What Trump Revoking Emergency Abortion Guidance Means for Care

Yahoo

2 days ago

Abortion-rights activists rally for reproductive rights and emergency abortion care outside the U.S. Supreme Court as it hears arguments in a case that deals with whether Idaho's near-total abortion ban conflicts with the federal Emergency Medical Treatment and Labor Act, in Washington, D.C., on April 24, 2024. Credit - Saul Loeb—AFP/Getty Images
The Trump Administration has added to the confusion surrounding the U.S.'s shifting patchwork of abortion laws by rescinding Biden-era guidance that directed hospitals to provide abortions in emergency situations, even in states where abortion is restricted.
The decision, announced on Tuesday, does not change the federal law that was at the heart of the Biden Administration's guidance: the Emergency Medical Treatment and Labor Act (EMTALA), which requires hospitals that receive Medicare funding—which is most of them—to provide stabilizing treatment to patients experiencing medical emergencies or transfer them to a hospital that can.
The Trump Administration's Centers for Medicare and Medicaid Services (CMS) said in a press release that it '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.' But the agency also said that it 'will work to rectify any perceived legal confusion and instability created by the former administration's actions.'
Doctors and abortion-rights advocates, however, said they feared that the Administration's move will amplify confusion over whether doctors can provide critical care, thereby putting lives at risk.
Dr. Jamila Perritt—an ob-gyn in Washington, D.C., and the president and CEO of Physicians for Reproductive Health—said in a press release that rescinding the Biden-era guidance would force "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.'
'This action sends a clear message: the lives and health of pregnant people are not worth protecting,' Perritt said.
The Biden Administration issued the guidance after the U.S. Supreme Court overturned Roe v. Wade in 2022, reminding hospitals of their 'obligations' under EMTALA, as state laws restricting or banning abortion began going into effect.
'Any state actions against a physician who provides an abortion in order to stabilize an emergency medical condition in a pregnant individual presenting to the hospital would be preempted by the federal EMTALA statute due to the direct conflict with the 'stabilized' provision of the statute,' the guidance stressed. 'Moreover, EMTALA contains a whistleblower provision that prevents retaliation by the hospital against any hospital employee or physician who refuses to transfer a patient with an emergency medical condition that has not been stabilized by the initial hospital, such as a patient with an emergent ectopic pregnancy, or a patient with an incomplete medical abortion.'
The guidance also said that physicians' fear of violating state laws prohibiting abortion could not be used as the basis for transferring a patient.
'When a direct conflict occurs between EMTALA and a state law, EMTALA must be followed,' the guidance stated.
EMTALA remains in place despite the change in the guidance.
The Trump Administration did not explicitly advise hospitals that they could deny patients abortions in emergency situations. CMS did specify in the memo announcing the revocation that the Department of Health and Human Services may not enforce the interpretation in the Biden Administration's guidance that EMTALA preempts Texas' near-total abortion ban, pointing to court rulings that have temporarily blocked the guidance in the state.
But abortion-rights advocates sharply criticized the Trump Administration's move, saying it endangers the lives of pregnant people.
'The Trump Administration would rather women die in emergency rooms than receive life-saving abortions,' Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a press release. 'In pulling back guidance, this administration is feeding the fear and confusion that already exists at hospitals in every state where abortion is banned. Hospitals need more guidance right now, not less.'
'We're making our health care professionals have to operate in a gray area when their work really needs to be clear,' says Monica Simpson, executive director of SisterSong, a reproductive justice collective. 'They're in the business of providing life-saving care to people on a daily basis, and they don't need to be put in a position where their decision making is compromised.'
When that confusion happens, she says, 'people die.' Simpson says that, for states that have banned or restricted abortion, like her home state of Georgia, rescinding the Biden-era guidance is 'just going to make things worse.'
'It's making it incredibly scary for the American people and pregnant folks who would need access to emergency services,' Simpson says. 'People's lives are at stake.'
Anti-abortion groups, meanwhile, celebrated the move.
'The Trump administration has delivered another win for life and truth – stopping Biden's attack on emergency care for both pregnant moms and their unborn children,' Susan B. Anthony Pro-Life America President Marjorie Dannenfelser said in a press release. She accused Democrats of creating confusion about people's access to care in medical emergencies, including miscarriages and ectopic pregnancies. 'In situations where every minute counts, their lies lead to delayed care and put women in needless, unacceptable danger,' she said.
More than a dozen states have banned abortion in almost all cases or after six weeks of pregnancy, before many people even know they're pregnant. There have been many reports of pregnant people experiencing complications being turned away from hospitals in states that have banned abortion.
Previously, the Biden Administration had sued Idaho over its near-total abortion ban, saying that the state's restrictions conflicted with EMTALA. In March, the Trump Administration dropped the lawsuit.
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