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Column: Antiabortion agitators are trying to cripple a lifesaving federal healthcare law
Here’s how the legal departments of two hospitals, legislators in two states and even the Supreme Court turned a pregnancy emergency for Mylissa Farmer into a life-threatening nightmare.
Farmer, 41, was 18 weeks into her pregnancy when her water broke prematurely. Her doctor instructed her to go to her local hospital in Joplin, Mo.
There, the hospital’s labor and delivery doctors determined that she had no amniotic fluid left. Her baby had “‘zero’ chance of survival” and she risked infection, blood loss and even death. The doctors advised her that they could help her undergo an “inevitable miscarriage,” or she could wait, at risk to her life.
Obstetricians in Idaho live in constant fear…. Idaho’s doctors have been warned that they are being tracked and scrutinized and they should fear prosecution for providing an abortion under any circumstances — even when medically necessary.
— Idaho Coalition for Safe Healthcare
She chose the former, and then the hospital’s legal department stepped in. Although Missouri’s antiabortion law has exceptions when continuing a pregnancy might cause the mother’s death or “irreversible physical impairment,” the lawyers determined she was not quite there yet.
The doctors advised Farmer to go out of state, but the only hospital capable of handling her condition was in Kansas, which was then in the thick of a political campaign over a proposed antiabortion constitutional amendment.
She arrived at University of Kansas Hospital on Aug. 2, 2022, the very day the vote was taking place. There the doctors offered either to induce labor or end her pregnancy surgically. Then that hospital’s lawyers stepped in. They forbade the doctors to provide any treatment at all, having ruled, according to a doctor, that it “was too risky in this political environment.” Three days later, she reached a clinic in Illinois that performed the necessary treatment.
Mylissa Farmer’s experience matches those of countless other women whose healthcare has been compromised by antiabortion state laws since 2022, when the Supreme Court in its so-called Dobbs decision overturned the guarantee of abortion rights established by Roe vs. Wade in 1973.
But there’s more to her case. The refusal by two major hospitals to treat her emergency condition violated federal law — the Emergency Medical Treatment and Labor Act of 1986, known as EMTALA.
The law, which was drafted to stop hospitals from “dumping” emergency patients without insurance by denying them treatment, requires all hospitals receiving Medicare funds — pretty much all hospitals — to provide all emergency room patients with the treatment required to “stabilize” their conditions before transferring them or sending them home.
Investigations by Medicare inspectors last year concluded that the Joplin hospital and University of Kansas Hospital violated EMTALA when they released Farmer without providing the requisite treatment. The penalties run up to $50,000 per incident and the termination of the hospitals’ Medicare contracts, but no actions have been announced.
There’s no exception in EMTALA when the required emergency treatment is an abortion. And that has made EMTALA the newest target of antiabortion agitators and politicians. They claim that the Biden administration is using the federal law to promote or even mandate abortions in all cases, which is false.
The claim, however, has caught the eye of the Supreme Court, which has scheduled oral arguments April 24 in a case involving Idaho’s antiabortion law and its manifest conflict with EMTALA.
The court’s decision to take up the case alarmed abortion rights advocates when it was announced on Jan. 5. It looms even larger now: The court has signaled, though not guaranteed, that it will reject a right-wing challenge to the Food and Drug Administration’s approval of mifepristone, the key drug in medication abortions, but the Idaho case could give its conservative majority another crack at strengthening state antiabortion policies nationwide.
“There was a lot of press around the mifepristone lawsuit,” says Michelle Banker of the National Women’s Law Center, which is providing Farmer with legal representation. “This is a bit of a sleeper case.”
The case is rooted in an advisory issued by Medicare authorities two weeks after the Dobbs decision overturned Roe vs. Wade. It emphasized to doctors and hospitals that when a pregnant woman arrived at an emergency room with a condition that required an emergency abortion, “the physician must provide that treatment.”
When a state law prohibited abortion and didn’t include an exemption when the life of the mother was threatened, the advisory said, “that state law is preempted ” by the federal law. (Boldfaced emphases in the original.)
Antiabortion advocates instantly took up arms against the advisory. They scurried to federal court in Lubbock, Texas, which has a single active judge, Trump appointee James Wesley Hendrix, who obligingly blocked it with a permanent injunction. The government’s appeal went to the notoriously right-wing U.S. 5th Circuit Court of Appeals, which upheld the injunction.
