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As states ban abortions, a 1968 federal law requires hospitals that receive Medicare dollars to stabilize patients in a medical emergency, creating a catch-22 for care providers

Dr Lauren Miller used to cry every day on her way to work.

A fetal maternal medicine specialist in Idaho, Miller despaired over the possibility she might be forced to tell patients she could not help them. Idaho has one of the strictest abortion bans in the nation, which means Miller could only perform abortions to save a woman’s life – and many patients, even those facing medical emergencies with potentially deadly consequences, were not yet sick enough to qualify.

“All I could say is: ‘We have to get them a transport out of state,’” she said. “It just breaks my heart that I knew them and had a relationship with them and couldn’t offer them the same care that I could have given them a year ago”, before Idaho’s ban went into effect.

One law, however, briefly allowed Miller to provide abortions in emergencies, Miller said: a 1986 federal law, almost unknown outside of the medical field, known as the Emergency Medical Treatment and Active Labor Act, or Emtala. That law requires hospitals that receive Medicare dollars to stabilize any patients who may show up at their doors in the midst of a medical emergency – a potentially lower threshold than what is allowed under Idaho’s ban, which allows for abortions if a woman’s life is in jeopardy. If a hospital can’t stabilize a patient, according to Emtala,the hospital must transport the patient to a facility that can.

But now even Emtala, the subject of a case that will be heard by the US supreme court this week, may be permanently pulled out from under Miller and other doctors in her situation who are struggling to understand what role they can play in treating patients in crisis.