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A federal law requires most US hospitals to provide an abortion to patients experiencing a medical emergency if an abortion is the proper medical treatment for that emergency. This law is unambiguous, and it applies even in red states with strict abortion bans that prohibit the procedure even when necessary to save a patient’s life or protect their health.

Nevertheless, the Supreme Court spent Wednesday morning discussing whether to write a new exception into this federal law, which would permit states to ban abortions even when a patient will die if they do not receive one.

Broadly speaking, the Court seemed to divide into three camps during Wednesday’s argument in Moyle v. United States. The Court’s three Democrats, Justices Sonia Sotomayor, Elena Kagan, and Ketanji Brown Jackson, all argued — quite forcefully at times — that the Emergency Medical Treatment and Labor Act (EMTALA) means what it says and thus nearly all hospitals must provide emergency abortions.

Meanwhile, the Court’s right flank — Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch — left no doubt that they will do whatever it takes to permit states to ban medically necessary abortions.

That left three of the Court’s Republicans, Chief Justice John Roberts and Justices Brett Kavanaugh and Amy Coney Barrett, in the middle. Kavanaugh and Barrett both asked questions that very much suggest they want states to be able to ban medically necessary abortions. But they also appeared to recognize, at times, that the arguments supporting such an outcome are far from airtight.

Realistically, it is highly unlikely that EMTALA will survive the Court’s Moyle decision intact. The Court already voted last January to temporarily allow the state of Idaho to enforce its strict abortion ban, despite EMTALA, while this case was pending before the justices. And Kavanaugh and Barrett have both taken extraordinary liberties with the law in the past when necessary to achieve an anti-abortion outcome.

Still, federal law is crystal clear that states cannot outright ban medically necessary abortions. So there is a chance that two of the Court’s Republicans will reluctantly conclude that they are bound by the law’s clear text.

How the Supreme Court ultimately rules in this case has implications with respect to abortion and beyond.

In the seven states where abortion bans conflict with EMTALA, patients may be denied appropriate emergency care they would have otherwise received. For example, if a woman experiences an ectopic pregnancy, in which the fertilized egg is growing outside of the uterus, health providers are limited in what kind of treatment they can provide.

Depending on the stage of pregnancy, ectopic pregnancies are typically terminated with medication or surgery. Ectopic pregnancies are never viable. But if they are not ended, the fertilized egg would develop outside the uterus, causing great risk to the pregnant person's life and fertility.

Catholic systems make up the largest group of nonprofit health care providers in the US, caring for one in seven hospital patients every day and accounting for 17.5 million emergency room visits a year. According to the watchdog group Community Catalyst, about 16 percent of acute-care hospitals around the country are Catholic. But in some states, Catholic providers account for a much bigger share of the health care infrastructure, including in such reproductive safe havens as Washington (almost 50 percent), Colorado (around 40 percent), and Oregon and Illinois (about 30 percent each).

Those hospitals—as well as their clinics, pharmacies, and physician practices—follow the Ethical and Religious Directives for Catholic Health Care Services, issued by the US Conference of Catholic Bishops, which ban or limit abortion, contraception, sterilization, fertility treatments, trans care, and physician-assisted suicide. Under the ERDs, Catholic hospitals—even in liberal parts of the country—have long treated pregnancy emergencies in ways that have become chillingly familiar in abortion-ban states. For decades, Catholic hospitals have been “doing as a norm what has now become the post-Dobbs landscape,” Georgetown Law professor and reproductive justice scholar Michele Bratcher Goodwin told my Mother Jones colleague Pema Levy. A Supreme Court decision in favor of Idaho could “further weaponize the arguments used by Catholic hospitals to deny emergency care,” Goodwin warns.

According to the poll released last week by The Associated Press-NORC Center for Public Affairs Research, 64 percent of U.S. Catholics (and 40 percent of Catholic Republicans) agreed that abortion should be legal in most or all cases, almost identical to the 65 percent of all adult Americans who held that view. Only 25 percent of evangelical Protestants held this view, putting Catholics closer to those with no religious affiliation at all (87 percent of whom said abortion should be legal in most or all case) than to their fellow Christians.