Trump rescinds Emtala guidance protecting women in need of emergency abortions

The Trump administration on Tuesday rescinded Biden-era guidance clarifying that hospitals in states with abortion bans cannot turn away pregnant patients who are in the midst of medical emergencies – a move that comes amid multiple red-state court battles over the guidance.

The guidance deals with the federal Emergency Medical Treatment and Labor Act (Emtala), which requires hospitals to stabilize patients facing medical emergencies. States such as Idaho and Texas have argued that the Biden administration’s guidance, which it issued in the wake of the 2022 overturning of Roe v Wade, interpreted Emtala incorrectly.

In its letter rescinding the guidance, the Trump administration said that the Centers for Medicare and Medicaid Services (CMS) “will continue to enforce Emtala, which protects all individuals who present to a hospital emergency department seeking examination or treatment, including for identified emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy. CMS will work to rectify any perceived legal confusion and instability created by the former administration’s actions”.

Abortion rights supporters said Tuesday that rescinding the Biden administration’s guidance will muddy hospitals’ ability to interpret Emtala and endanger pregnant patients’ lives. Since Roe’s collapse, dozens of women have come forward to say that they were denied medical treatment due to abortion bans. A reported five pregnant women have died after having their care denied or delayed, or being unable to access legal abortions.

“This action sends a clear message: the lives and health of pregnant people are not worth protecting,” Dr Jamila Perritt, an OBGYN and the president of Physicians for Reproductive Health, said in a statement. “Complying with this law can mean the difference between life and death for pregnant people, forcing providers like me to choose between caring for someone in their time of need and turning my back on them to comply with cruel and dangerous laws.”

Last year, the US supreme court heard arguments in a case involving Idaho’s abortion ban, which at the time only allowed abortions in cases where a woman’s life was at risk. In contrast, most state abortion bans permit abortions when a patient’s “health” is in danger – a lower standard that could make it easier for doctors to intervene. Idaho’s standard, the Biden administration said, blocked doctors from providing abortions in some emergencies and thus violated Emtala’s requirement that hospitals must stabilize patients.

Ultimately, the supreme court punted on the issue by ruling 6-3 on procedural grounds that the case had been “improvidently granted”, indicating they should have never taken it up in the first place.

“This court had a chance to bring clarity and certainty to this tragic situation and we have squandered it,” wrote Ketanji Brown Jackson, a supreme court justice, at the time. “And for as long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas and elsewhere will be paying the price.”

The Trump administration’s Tuesday move is not unexpected. In March, the administration moved to drop out of the case over the Idaho abortion ban. A local Idaho hospital later filed its own lawsuit over the ban.