The Texas case hasn’t made it yet to the Supreme Court. It was outrun by the Idaho case, in which the federal government moved to block Idaho’s antiabortion law to the extent it conflicted with EMTALA.
The conflict, as the government points out, is that the law requires doctors to perform an emergency abortion if necessary to prevent a patient’s condition from deteriorating or to protect her from potentially severe or permanent injury. Idaho law forbids an abortion unless it’s necessary to avert a patient’s death. Doctors caught in this vise are in effect being told that they must allow a pregnant woman’s condition to deteriorate until she is near death before they can act.
It wasn’t entirely surprising that Idaho would become the battleground for the issue. The state is doing very well in the race to enact the most goonishly malevolent antiabortion policies. Its abortion law criminalizes abortion at all stages of pregnancy, with narrow exceptions for cases in which continuing a pregnancy would threaten the mother’s life.
Idaho law also makes it a felony to help a minor leave the state for an abortion. (A federal judge has temporarily blocked the so-called abortion trafficking law while a lawsuit challenging its constitutionality proceeds.)
The state has claimed that its abortion law makes it a felony for a healthcare provider to refer a patient for an abortion out of state. (Also blocked, for now, by a federal judge.) Another state law exposes professors at Idaho public universities with jail terms of up to 14 years for teaching, discussing, or writing about abortion.
Put all that together, and a ruling that it can flout federal law to protect its antiabortion credentials would be right up Idaho’s alley.
In making its case, Idaho asserts that after the Dobbs decision the Biden administration “reinterpreted” EMTALA “to create a nationwide abortion mandate” — a mandate the administration only “discovered” nearly 40 years after EMTALA’s enactment.
As the government points out, however, the mandate was always within EMTALA; it never had to be spelled out because the right to abortion became the law of the land via Roe vs. Wade 13 years before EMTALA was enacted. Until Dobbs, the role of abortion as an emergency treatment almost never came under question.
Antiabortionists maintain that Dobbs “caused a sea change in the law,” as 5th Circuit appellate judge Kurt D. Englehardt, another Trump appointee, wrote for the three-judge appeals panel upholding the Texas injunction.
That was a cute bit of legerdemain. EMTALA didn’t change as a result of Dobbs — it was healthcare laws in red states that changed to outlaw abortion. “It has always been the case that EMTALA has been understood to require abortion care when that’s necessary to stabilize a patient’s medical condition,” Banker told me. “The only thing that’s new is that Roe vs. Wade has been overturned.”
Indeed, according to a friend-of-the-court brief filed by six former Medicare administrators and former Health and Human Services Secretary Donna Shalala, who served under both President Bush as well as Presidents Clinton and Obama, Medicare repeatedly issued public guidance stressing that abortion should be considered appropriate emergency treatment when warranted, even before Dobbs.
Idaho, like its apologists in the right-wing fever swamp, maintains that EMTALA “merely prohibits emergency rooms from turning away indigent patients with serious medical conditions” and doesn’t mandate “any specific type of medical treatment, let alone abortion.”
This is a crabbed and mendacious interpretation of the law. It’s a cynical attempt to conflate the problem that prompted Congress to act — hospitals were turning away emergency patients without insurance, a process known as “dumping” — with the much broader law Congress enacted.
EMTALA explicitly protects “any individual” who presents at an emergency room, regardless of their financial or insurance situation. Hospitals aren’t even allowed to inquire about the patient’s financial or insurance status if that would delay examination or treatment.
Idaho’s interpretation suggests that hospitals could simply keep indigent patients in their corridors, untreated, until they wasted away, without violating EMTALA. That’s not what the law says. It explicitly mandates that hospitals “provide either … such treatment as may be required to stabilize the medical condition” or transfer the patient to another facility that can provide the treatment — as long as the transfer itself won’t harm the patient.
What does “stabilize” mean? The law defines the term as meaning that “no material deterioration of the condition” would result from discharging or transferring the patient. It also defines an “emergency medical condition” as one that, without treatment, would jeopardize “the health of the individual,” or cause “serious impairment to bodily functions” or to any organ or body part.
Far from ignoring pregnancy issues, EMTALA has always explicitly covered women presenting with a pregnancy emergency. In those cases, the law says, the hospitals are bound to provide treatment that protects “the health of the woman or her unborn child.”
