Trump administration rescinds policy protecting emergency room abortions

Yahoo

3 days ago

The Trump administration has rescinded a Biden-era policy that protected emergency room abortions, stripping away a critical legal shield for doctors and pregnant women who live in states that ban the procedure. Photo by Tetra Images | Getty Images
The Trump administration has rescinded a Biden-era policy that protected emergency room abortions, stripping away a critical legal shield for doctors and pregnant women who live in states that ban the procedure.
Three years ago, the U.S. Supreme Court overturned the federal right to abortion in Dobbs v. Jackson Women's Health Organization. Many states, including Arizona, responded by passing restrictive laws or outright bans. While Arizonans last year voted to enshrine a fundamental right to abortion in the state Constitution, as many as 13 other states currently outlaw abortion in all cases. Shortly after the fall of Roe v. Wade, efforts to restore the right stalled in Congress, but the U.S. Department of Health and Human Services, at former President Joe Biden's direction, circumvented that gridlock by issuing guidance that sought to assuage the fear of criminalization among health care providers and prevent delays in care for women facing pregnancy complications.
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In a July 2022 letter, then Secretary Xavier Becerra underscored the responsibility of virtually every hospital — even those in states with abortion bans — to perform an abortion if one is necessary to keep a pregnant patient stable. While the majority of abortions occur in abortion clinics, some are performed in hospitals, when women dealing with immediate pregnancy complications seek help at their local emergency rooms. In 2023, the latest year for which there is data, 33 of 12,705 abortions performed in Arizona occurred in hospitals.
In his letter, Becerra wrote that the Emergency Medical Treatment and Active Labor Act, which governs how hospitals treat patients dealing with medical emergencies, supersedes state law. Known as EMTALA, the act has long required hospitals that participate in Medicare ensure patients are medically stable before transferring or discharging them. Expanding the act's protections to abortions was a bid to create one last line of defense for women in hostile states who were confronting the life-endangering consequences of abortion bans. One woman in Oklahoma with an unviable pregnancy was told by hospital staff they couldn't help her until she was 'crashing out,' and advised her to wait in the parking lot until that happened. And a Tennessee woman whose local hospital refused to perform an emergency abortion was transported by ambulance six hours away to North Carolina to receive care, where she arrived with dangerously high blood pressure and signs of kidney failure.
That legal shield was revoked on Tuesday, with a statement posted to the website of the Centers for Medicare and Medicaid Services saying that the Biden-era interpretation does 'not reflect the policy of this Administration'. EMTALA will still be enforced, according to the update, including for 'emergency medical conditions that place the health of a pregnant woman or her unborn child in serious jeopardy'.
The change is the latest move from the administration to solidify its pro-life stance and drop the previous administration's resistance against state-level abortion bans, effectively greenlighting their continued existence. Along with expanding the role of EMTALA, the Justice Department under Biden sued Idaho over its abortion ban, arguing that it was a violation of federal law. In March, however, the Trump administration abandoned that lawsuit. A related lawsuit headed by Idaho's largest healthcare provider is on its way to the U.S. Supreme Court, and has successfully won a ruling that prevents Idaho from enforcing its abortion ban in emergency rooms, for now. It's unclear where the justices will land on the conflict when it it goes before the high court; a hearing in the lawsuit brought by the Biden administration showed them split on the issue last year, and the court later dismissed the case as mistakenly granted, leaving in place a previous ruling that froze Idaho's law in medical emergencies, rather than consider the problem.
Reproductive rights advocates decried the decision to walk back the Biden guidance as 'callous'. Amy Friedrich-Karnik, the director of federal policy for the Guttmacher Institute, a research organization that advocates for abortion access, noted that while federal law still directs doctors to provide stabilizing care for their patients, even if that means an abortion, the elimination of the guidance that clearly spells that out is worrying.
'While this action by the Trump administration does not change the law and providers' obligation to guarantee patients access to abortion care in an emergency, it does tell us everything we need to know about the anti-abortion movement: They would rather let pregnant people suffer life-threatening health consequences than allow them to receive stabilizing abortion care,' she said, in a written statement.
Skye Perryman, the president and CEO of Democracy Forward, a legal group that defended Biden's interpretation of EMTALA in court, said that erasing the guidance would prove dangerous for pregnant women seeking reproductive healthcare in states with abortion bans on the books.
'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,' she said, in a written statement. 'Every American deserves the right to access the necessary care in emergency scenarios, including pregnant people, without political interference.'
Arizona Democratic leaders, too, lambasted the recission. Gov. Katie Hobbs, who campaigned on protecting abortion access while the state grappled with abortion bans, echoed concerns that removing the guidance would harm women.
'Politicians should not make decisions for women and their doctors,' she wrote, in a post on social media site X, formerly Twitter. 'This cruel and reckless policy will put women's lives at risk.'
Arizona Attorney General Kris Mayes, who has also been a strong advocate of reproductive rights and has mobilized her office to defend against the criminalization of health care providers, added that doctors shouldn't be worried about treating their patients.
'Doctors shouldn't have to guess if they're allowed to save a woman's life,' Mayes wrote, in a post on X.
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