Trump administration strips federal protections for emergency abortion providers
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Anti-abortion demonstrators outside the Supreme Court, June 26, 2024. Photo: Anna Rose Layden/Getty Images
The Trump administration on Tuesday rescinded guidance telling health providers who perform abortions in emergency cases that they're protected under federal law even if bans exist in their states.
Why it matters: The directive was issued by the Biden administration to give legal assurances to physicians and other providers facing questions about what qualifies as an emergency under a state ban.
- Since then, courts have grappled with how state restrictions and federal directives on emergency health care mesh. The Supreme Court last year dismissed a case surrounding Idaho's ban without ruling on the merits.
Driving the news: The Centers for Medicare and Medicaid Services said Tuesday that the 2022 guidance and an accompanying directive from former Health and Human Services Secretary Xavier Becerra "do not reflect the policy of this administration."
- It said it would continue to enforce a federal law that requires emergency rooms to perform necessary care for anyone who comes through the door and "work to rectify any perceived legal confusion and instability created by the former administration's actions."
The policy change tracks with the principles laid out in the Heritage Foundation's Project 2025, which called for HHS to rescind Biden-era guidance around the emergency care law, known as EMTALA.
CMS Administrator Mehmet Oz on Wednesday reaffirmed a commitment to enforce EMTALA.
- "EMTALA is clear and the law has not changed: women will receive care for miscarriage, ectopic pregnancy and medical emergencies in all fifty states—this has not and will never change in the Trump administration," Oz wrote on X.
The other side: The decision "shows a callous disregard for the law and people's lives," said Amy Friedrich-Karnik, director of federal policy at the pro-abortion rights Guttmacher Institute.
- "EMTALA's importance has only increased as our nation reckons with the fallout from the Dobbs decision, which has led to a fractured and chaotic abortion access landscape," she said.
- Alexa Kolbi-Molinas, deputy director of the ACLU's Reproductive Freedom Project, said the administration sent a clear signal that it is siding with its anti-abortion allies — a move the group said will come at the expense of women's lives.
- 13 states have total abortion bans in place and others restrict care throughout pregnancy, per Guttmacher.
Catch up quick: The Biden administration issued the directive soon after the Supreme Court overturned Roe v. Wade.
- The concern was that treating a pregnancy-related medical emergency, or transferring a patient to another facility, could run afoul of state laws and make the providers subject to prosecution.
- Some of the state bans allow exceptions for medical emergencies. But abortion rights advocates and some patients and doctors have gone to court, arguing that ambiguous wording has resulted in delayed or denied care and jeopardized patients' health.
- Media reports have cited multiple instances in which women died in states with abortion bans while having complicated miscarriages at a hospital. Experts have said emergency abortions could have prevented the deaths.
The 5th U.S. Circuit Court of Appeals early last year ruled that EMTALA did not preempt Texas' strict abortion ban. The Supreme Court declined to hear a Biden administration appeal.
Editor's note: This story has been updated with Oz's statement.