The friend-of-the-court briefs piling up on the Supreme Court’s EMTALA docket include several outlining the horrific moral and legal trap facing doctors caught between EMTALA and antiabortion state laws.
“Obstetricians in Idaho live in constant fear,” states a brief filed by a coalition representing 678 Idaho doctors and other medical professionals. “Always at the back of their minds is the worry that a pregnant patient will arrive at their hospital needing emergency care that they will not be able to provide.”
Under Idaho law, doctors face prison terms of up to five years and the loss of their medical licenses for following medical protocols unless “the patient is face-to-face with death.” The federal and state laws are totally irreconcilable: Doctors confronted with an emergency pregnancy, the brief says, have the choice of complying with EMTALA and thus risking a stiff prison term and the end of their careers, or complying with state law and thus risking their patient’s health or even causing her death.
What’s worse, “the culture of fear surrounding Idaho’s abortion laws has only exacerbated the struggle,” the brief says. “Idaho’s doctors have been warned that they are being tracked and scrutinized and they should fear prosecution for providing an abortion under any circumstances — even when medically necessary.”
Is there any mystery why OB/GYNS are leaving Idaho by the score? Half of the state’s 44 counties have no practicing obstetricians at all.
A solution, albeit a modest one, to the confusion over the responsibilities of obstetricians in antiabortion states would be for the Supreme Court to clarify that federal law prevails when it runs up against a more restrictive state law. Making that clear in Idaho would send a signal to Texas, Missouri and other states that a mother’s life and health can’t be legislated away.
The EMTALA case gives the Supreme Court an opportunity to uphold science and morality on women’s reproductive healthcare, as it appears to be preparing to do on mifepristone. But what if it follows that case by allowing states to sentence pregnant women to substandard emergency care?
It has been a bumpy road for the electric vehicle market as declining federal support and plateauing public interest have eaten away at sales.
But EV sellers could soon receive a boost from an unexpected source: The war in Iran is pushing up gas prices.
As Americans look to save money at the pump, more will consider switching to an electric or hybrid vehicle. Average gas prices in the U.S. have risen nearly 17% since Feb. 28 to reach $3.48 per gallon. In California, the average is $5.20 per gallon.
Electric vehicles are pricier than gasoline-powered cars and charging them isn’t cheap with current electricity prices, but sky-high gas prices can tip the scales for consumers deciding which kind of vehicle to buy next.
“We probably will see an uptick in EV adoption and particularly hybrid adoption” if gas prices stay high, said Sam Abuelsamid, an auto analyst at Telemetry Agency. “The last time we had oil prices top $100 per barrel was early 2022 and that’s when we saw EV sales really start to pick up in the U.S.”
In a 2022 AAA survey, 77% of respondents said saving money on gas was their primary motivator for purchasing an electric vehicle. That year, 25% of survey respondents said they were likely or very likely to purchase an EV.
As oil prices cooled, the number fell to16% in 2025.
In California, annual sales of new light-duty zero-emission vehicles jumped 43% in 2022, according to the state’s Energy Commission. The market share of zero-emission vehicles among all light-duty vehicles sold rose from 12% in 2021 to 19% in 2022.
“Prior to 2022, we didn’t really have EVs available when we had oil price shocks,” Abuelsamid said. “But every time we did, it coincided with a move toward more fuel-efficient vehicles.”
Dealers are anticipating a windfall.
Brian Maas, president of the California New Car Dealers Assn., predicted enthusiasm for EVs will rebound across California if oil prices don’t come down.
“If prior gasoline price spikes are any indication, you tend to see interest in more fuel-efficient vehicles,” he said.
Rising gas prices could be a lifeline for EV makers at a time when federal support for green cars has been declining.
Under President Trump, a federal $7,500 tax incentive for new electric vehicles was eliminated in September, along with a $4,000 incentive for used electric vehicles.
In California, the zero-emission vehicle share of the total new-vehicle market was 22% through the first 10 months of 2025, then dropped sharply to 12% in the last two months of the year, according to the California Auto Outlook.
Meanwhile Tesla, the most popular EV brand in the country, has grappled with an implosion of its reputation with some consumers after its chief executive, Elon Musk, became one of Trump’s most vocal supporters and helped run the controversial Department of Government Efficiency.
Over the last several months, Ford, General Motors and Stellantis have pared back EV ambitions.
Other automakers, including Nissan, announced plans to stop producing their more affordable electric models.
