewing or revoking a license. In addition, the guidance provides that the failure of a hospital to provide abortion care when required to avoid the risk of loss of life of a pregnant person or serious harm to their health is a violation of EMTALA and related state statutes and regulations, which could result in revocation of a hospital’s license to operate in Massachusetts. 

DPH also issued guidance to licensed health care providers and physicians, stating that providers have a professional obligation to treat emergency medical conditions, including when necessary to avoid the risk of loss of life of a pregnant person or serious harm to their health. The guidance states that a health care provider’s failure to treat an emergency medical condition may violate recognized standards of practice and may be grounds for discipline of the individual’s license to practice.

“Over the past two years, we’ve seen the very real consequences of what can happen when states limit access to reproductive health care for patients in need,” said Health and Human Services Secretary Kate Walsh. “Abortions can be medically necessary, life-saving treatment – and in Massachusetts, we will always make sure patients have access to the care they need. That is why today, on the two-year anniversary of Dobbs, we are taking action to further cement these reproductive rights, so that no one in our state will have to worry about whether they can access or afford life-saving treatment.” 

Insurer requirements
The Division of Insurance also issued a bulletin to insurers identifying the state’s expectations regarding carriers’ requirements to provide coverage for abortion, abortion-related care, and medication abortion services, including emergency abortion care. DOI also issued a bulletin to commercial insurers offering medical malpractice coverage to identify expectations regarding medical malpractice coverage for providers that may provide reproductive or gender-affirming care, including emergency abortion care.

“With this guidance from the Division of Insurance, we stand with Governor Healey in affirming reproductive rights in Massachusetts and protecting access to medication abortion services and emergency abortion care,” said Secretary of Economic Development Yvonne Hao. “Massachusetts prides itself as a state that values freedom – that's what makes us unique and gives us an economic edge. Today’s action will ensure residents in our state will have the freedom to make critical, life-saving decisions about their health care.”

Massachusetts’ leadership
Since the Dobbs decision in 2022, Massachusetts has stepped up in a number of ways to protect and expand reproductive rights. Shortly after the ruling, the Legislature passed a Shield Law, which protects providers, patients, pharmacists and anyone who helps someone obtain an abortion from civil and criminal consequences.

When access to mifepristone was threatened, Governor Healey stockpiled 15,000 doses of mifepristone, created a $1 million grant program for providers to purchase their own doses, and signed an Executive Order confirming that the Shield Law extends to medication abortion. The Healey-Driscoll administration has also invested millions of dollars for the health care providers and grassroots organizations who support access to abortion and health care at the local level and proposed an additional $2 million in the FY25 budget.  

Statements of Support

Attorney General Andrea Joy Campbell:
“Since the Dobbs decision, it is up to the states to protect access to reproductive care, and Massachusetts continues to lead as demonstrated by our collective action today including the Governor’s Executive Order. State attorneys general are on the frontlines of this fight, and my office will continue to prioritize this issue and fight as long and as hard as necessary to ensure access to emergency abortion care and a full spectrum of reproductive health care.”

State Treasurer Deborah B. Goldberg:
“I am proud to stand with the Governor today. The Dobbs decision has harmed the safety of all women throughout our country. Access to reproductive healthcare is not only a health issue but is directly linked to women’s economic opportunity and security. We must continue to advocate for new federal laws and expanded state laws to protect reproductive rights for all women and their families.”

House Speaker Ronald J. Mariano (D-Quincy):
“As state legislatures across the country act to dismantle reproductive rights in the wake of the Dobbs decision, I’m incredibly proud of the work that we have done here in Massachusetts to expand those rights. That work is more important now than ever before, as the Supreme Court’s conservative super-majority will almost certainly continue to allow for greater restrictions on a woman’s right to choose. I want to thank Governor Healey for her continued focus on protecting reproductive rights, as well as my colleagues in the House, and our partners in the Senate, for the work that they have already done to codify and expand abortion rights in the Commonwealth.”

