M Kagan U Mr Turner practicing medicine is hard but there are standards of care aren't there yes there are and one of those standards of care with respect to abortion is that in certain tragic circumstances as you yourself as your own State's law acknowledges where a woman's um life is in Peril and abortion is the appropriate standard of care isn't that right that's right and mtala goes further it says that um the appropriate standard of care uh can't only be about protecting a woman's life it also has to be about protecting a woman's health that's what mtala says doesn't it no it doesn't it defines the emergency medical condition with a broader set of triggering conditions but the the key question here is what is the stabilization requirement and that is qualified by the availability term this this the stabilization requirement is um is written in terms of um making sure that uh a transfer would not result in a material deterioration as to the emergency condition nothing about has to be at death store right I think that's right yeah um and there is a standard of care with respect to that on abortions too right if a woman is going to lose her reproductive organs unless she has an abortion which happens in certain tragic circumstances a doctor is supposed to provide an abortion isn't that right and tala doesn't contain any standard of care I I don't know where the administration is do you dispute that there's a medical standard of care that when a woman is about to lose her reproductive organs unless she has an abortion that that doctors would not say that an abortion is the appropriate standard of care in that situation what I dispute is that there is a national uniform standard of care that requires a top- down approach in all states Idaho has set its own standard of care and it has drawn the line uh on a difficult question and it's inconceivable to me to think that Congress attempted to answer this very fraught complicated question in a four p in four pages of the US code it did not Congress said as to any condition in the world if an emergency patient comes in you're supposed to provide the emergency care that will ensure that that patient does not see a material deterioration in their health and always that's what Congress said and the abortion exceptionalism here is on the part of the state saying we're going to accept that with respect to every other condition but not with respect to abortion we will not comply with the standard of care that doctors have um accepted abortion isn't exceptional there are numerous cases where States intervene and say the standard of care in this circumstance for this condition is X not y opioids for example in New Jersey a doctor cannot stabilize chronic pain with more than a 5-day supply of opioids in uh Pennsylvania it can be seven in other states There's No Limit they're reading of Impala requires that those limitations get wiped out and you impose a National Standard there are numerous other instances where states are coming in and saying in our state the practice of medicine must conform to this standard and I know who has done that with abortion it's done it with opioids it's done it with marijuana use there are countless examples your honor and your theory um although the Supreme Court has narrowed the reach of your statute your theory would apply even if it hadn't I mean it would apply to a topic pregnancies it would apply uh even if there were not a death exception I mean all of your theory would apply no matter what really Idaho did wouldn't it if yeah I think the answer is and tala doesn't speak to that but there are other background principles and limitations like rational basis review Justice rquest the Chief Justice your theory of amtala is that amtala preempts none of it that a state tomorrow could say even if death is around the corner a state tomorrow could say even if there's an ectopic pregnancy that still that's a that's a a choice of the state and mtala has nothing to say about it and that understanding is a humble one with respect to the federalism role of States that's the primary care providers for their citizens not the federal government it may be too humble for Women's Health you know okay thank you