Trump Has Revoked Federal Guidance On Emergency Abortion Care First Established In 1986
EMTALA was created to enable access to emergency medical care regardless of state law. Now, the administration says it will not enforce the statute.
On Tuesday, the Trump administration revoked federal guidance to hospitals in regard to emergent abortion care, which has been in place for nearly 40 years, and had been more recently reasserted by the Biden administration. The move has some worried about how this will affect pregnant people in states without abortion protections, who may face increased risk as hospitals weigh their legal obligation to their patients and state laws.
After Roe v. Wade was overturned by the Supreme Court in 2022 under its Dobbs v. Jackson Women’s Health Organization ruling, abortion law was returned to the jurisdiction of states for the first time in more than 50 years. While some states not only preserved but protected the right to complete reproductive healthcare, including abortion, many others instantly banned or limited access through trigger laws — statutes that had been on the books but unenforceable with Roe in place.
In an effort to assert the right to emergent abortion care, the Biden administration announced that it would continue to enforce the Emergency Medical Treatment and Active Labor Act (EMTALA), a 1986 law that ensures a federal right to emergency medical care in hospitals that accept Medicaid (basically all of them). Then Health and Human Services (HHS) Secretary Xavier Becerra highlighted the role of EMTALA’s protection of providers to screen, stabilize, and transfer patients for appropriate care — including abortion care — “irrespective of any state laws or mandates that apply to specific procedures.”
While EMTALA fell far short of re-instituting Roe-era access to abortion services — it only ever applied only to specific clinical settings, generally emergency departments — Becerra cited appropriate treatment of ectopic pregnancy, complications of pregnancy loss, and emergent hypertensive disorders like preeclampsia as protected throughout the country.
Now, the Trump administration has reversed course, declaring that Centers for Medicare & Medicaid Services (CMMS), run by Dr. Mehmet Oz, would no longer be upholding the long-standing rule, prompting outcry from abortion rights activists..
“The Trump administration cannot simply erase four decades of law protecting patients’ lives with the stroke of a pen,” said Alexa Kolbi-Molinas, deputy director of the American Civil Liberties Union (ACLU)’s Reproductive Freedom Project in a joint statement with a number of other organizations.
“The Trump administration’s decision to withdraw EMTALA guidance guaranteeing pregnant people medical care in emergency situations will sow confusion for providers and endanger the lives and health of pregnant people,” said Skye Perryman, President & CEO of Democracy Forward. “Every American deserves the right to access the necessary care in emergency scenarios, including pregnant people, without political interference.”
Already, restrictive abortion laws have been linked to the deaths of at least nine women.
The issue of EMTALA protections butting against state abortion law was taken up by the Supreme Court last year via Idaho v. United States and Moyle v. United States, consolidated cases brought by the Biden administration challenging Idaho’s draconian abortion law The Defense of Life Act. Ultimately, however, the procedural ruling, leaving the issue of protection for pregnant patients facing hemorrhage, organ loss, sepsis, or any number of common, adverse outcomes that could be addressed with an abortion, unclear.