The Trump administration has moved to roll back federal fuel economy standards and revoked California’s permission to implement a ban on new gas-powered car sales by 2035.
David Reichmuth, a researcher with the Clean Transportation program in the Union of Concerned Scientists, said the shift in production plans will affect EV availability, even if demand surges.
That could keep people from switching to cleaner vehicles regardless of higher gas prices.
“This is a transition that we need to make for both public health and to try to slow the damage from global warming, whether or not the price of gasoline is $3 or $5 or $6 a gallon,” he said.
According to Cox Automotive, new EV sales nationally were down 41% in November from a year earlier. Used EV sales were down 14% year over year that month.
To be sure, oil prices can fluctuate wildly in times of uncertainty. It will take time for consumers to decide on new purchases.
Brian Kim, who manages used car sales at Ford of Downtown LA, said he has yet to see a jump in the number of people interested in EVs, hybrids or more fuel-efficient gas-powered engines.
Still, if the price at the pump stays stuck above its current level, it could happen soon.
“Once the gas prices hit six [dollars per gallon] or more and people feel it in their pocket, maybe things will start to change,” he said.
A total of 59 gigawatts of U.S. clean energy projects are facing delays at a time when demand for power from AI data centers is surging, according to a trade group study.
Developers are seeing an average delay of 19 months over issues such as long interconnection times, supply constraints and regulatory barriers, the American Clean Power Assn. said in a quarterly market report.
The backlog is happening despite the growing need for power on grids that are being taxed by energy-hungry data centers and increased manufacturing. The Trump administration has implemented a slew of policies to slow the build-out of solar and wind projects, including delaying approvals on federal lands.
The potential energy generation facing delays is the equivalent of 59 traditional nuclear reactors, enough to power more than 44 million homes simultaneously.
“Current policy instability is beginning to impact investor confidence and negatively impact project timelines at a time when demand is surging,” American Clean Power Chief Policy Officer JC Sandberg said in a statement.
Despite the hurdles, developers were able to bring more than 50 gigawatts of wind, solar and batteries online in 2025, accounting for more than 90% of all new power capacity in the U.S., the report found. Clean power purchase agreements declined 36% in 2025 compared with 2024, signaling that the build-out of clean power in the U.S. could be lower in the 2028 to 2030 time period, according to the report.
Chediak writes for Bloomberg.
The high-stakes feud between Paramount Skydance President Jeff Shell and Las Vegas gambler and self-professed “fixer” Robert James “R.J.” Cipriani spilled into court on Monday.
Cipriani filed a lawsuit against Shell on claims of fraud and eight other counts, alleging that he reneged on an oral agreement to develop an English-language version of a Spanish music show that streams on Roku TV.
He is seeking $150 million in damages.
In the 67-page lawsuit, filed in Los Angeles County Superior Court, Cipriani claims that in exchange for providing “sophisticated, high-value crisis communications services, entirely without compensation” over 18 months, Shell had agreed to develop the show “Serenata De Las Estrellas,” (Star Serenade), but failed to do so. Cipriani and his wife were to be named as co-executive producers.
“This case arises from the oldest form of fraud: a powerful man took everything a less powerful man had to offer, promised to repay him, lied to him when he asked about it, and then refused to compensate him at all,” states the complaint.
Cipriani — who has producer credits on a 2020 documentary about Vegas, “Money Machine: Behind the Lies,” and the 2015 movie “Wild Card” — intended to make “Serenata” as a “lasting legacy for his mother,” Regina, saying the effort “has been the driving force and the most important thing consuming [Cipriani’s] entire life of almost sixty-five years,” according to the suit.
The show was inspired by a song that the Philadelphia-born Cipriani used to sing to his late mother when he was growing up.
The litigation is the latest twist in a simmering behind-the-scenes scandal that has left much of Hollywood slack-jawed.
For weeks, Cipriani had threatened to file a lawsuit against Shell, with the potential to derail his comeback at Paramount, three years after he lost his job as NBCUniversal’s chief executive over an inappropriate relationship with an underling.
Cipriani’s suit alleges Shell wasdesperate for help in quelling negative stories about him.
It also portrays him as someone who was indiscreet, allegedly sharing sensitive information during the period when the Ellison family, through Skydance Media, was preparing to close its deal to acquire Paramount and then was actively pursuing Warner Bros. Discovery to add to its growing entertainment and media empire.