Senate President Karen E. Spilka (D-Ashland):
“Massachusetts has always been clear that we trust women to make their own healthcare decisions. Access to abortion is a right that is protected here in Massachusetts, as is delivering abortion services, and the Senate has proudly worked alongside our partners to protect those rights as they have been eroding in other parts of the country. Today, as we anticipate yet another attack on women’s health, the Senate stands steadfastly with the Governor, on the right side of history.”

Rebecca Hart Holder, President, Reproductive Equity Now:
“Two years after Dobbs, anti-abortion extremists have not slowed their crusade to put politicians in exam rooms, stand in the way of emergency medical care, and ban abortion in any and all circumstances, no matter the consequences to patients’ health. The anti-abortion movement is putting their cruelty on full display. But here in Massachusetts, we’re not going to let it stand. This Executive Order will ensure that every hospital in our state continues to treat abortion as the life-saving and life-affirming care that it is. Thanks to the Healey-Driscoll administration’s leadership, Massachusetts will continue to be a beacon for reproductive health care in a post-Roe world-no matter how the Supreme Court rules.”

Dominique Lee, President and CEO, Planned Parenthood League of Massachusetts:
"When Roe v. Wade was overturned, reproductive health care providers, advocates, and lawmakers responded with a clear vision and plan to safeguard and expand abortion access in Massachusetts. Because of that action, we have been able to meet an increased demand from out-of-state patients, make medication abortion more accessible than ever, and start innovative training programs to strengthen the reproductive health care workforce. As national threats to abortion access grow, Governor Healey continues to have patients' and providers' backs. Just like last year's order protecting mifepristone, today's order on emergency abortion care affirms that abortion is health care and that doctors should always be able to provide the most effective, evidence-based care to their patients, without interference from judges or politicians."

Carol Rose, Executive Director, ACLU of Massachusetts:
“In the two years since the Supreme Court overturned Roe v. Wade, 21 states have banned or severely restricted abortion access and millions of people face life or death consequences. We know Dobbs was never the end goal, with extremists trying to ban abortion and other reproductive health care nationwide. Massachusetts is fighting back and leading the way on reproductive freedom for all people. We thank the Healey-Driscoll administration and other state policymakers for their continued leadership to preserve, defend, and push forward reproductive freedom in Massachusetts and nationwide.”

Steve Walsh, President and CEO, Massachusetts Health and Hospital Association:
“In the two years since the Dobbs ruling, we have seen its devastating impact on patients and providers around the country. Our caregivers take an oath to provide lifesaving care to everyone they serve, regardless of the personal cost, and it is not a given that elected leaders share in that commitment. That makes the partnership we have in the commonwealth all the more important. The Healey-Driscoll Administration stands shoulder-to-shoulder with our providers on safeguarding emergency abortion services, and we applaud the enormous step announced today. MHA and our members will continue to do everything in our shared power to protect the patients and professionals at the heart of reproductive care in Massachusetts.”

Lora Pellegrini, President and CEO, Massachusetts Association of Health Plans:
“On behalf of the Massachusetts Association of Health Plans and our member plans, I am proud to stand with Governor Healey today supporting the right to reproductive freedom and ensuring that Massachusetts women have access to the full complement of reproductive health care, including medication-assisted abortion and emergency abortion care. As states across the country seek to limit access to these essential reproductive health services, MAHP and our member plans applaud the Governor’s efforts to ensure that reproductive health care continues to be provided in the Commonwealth, without interruption.”

Sarah Iselin, President and CEO, Blue Cross Blue Shield of Massachusetts:
“Blue Cross Blue Shield of Massachusetts is deeply committed to ensuring that our members have access to the reproductive health care they need. We are grateful for the efforts of the Healey/Driscoll Administration to protect that access and we will continue to do everything we can to show up for our members with the care and support they deserve.”