The eventual rift between the unlikely pair began in August 2024. Patty Glaser, the high-powered entertainment litigator, convened a meeting between the two men.
During the meeting with Shell, the executive expressed to Cipriani his concern that emails and texts between him and Hadley Gamble, the CNBC anchor Shell had been involved with, would come out, saying “that would absolutely destroy me,” according to the suit.
Cipriani claims in his lawsuit Shell was facing “catastrophic personal exposure arising from his conduct toward yet another woman in the media industry,” similar to what had prompted his ouster from NBCUniversal and that he “solicited” his “crisis communications services.”
According to the suit, Cipriani was in a position to help him, having engaged in a “longstanding practice of exposing misconduct in the entertainment and media industries.”
Robert James “R.J.” Cipriani in Amazon Prime Video’s 2025 series “Cocaine Quarterback.”
(Courtesy of Prime)
A high-rolling blackjack player, Cipriani’s colorful résumé includes aiding the FBI in the arrest and conviction of USC athlete-turned global drug kingpin Owen Hanson, who was sentenced to 21 years in federal prison, and filing a RICO suit against Resorts World Las Vegas.
Leveraging his “unique media relationships and industry influence,” Cipriani said in his complaint that he provided Shell with “ongoing threat-monitoring and intelligence services,” and “took proactive steps to suppress, redirect, or neutralize” negative coverage against Shell before publication.
Cipriani said Shell expressed “effusive gratitude” to him after he planted a story about another entertainment industry figure “in order to divert media attention” away from Shell. “Thank you thank you thank you,” Shell wrote in a text to Cipriani, according to the lawsuit, which included a copy of the text.
During tense negotiations over Paramount’s streaming rights for the highly successful “South Park” franchise last summer, Shell allegedly asked to talk to Cipriani about the matter. Cipriani then “orchestrat[ed] the placement of a highly favorable news article,” that was “devastating to Shell’s and Paramount’s adversaries in the dispute,” the suit states.
After a story published in a Hollywood trade, Cipriani wrote to Shell on WhatsApp, “I’m the one that put the article out for you!!!” and “I didn’t want to tell you till it hit so you have plausible deniability.”
According to a message cited in the lawsuit, Shell responded, “I love you!!!! …Thank you Rj,” adding “I owe you dinner at least!”
Despite those boasts, Paramount ultimately paid “South Park” creators millions more than Skydance had intended. To remove obstacles from Skydance’s path to buy Paramount, the media company agreed to two blockbuster deals that include paying the “South Park” production company more than $1.25 billion to continue the cartoon — making it one of the richest deals in television history.
During the course of their relationship, Cipriani further alleges that Shell alerted him to a then-pending $7.7-billion Paramount deal for the rights to UFC fights, while Netflix “believed” it had a “handshake deal” for the same rights, according to the suit.
Cipriani disclosed in his lawsuit that he filed a whistleblower complaint with the Securities and Exchange Commission over the disclosure of material information, claiming that Shell told him that not even UFC President Dana White knew of the transaction. In a WhatsApp message cited in the lawsuit, Shell told Cipriani that the deal was “very hush, hush until we sign.”
While the gambler continued to provide his services to Shell gratis, their relationship began to sour.
Cipriani became enraged that Shell did not uphold his end of the alleged deal to help him with the TV show, viewing it as a slap to him and his mother.
In February, the pair met to resolve their growing dispute. According to the lawsuit, also in attendance was an unidentified entertainment attorney who had represented both men in separate matters.
Patty Glaser has been widely reported as having represented Shell and Cipriani. She introduced them in summer 2024, as The Times reported Saturday.
“We were presented with a draft complaint riddled with clear errors of fact and law,” Glaser said in a statement last week. “We will strongly respond.”
The February meeting did not go well.
Shell not only “refused to compensate” Cipriani, but also told him that he could not “assist” him “in obtaining a television show or other entertainment industry opportunity.”
Cipriani further alleged in his lawsuit that during their “failed summit,” Shell revealed his “disdain” for David Zaslav, the Warner Bros. Discovery CEO, and disclosed that Paramount intended to “sweeten” its pending hostile offer for the studio to fend off Netflix prior to announcing its intention to do so publicly.
After the meeting, Cipriani stated in his complaint that Shell’s attorney privately offered Cipriani a “$150,000 personal loan” to resolve the dispute.
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